Experimental comparison of high power (80 W) potassium titanyl phosphate laser vaporization and transurethral resection of the prostate.

Abstract

Perioperative hemorrhage is still the major complication of standard transurethral prostate resection (TURP). Potassium titanyl phosphate (KTP) laser vaporization using 80 W is a novel technique that promises instant hemostatic tissue ablation. In this ex vivo investigation we compared the hemostatic properties of the 2 procedures. Ex vivo, blood perfused porcine kidneys were used to verify the hemostatic efficacy of KTP laser vaporization and TURP-like tissue resection. Bleeding could be exactly quantified in relation to tissue ablation for the 2 techniques. In addition, specimens were examined microscopically. KTP laser vaporization demonstrated highly significantly decreased bleeding as compared to conventional tissue resection for a standardized ablation volume of 16 cm tissue (2.1 vs 23.3 ml per minute, p <0.0001). Tissue ablation was more rapid in the resection group (20 vs 100 seconds, p <0.001). Histological examinations revealed larger coagulation zones for the KTP group compared to conventional tissue resection (0.9 vs 0.6 mm, p <0.01). Ex vivo, 80 W KTP laser vaporization is a virtually bloodless ablative procedure, giving rise to hemostasis that is highly superior to conventional TURP-like tissue resection. However, the novel procedure is considerably more time-consuming.