Diode Laser Treatment of Human Prostates

INTRODUCTION: Laser-assisted vaporization of prostate tissue by means of the potassiumtitanyl- phosphate (KTP) laser is in clinical use. Alternative laser sources are available but are lacking clinical experience.The 980 nm wavelength diode laser provides good hemostasis, in addition to a more rapid ablation rate. The aim of this study is approving the capability, feasibility, and good post-operative outcome of vaporization of prostate by means of a diode laser in a long-term follow up.METHODS: The light (980 nm, 100 W) of a diode laser was transmitted to prostate tissue. The study included 70 men suffering from bladder outlet obstruction due to benign prostatic hyperplasia (BPH). The prostatic lobes were vaporized within the prostatic capsule. Post-operative outcome and voiding were evaluated during a follow-up period of 24 months.RESULTS: During surgery, no significant blood loss or any fluid absorption occurred. Catheters were removed in the 20.1±4.6 hours. All patients except two were satisfied with their voiding outcome. After removing the catheter, the mean peak urine flow rate significantly increased from 6.8±2.5 ml/s pre-operatively to 15.6±3.1 ml/s postoperatively. No evidence of urgency, dysuria, hematuria, or incontinence was observed. Four patients required re-catheterization, and two of them needed consecutive TURP. After a 1- month, as well as after a 6-month, a 12-mouth, and a 1-year follow-up, all patients were still satisfied with the outcome.CONCLUSION: This long term experience showed that 100 W-980 nm-diode-laser vaporization prostatectomy was feasible and appeared to be safe and effective for quickly relieving bladder outlet obstruction due to BPH

Flexible Ureterorenoscopy Versus Extracorporeal Shock Wave Lithotripsy for the Treatment of Renal Pelvis Stones of 10–20 mm in Obese Patients

Introduction: To compare outcomes of retrograde intrarenal surgery (RIRS) with extracorporeal shock wave lithotripsy (ESWL) as treatment of choice.Methods: A total number of 46 patients with renal pelvic stones 10-20 mm and body mass index (BMI) >30 randomized in two groups underwent RIRS and ESWL from 2011 to 2014 and followed for 3 months.Results: The patients mean ± SD age was 36.1 ± 13.1 years in ESWL and 33.2 ± 11.4 years in RIRS groups (P = .1) with comparable BMI in both groups (36.2 vs 38.1). In ESWL and RIRS groups, the operation time was 72.2 ± 21 vs 66.5 ± 19 minutes (P = .061), respectively. Stone free rate (SFR) at 3 months was 68% in ESWL group vs 90.4% in RIRS group (P = .019). The complication rate was 20% in ESWL group vs 14.2% in RIRS group (P = .211) but all of them were minor and managed conservatively.Conclusion: According to our study, RIRS procedure in comparison with ESWL is a safe and successful option of treatment for renal pelvis stone of 10-20 mm in obese people

Holmium-YAG Laser Ureteroscopic Lithotripsy in a Patient with Ectopic Malrotated Kidney

The incidence of stone disease among patients with congenital renal anomalies including malrotated kidney is more than in normal population due to poor urine drainage and stasis (1). Various minimally invasive options have been used for the management. Ureteroscopy and Holmium:YAG laser lithotripsy have been reported with favorable outcomes (2). We report a 30-year-old male who presented to our hospital having a right side malrotated kidney with a large stone in it. He underwent two session of ureteroscopy and Holmium:YAG laser lithotrips

Retrograde Holmium- YAG Laser Endopyelotomy

Endourologic pyeloplasty is being a substitute of open pyeloplasty in management of ureteropelvic junction obstruction. This procedure can be done in different manners like balloon dilation, cold knife and electrosurgical endoureterotomy, accucise and lasers.A 47 year old woman referred with history of previous open pyeloplasty. Hydronephrosis of right kidney with unremarkable T ½ was found in DTPA scan. A full-thickness lateral incision was done with holmium:YAG laser just below the right UPJ and carried through the stenotic segment until the renal pelvis was reached. Half-time of radioisotope excretion was 13 min for the right kidney in diuretic renogram 3 months following operatio

Direct Vision Internal Urethrotomy with Application of Holmium: YAG Laser

INTRODUCTION: Male urethral stricture is a complicated urologic disease that could be successfully treated using internal urethrotomy. Laser internal urethrotomy has been used in many cases with favorable outcome in many studies. Holmium: YAG laser with its incisional properties on tissue is one of the laser types applied for internal urethrotomy.METHODS: We present a 19 year-old male with history of aortic valve stenosis and metallic aortic valvoplasty on prescription of oral anti-coagulant therapy (Warfarin) who was a candidate for internal urethrotomy due to bulbar urethral stricture. Holmium laser core-through urethrotomy was performed for him.RESULTS: Internal urethrotomy was done using the ablative 50-watt Holmium: YAG laser 2140 nm (manufactured by the Atomic Energy Organization of Iran [AEOI]). No complication was observed intra- and post-operatively. After 6 months of followup no evidence of urethral stricture was observed.CONCLUSION: According to our study, Ho-YAG laser core through urethrotomy is a safe and effective procedure. It is a less invasive alternative to more complex urethroplasty procedures for patients with post-traumatic urethral stricture with high risk of urethral bleeding due to anti-coagulant therap

Primary penoscrotal myxoid chondrosarcomas

Introduction: Extraskeletal myxoid chondrosarcoma (EMC) is a rare tumor of cartilaginous origin, most commonly located in the extremities that usually presents as a slow growing mass in fifth to sixth decades of life. Primary genitourinary tract involvement is extremely rare; about ten cases reported so far and due to such a low incidence, therapeutic approach is very challenging Case presentation: We report 2 year follow-up of a 38-year-old man with penoscrotal EMC that has been managed by complete tumor excision.Conclusion: Wide excision seems to be the best treatment. Our patient had no signs of local recurrence or metastasis during 4 years of follow up period

Effect of KTP Laser on Surgically Resected Adenomas of Prostate

INTRODUCTION: Palmoplantar psoriasis could hardly be differentiated from chronic tylotic eczema both clinically and histologically. The most commonly used therapeutic options for palmoplantar psoriasis are long-term therapy with topical corticosteroids and local PUVA. Frequently, it is a recalcitrant disease. We investigated the efficacy and tolerability of the combination of topical calcipotriol with local UVA radiation in comparison with local PUVA therapy.METHODS:In a total of 43 patients with palmoplantar psoriasis, 33 were given 15 sessions of local UVA radiation and topical calcipotriol and the remainder received 15 sessions of local PUVA (psoralen + UVA radiation).RESULTS:The statistical analyses of the results showed that the effect and tolerability of both therapeutic modalities are comparable.CONCLUSION: Combination of topical calcipotriol and local UVA radiation is an optional corticosteroid-free therapeutic modality for palmoplantar  psoriasis. It has a comparable effectiveness and tolerability with local PUVA

Trans-Ureteral Ureterolithotripsy of Ureteral Calculi:Which is the Best; Pneumatic or Holmium Laser Technique?

INTRODUCTION: Our aim was compare of two types of lithotripter include holmium: YAG laser and pneumatic one in transurethral ureterolithotripsy (TUL) for the management of ureteral calculi ≥1 cm.METHODS: 112 patients with ureteral calculi more than 1 cm were selected in randomized order for pneumatic or holmium: YAG laser transurethral ureterolithotripsy (56 patients in each group). Ultrasonography and intravenous urography were performed for all patients before surgery. Complete clearance and success was defined as the absence of any fragments on post operation KUB and ultrasonography images.RESULTS: Success rate was 85.7% in pneumatic group and 100% in holmium: YAG laser group (p =0.003). Stone migration up in the pelvicalyceal system was observed only in 8 cases of pneumatic group. No statically differences were observed in terms of patient’s age, hospital stay, and complications between two groups.CONCLUSION: According to our experience, for ureteral stone larger than 1 Cm treatment with ureteroscopy and laser lithotripsy is a preferring approach with favorable operation time and hospital admission, and no more significant complication