Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: a Single-Surgeon Experience.

PURPOSE: To identify incidence and predictors of stress urinary incontinence (SUI) following Holmium laser enucleation of the prostate (HoLEP). MATERIALS AND METHODS: We performed a retrospective review of 589 HoLEP patients from 2012-2018. Patients were assessed at pre-operative and post-operative visits. Univariate and multivariate regression analyses were performed to identify predictors of SUI. RESULTS: 52/589 patients (8.8%) developed transient SUI, while 9/589 (1.5%) developed long-term SUI. tSUI resolved for 46 patients (88.5%) within the first six weeks and in 6 patients (11.5%) between 6 weeks to 3 months. Long-term SUI patients required intervention, achieving continence at 16.4 months on average, 44 men (70.9%) with incontinence were catheter dependent preoperatively. Mean prostatic volume was 148.7mL in tSUI patients, 111.6mL in long-term SUI, and 87.9mL in others (p \u3c 0.0001). On univariate analysis, laser energy used (p \u3c 0.0001), laser on time (p=0.0204), resected prostate weight (p \u3c 0.0001), overall International Prostate Symptom Score (IPSS) (p=0.0005), and IPSS QOL (p=0.02) were associated with SUI. On multivariate analysis, resected prostate weight was predictive of any SUI and tSUI, with no risk factors identified for long-term SUI. CONCLUSION: Post-HoLEP SUI occurs in ~10% of patients, with 1.5% continuing beyond six months. Most patients with tSUI recover within the first six weeks. Prostate size \u3e100g and catheter dependency are associated with increased risk tSUI. Larger prostate volume is an independent predictor of any SUI, and tSUI

Effect of Low-Level Laser Therapy Versus Bioptron on Psoriasis

Purpose: The current study was carried-out to examine the effectiveness of low-level laser therapy versus bioptron on psoriasis. Subjects and Methods: 60 patients of both sexes with psoriasis contributed in this study and they were aged from 30 to 60 years. They were randomized into two groups of the same number (A and B). Group (A) were given low level laser therapy (LLLT) and medical care, while group (B) were given bioptron light therapy (BLT) and the same medical care that received in group (A). The variables included Psoriasis Area Severity Index (PASI) and Dermoscopic finding were measured pre and post intervention program on psoriatic patients in both groups. Both groups were given treatment program 3 sessions a week for 8 weeks. Results: following 8 consecutive weeks, both groups showed statistically significant improvement in all outcome measures, however there was a significant difference between them post treatment, favoring group (A). Conclusion: Low level laser therapy and bioptron were beneficial treatment modalities in psoriatic patients and LLLT may be more effective in treating psoriasis

Efficacy of a Laser Device for Hazing Canada Geese from Urban Areas of Northeast Ohio

Author Institution: Ohio Department of Natural Resources, Division of Wildlife, Crane Creek Wildlife Research Station ; US Department of Agriculture, APHIS, Wildlife ServicesComplaints about Canada geese in Ohio have increased nearly 400% in the past decade, with 732 recorded in 2001. Harassment techniques such as pyrotechnics and mylar flagging have been used to reduce goose conflicts but are frequently ineffective, and initial experiments indicated that laser harassment may disperse Canada geese. We evaluated whether lasers could cause geese to abandon urban sites, the duration of site abandonment, and dispersal distance of harassed geese. One hundred ninety geese were banded and collared in June 2001 at 6 sites in northeast Ohio. Radio transmitters were attached to 40 collars. We conducted nocturnal laser harassment of geese in four 5-day periods from July 2001 through January 2002 at 3 treatment sites. No harassment occurred at 3 control sites. One-day surveys of collared geese were conducted 2 weeks prior to the 5-day hazing period, during the hazing period, and 2 weeks post-hazing. Geese were located through radio telemetry using air- and ground-based receivers during all 3 time periods. Laser harassment caused geese to leave the site after a mean of 4.6 (SE = 0.8) minutes of treatment. Over the 5-day treatment period, the mean number of geese observed at night decreased from 92 to 14; however, we found no differences between numbers of geese observed 2 weeks prior to initial harassment and those observed post-harassment. Telemetry indicated that geese moved <2.0 km from all but one banding site. Laser harassment was more effective in reducing goose numbers at night rather than reducing numbers during the day. Site characteristics such as ambient lighting, human disturbance, and size of pond appeared to be the primary factors determining the laser’s effectiveness

Comparison of Therapeutic Effects between Pulsed and Continuous Wave 810-nm Wavelength Laser Irradiation for Traumatic Brain Injury in Mice

Background and Objective Transcranial low-level laser therapy (LLLT) using near-infrared light can efficiently penetrate through the scalp and skull and could allow non-invasive treatment for traumatic brain injury (TBI). In the present study, we compared the therapeutic effect using 810-nm wavelength laser light in continuous and pulsed wave modes in a mouse model of TBI. Study Design/Materials and Methods TBI was induced by a controlled cortical-impact device and 4-hours post-TBI 1-group received a sham treatment and 3-groups received a single exposure to transcranial LLLT, either continuous wave or pulsed at 10-Hz or 100-Hz with a 50% duty cycle. An 810-nm Ga-Al-As diode laser delivered a spot with diameter of 1-cm onto the injured head with a power density of 50-mW/cm2 for 12-minutes giving a fluence of 36-J/cm2. Neurological severity score (NSS) and body weight were measured up to 4 weeks. Mice were sacrificed at 2, 15 and 28 days post-TBI and the lesion size was histologically analyzed. The quantity of ATP production in the brain tissue was determined immediately after laser irradiation. We examined the role of LLLT on the psychological state of the mice at 1 day and 4 weeks after TBI using tail suspension test and forced swim test. Results The 810-nm laser pulsed at 10-Hz was the most effective judged by improvement in NSS and body weight although the other laser regimens were also effective. The brain lesion volume of mice treated with 10-Hz pulsed-laser irradiation was significantly lower than control group at 15-days and 4-weeks post-TBI. Moreover, we found an antidepressant effect of LLLT at 4-weeks as shown by forced swim and tail suspension tests. Conclusion The therapeutic effect of LLLT for TBI with an 810-nm laser was more effective at 10-Hz pulse frequency than at CW and 100-Hz. This finding may provide a new insight into biological mechanisms of LLLT.National Institutes of Health (U.S.) (NIH grant R01AI050875)Center for Integration of Medicine and Innovative Technology (DAMD17-02-2-0006)United States. Dept. of Defense. Congressionally Directed Medical Research Programs (W81XWH-09-1-0514)United States. Air Force Office of Scientific Research (Military Photomedicine Program (FA9950-04-1-0079))Japan. Ministry of Education, Culture, Sports, Science and TechnologyJapan Society for the Promotion of Scienc

Hyperthermic laser ablation of recurrent glioblastoma leads to temporary disruption of the peritumoral blood brain barrier

BACKGROUND:Poor central nervous system penetration of cytotoxic drugs due to the blood brain barrier (BBB) is a major limiting factor in the treatment of brain tumors. Most recurrent glioblastomas (GBM) occur within the peritumoral region. In this study, we describe a hyperthemic method to induce temporary disruption of the peritumoral BBB that can potentially be used to enhance drug delivery. METHODS:Twenty patients with probable recurrent GBM were enrolled in this study. Fourteen patients were evaluable. MRI-guided laser interstitial thermal therapy was applied to achieve both tumor cytoreduction and disruption of the peritumoral BBB. To determine the degree and timing of peritumoral BBB disruption, dynamic contrast-enhancement brain MRI was used to calculate the vascular transfer constant (Ktrans) in the peritumoral region as direct measures of BBB permeability before and after laser ablation. Serum levels of brain-specific enolase, also known as neuron-specific enolase, were also measured and used as an independent quantification of BBB disruption. RESULTS:In all 14 evaluable patients, Ktrans levels peaked immediately post laser ablation, followed by a gradual decline over the following 4 weeks. Serum BSE concentrations increased shortly after laser ablation and peaked in 1-3 weeks before decreasing to baseline by 6 weeks. CONCLUSIONS:The data from our pilot research support that disruption of the peritumoral BBB was induced by hyperthemia with the peak of high permeability occurring within 1-2 weeks after laser ablation and resolving by 4-6 weeks. This provides a therapeutic window of opportunity during which delivery of BBB-impermeant therapeutic agents may be enhanced. TRIAL REGISTRATION:ClinicalTrials.gov NCT01851733

Transcranial Low-Level Laser Therapy Improves Neurological Performance in Traumatic Brain Injury in Mice: Effect of Treatment Repetition Regimen

Low-level laser (light) therapy (LLLT) has been clinically applied around the world for a spectrum of disorders requiring healing, regeneration and prevention of tissue death. One area that is attracting growing interest in this scope is the use of transcranial LLLT to treat stroke and traumatic brain injury (TBI). We developed a mouse model of severe TBI induced by controlled cortical impact and explored the effect of different treatment schedules. Adult male BALB/c mice were divided into 3 broad groups (a) sham-TBI sham-treatment, (b) real-TBI sham-treatment, and (c) real-TBI active-treatment. Mice received active-treatment (transcranial LLLT by continuous wave 810 nm laser, 25 mW/cm[superscript 2], 18 J/cm[superscript 2], spot diameter 1 cm) while sham-treatment was immobilization only, delivered either as a single treatment at 4 hours post TBI, as 3 daily treatments commencing at 4 hours post TBI or as 14 daily treatments. Mice were sacrificed at 0, 4, 7, 14 and 28 days post-TBI for histology or histomorphometry, and injected with bromodeoxyuridine (BrdU) at days 21–27 to allow identification of proliferating cells. Mice with severe TBI treated with 1-laser Tx (and to a greater extent 3-laser Tx) had significant improvements in neurological severity score (NSS), and wire-grip and motion test (WGMT). However 14-laser Tx provided no benefit over TBI-sham control. Mice receiving 1- and 3-laser Tx had smaller lesion size at 28-days (although the size increased over 4 weeks in all TBI-groups) and less Fluoro-Jade staining for degenerating neurons (at 14 days) than in TBI control and 14-laser Tx groups. There were more BrdU-positive cells in the lesion in 1- and 3-laser groups suggesting LLLT may increase neurogenesis. Transcranial NIR laser may provide benefit in cases of acute TBI provided the optimum treatment regimen is employed.National Institutes of Health (U.S.) (Grant R01AI050875)Center for Integration of Medicine and Innovative Technology (DAMD17-02-2-0006)United States. Dept. of Defense. Congressionally Directed Medical Research Programs (W81XWH-09-1-0514)United States. Air Force Office of Scientific Research. Military Photomedicine Program (FA9550-11-1-0331

Effect of Laser Irradiation on sIg A and Mucosa Structure of Upper Respiratory Tract with Six-week Incremental Exercise

[Objective] Mucosal immune suppression, with chronic intensive exercise, can be associated with an increased risk of upper respiratory tract infections, which should be related to the deterioration of the nasal mucosa structure. This study aimed to observe the change of nasal mucosa structure with 6-week incremental exercise, and to explore the effect of low level laser irradiation on nasal mucosa structure and mucosal immune function. [Methods] 40 Sprague–Dawle rats, aged 8 weeks, were divided into 4 groups : Control, Exercise, Low power (4mw, 12.23 J/cm2) and High power laser (6mw, 18.34J/cm2) groups. Incremental treadmill exercise protocols: successive 6 weeks, 6 days/week, 30min /day. 10 m/min velocity during wk1, 20 m for wk2, with 5m/min/wk increment following weeks. The treatment of low level laser as following: He-Ne laser (0.19625 cm2 ), two irradiation point of nasal ala, 6-week duration, 6 days/wk, 2 times/day; 5min/time. Samples were taken pre and post 6-week exercise. Structure of mucosa of nose was observed by HE staining and sIgA tested by ELISA. [Results] 1) following changes occurred in Exercise group after 6-wk exercise: nasal mucosa was seriously damaged and cilia layer of free edge fell essentially off. And mucous degeneration, necrosis and inflammatory cell infiltration were observed. 2）compared with exercise group, significant improvement was found with laser treatment. 3) sIgA with different groups saw as Table 1. Table 1 sIgA changes after 6-wk exercise groups Control Exercise Low dose laser High dose laser sIgA(μg/ml) 52.92±6.69 50.20±4.76 70.77±4.24 73.71±3.91* * P\u3c0.05 [Conclusion] The long-term high-intensity exercise training would lead to destruction of nasal mucosa structure, and low energy laser irradiation had a beneficial effect on sIgA and nasal mucosa structure

Ablative Fractional 10 600 nm Carbon Dioxide Laser Versus Non-ablative Fractional 1540 nm Erbium-Glass Laser in Egyptian Post-acne Scar patients

Introduction: Non-ablative fractional erbium-doped glass 1540 nm and fractional ablative 10600 nm carbon dioxide lasers are regarded as effective modalities for treating acne atrophic scars. In this study, we aimed to compare the effectiveness of fractional CO2 laser and fractional non-ablative 1540 nm erbium doped glass laser in treating post acne atrophic scars in Egyptian patients.Methods: Fifty-eight patients complaining of moderate and severe acne atrophic scars were randomly divided into 2 groups of 29 patients each. Both groups were subjected to 4 treatment sessions with 3 weeks interval and were followed up for 3 months. In group A, enrolled patients received CO2 laser, while in group B, patients were treated with 1540 nm erbium glass fractional laser.Results: Clinical assessment revealed that the mean grades of progress and improvement were higher with fractional 10600 nm CO2 laser but with non-significant difference between both treatments (P = 0.1). The overall patients’ satisfaction with both lasers were not significantly different (P = 0.44).Conclusion: Both fractional ablative CO2 and fractional non-ablative erbium glass lasers are good modalities for treating acne scars with a high efficacy and safety profile and good patient satisfaction. The fractional ablative laser showed higher efficacy while non-ablative laser offered less pain and shorter downtime

High-power laser therapy improves healing of the equine suspensory branch in a standardized lesion model

High-power laser therapy is often used as a treatment for human sport injuries but controlled standardized studies on its efficacy are lacking. The technique has also been introduced in the equine field and recently promising results were reported in a retrospective study focusing on 150 sporthorses suffering from tendinopathy and desmopathy of the SDFT, DDFT, suspensory ligament, and suspensory branches. The goal of the present study was to evaluate the effect of high-power laser in a standardized lesion model in horses. Lesions were created in all lateral suspensory branches of 12 warmblood horses. In each horse, 2 of the 4 lesioned branches were treated daily with a multi-frequency high-power laser for 4 weeks. Color Doppler ultrasonography was performed during and after the treatment period. Six horses were euthanized 4 weeks post-surgery (short-term) and 6 were further rehabilitated until 6 months and then euthanized (long-term). High-field MRI evaluation was performed on all cadaver limbs. On ultrasound, transverse size of the lesion was significantly smaller after 2- and 3 months (p= 0.026 andp= 0.015) in the treated branches. The expected post-surgery enlargement of the lesion circumference and cross-sectional area (CSA) over time, was significantly lower in the short-term laser treated group (p= 0.016 andp= 0.010). Treated lesions showed a significantly increased Doppler signal during treatment (p< 0.001) compared with control. On MRI, in the short and long-term group, the CSA of the lesions was significantly smaller (p= 0.002), and the mean signal significantly lower in the treatment groups (p= 0.006). This standardized controlled study shows that multi-frequency high-power laser therapy significantly improves healing of a suspensory branch ligament lesion