High-Power Potassium-Titanyl-Phosphate or GreenLight HPS TM Laser Photoselective Vaporization Prostatectomy: A Systematic Approach

Abstract

Background and Purpose:

Care must be taken to avoid adverse events when using a high-power laser system for the treatment of benign prostatic hyperplasia. We describe a systematic, safe, effective, and reproducible technique for potassium-titanyl-phosphate (KTP) and GreenLight HPS^TM laser photoselective vaporization prostatectomy (PVP).

Technique:

With the patient under anesthesia in the dorsal lithotomy position, cystoscopy is performed. Using a high-power KTP/GreenLight HPS^TM laser system, a groove is created along the lateral–median lobe junction from the bladder neck to the verumontanum to delineate the margins of vaporization. The remainder of the ipsilateral lobe is vaporized using a series of overlapping passes along the length of the groove. The contralateral lobe is vaporized in a similar manner. Finally, the median lobe is vaporized from lateral to medial. A 20F urethral catheter is placed at the conclusion of the procedure.

Results:

This technique has been successful in over 500 consecutive patients.

Conclusion:

This systematic approach has been safe, effective, and reproducible for KTP/LBO laser PVP. It has become our standard technique for this procedure. The author is a consultant for American Medical Systems, Inc.

Runtime of video: 6 min 59 sec