Quartz Head Contact Laser Fiber: A Novel Fiber for Laser Ablation of the Prostate Using the 980 nm High Power Diode Laser

Abstract

High power 980 nm diode laser ablation of the prostate using the side firing fiber has proven its efficiency and safety in treating lower urinary tract symptoms secondary to benign prostatic hyperplasia. Nevertheless, this procedure is associated with some drawbacks such as prolonged irritative symptoms and tissue sloughing. In this study we evaluated the clinical outcome of high power 980 nm diode laser ablation of the prostate using a new quartz head contact fiber, and compared it to the standard side firing fiber in a randomized fashion. A total of 120 patients with benign prostatic hyperplasia scheduled for high power 980 nm diode laser ablation of the prostate were randomized to receive treatment with the standard side firing fiber or the novel quartz head contact fiber between April 2009 and April 2010. Patients were followed for at least 6 months, although 7 were lost to followup. The side firing fiber and quartz head contact fiber groups demonstrated significant improvement in International Prostate Symptom Score (from 20 to 8.39 vs 21.63 to 9.91), International Prostate Symptom Score-quality of life (from 4.47 to 1.94 vs 4.57 to 1.98) and maximum flow rate (from 7.79 to 22.22 vs 8.93 to 29.63 ml per second), and decreased prostate volume (47.79% vs 55.54%) and prostate specific antigen (59.69% to 60.61%), respectively. Complications, postoperative passage of tissue remnants and irritative symptoms were significantly less in the quartz head contact fiber group, as was the number of fibers per case. The quartz head contact fiber can produce similarly good outcomes in ablating the prostate using the high power 980 nm diode laser compared to the side firing fiber, and with fewer complications and side effects.