Outpatient visual laser-assisted prostatectomy under local anesthesia

Transurethral Resection of the Prostate and Laser Prostatectomy under Local Anesthesia

“…The results of our study indicate a similarity to the results of the study by Leach et al [4]. Carrying out TULAP under local anesthesia may decrease the duration of patient hospitalization and operation costs.…”

“…Patients who are in the risk group can be protected from the mortality or morbidity of general and spinal anesthesia [4]. …”

Side-Firing Neodymium:YAG Laser Prostatectomy

“…While the anesthetic requirement may be somewhat less than conventional TURP, it is significantly more than required for some technologies such as microwave thermotherapy, and obviously more than medical therapy with alpha-adrenergic blockade. Patients who are prohibitive candidates for anesthesia may be successfully treated with local periprostatic nerve block as described by Leach et al [33]. Thus, laser prostatectomy, while an ideal outpatient surgical procedure, is not an office-based procedure.…”

“…Prostate symptom scores (AUA or IPSS) and objective measures of uroflowmetry and post void residual urine volumes all show clinically significant improvement which is the equivalent of TURP and superior to most other new medical and surgical treatments for BPH (table 2) [10, 13, 14, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43]. Kabalin et al [30]reported that 85% of men undergoing side-firing Nd:YAG laser prostatectomy could expect at least a 50% improvement in either prostate symptom score or peak urinary flow rate.…”

“…Because there is no fluid absorption during Nd:YAG laser prostatectomy, sterile water is typically used for intraoperative irrigation. The operation may be performed under general or regional anesthesia, or under local periprostatic block as described by Leach et al [33]. Typical operating time is approximately 45 min or less.…”