Lasers in urology

Abstract

In contrast to other technical developments, it was understood at an early stage that lasers would be of great help for medical purposes and the medical society embraced this new tool instantly. Interestingly, the typically destructive feature of laser technology was not the original focus. This lay in the area of reconstructive potential and was therefore used in ophthalmology for retina repair. In contrast to almost all other technical developments a sharing of knowledge between physicians and scientists took place from the very beginning. Whereas this cross subject exchange worked very eVectively in the initial phase, a time came where, Wrst and formost, physicians did not heed the principles of laser technique and thereby ignored the balance of eVect and side eVect. This was when the medical application of lasers took a wrong turning, which led to a detriment in the reputation of laser technology for a long time. It is therefore understandable that after the initial enthusiasm in the early 1990s the laser, although physically present in many clinics, was hardly in use anymore. Hence, we felt the need to introduce the basic technical aspects of lasers after displaying the historic development of lasers in our article. We are especially pleased that the physicist and pioneer of Holmium laser technology, Heinrich-Otto Teichmann, has agreed to contribute a review on the subject “Technical aspects of lasers in urology”. For the past 20 years he has been well acquainted with the problems and needs of urologists in this Weld. In his article, he explains the physical basics of laser systems, whose application is theoretically possible and feasible in the Weld of urology. The article “Lasers in clinical urology: state of the art and new horizons” could be seen as the clinical pendant to the work of Heinrich-Otto Teichmann. Here, we have the same approach, but this time from the perspective of the urologists Andrew Marks and Joel Teichman from Vancouver, Canada, both with major reputations in their respective Welds of endoscopy and laser therapy. Today, the use of lasers in clinical urology mainly consists of stone therapy and transurethral ablation of the prostate. For these speciWc application we were able to enlist Sean Pierre and Glen Preminger from Duke, USA and Rainer Kuntz from Berlin as distinguished urologists. Both Preminger and Kuntz are pioneers in their Weld and experienced laser therapists. Courtney Philips and Jamie Landman from New York complete the line up of the afore-mentioned excellent urologists. In their article “Lasers in the upper urinary tract for non-stone disease” they refer to the utilisation of laser systems outwith the above-mentioned Welds. Technical innovation and medical demands/requirements evoke a constant evolution in medical laser systems and their applications. In this respect, the Thullium:YAG laser is the “new kid on the block”. It is a continuous laser on almost the same wavelength as the Holmium:YAG laser. Our group presents early results in the treatment of BPH and recurrent bladder neck strictures. Lasers have become the interesting products they are mainly through the tools with which they are utilized. The downside is the high cost of purchase of the lasers and the T. R. W. Herrmann (&) Department of Urology and Pediatric Urology, Medical School of Hannover, Carl Neuberg Strasse 1, 30625 Hannover, Germany e-mail: trwh@trwh.de URL: http://www.mh-hannover.de