Penetration depth with the XPS Greenlight ® laser assessed by contrast enhanced ultrasound
Bruyere F, Bodin T, Bleuzen A, Patat F, Brunereau L.J Endourol. 2013 Jul 9. [Epub ahead of print]


CHU Bretonneau, urology, 2 bdTonnellé, Tours, Loire Valley, France, 37044, +33247474730, +33247476991, CHU Bretonneau, Centre d'InnovationsTechnologiques, 2 bdTonnellé, Tours, Loire Valley, France ;


Objective: The Greenlight laser is one of the main alternative treatments for Benign Prostate Hyperplasia (BPH). Ultrasound with contrast (ECUS) is one of the main innovations in radiology that has led to the examination of tissue vascularity. The objective of the study was to measure the impact of Photovaporisation of the Prostate (PVP) on the prostate gland with the ECUS. Methods: We conducted a pilot study to assess the impact of PVP on the prostate by using ECUS intraoperatively (ethical committee approval No. 2012-001451-39). Twelve patients undergoing PVP for symptomatic BPH were enrolled in this study after providing their informed consent. ECUS were performed just before and after PVP in the operating room and at 1 month post operatively. Results: Comparative analysis showed that after PVP, a non-vascularised area with an average thickness of 11.1 mm was observed beyond the operative cavity. The non vascularised area was thinner at 1 month post operatively and disappeared at 6 months for the 6 patients evaluated. This is the first study using contrast-enhanced ultrasound to measure the impact of PVP on the prostate. Our study has the limitations of a pilot study with a small population and a short follow-up. Based on these results we would advise beginners to take into account the necrosis thickness, and to limit the depth of vaporization. Conclusions: Through the use of ECUS, our study demonstrated that a large area of necrosis is induced around the surgical cavity due to the action of the Greenlight laser. Being aware of this phenomenon will certainly reduce the risk of complications induced by surgery.