Multiple use of fibres in the visual laser ablation of the prostate.

OBJECTIVE

To investigate the possibility of re-using laser fibres for the visual laser ablation of the prostate (VLAP).

PATIENTS AND

METHODS

Thirty-four patients, each with a mean maximum urinary flow rate of < 14.0 mL/s and an American Urological Association symptom score of > 19, were evaluated. All underwent VLAP: laser energy, generated by a Neodymium:YAG system, was delivered with a side-firing fibre. The laser generator was fitted with a custom-built power meter that measured the energy delivered by the fibre. Fibres were re-used until the energy output fell below 60 W despite increases in laser generator power. Each patient was followed for at least 12 months.

RESULTS

A total of seven fibres was used to treat the 34 patients; between one and nine patients were treated with each fibre. The outcome obtained with the first use of a fibre compared well with those obtained with each subsequent use. After 12 months, 25 patients (74%) expressed satisfaction with the results of their operation. Five patients (15%) had urinary tract infections. As each fibre costs about pound 650, multiple use saved a mean of pound 516 for each patient treated.

CONCLUSION

This evaluation implies that there is no justification for the single use of laser fibres on the basis of efficacy, provided that a power meter is used to monitor the efficiency of the delivery device.