Nd:YAG Laser Efficacy as a Urological Tool


Authors: G. J. Buckham, T. M. Craig

St. Andrews Hospital, Toowoomba
Published: Urological Society of Australasia – 51st Annual Scientific Meeting March 1998

Nd:YAG laser was evaluated for its safety, efficacy, ability to reduce blood loss and length of stay in over 600 patients undergoing Visual Urethrotomy, Radical Perineal Prostatectomy, VLAP and Bladder Neck Incision procedures over the past 3 1/2 years.

Additional clinical cases for Radical Perineal Prostatectomy are required to make statistical inferences on the efficacy of the laser, although length of stay is already below DRGs.  Patients undergoing multiple procedures which included Visual Urethrotomy by laser, exhibited a significant (P <0.0001) decrease in length of stay (1.89 vs 2.75) compared to non laser cases.  Laser Ablation of the Prostate indicated a significant (P < 0.0001) decrease in length of stay (1.74 vs 6.64) when compared to TURP.  Length of stay for Bladder Neck Incision done by laser was significantly decreased (P <0.001)  (1.06 vs 3.0) vs non laser.  No inference can be drawn from the blood data as so little was used.  Ongoing evaluation of this parameter will continue.

Our initial work has found that the safety and efficacy of laser is superior to conventional methods, with blood loss minimal or absent and length of stay markedly reduced compared to conventional methods.  The laser has frequently enabled these procedures to become day case out - patient based treatments.  We therefore use Nd: YAG laser as our preferred method of treatment.  Ongoing research will continue to evaluate the efficacy of laser usage in the procedures described extended procedures within our discipline and possible appropriate procedures in other specialties.