GreenLight Laser Research Articles

First-Time Successful Trial Without Catheter (TWOC) After GreenLight Laser Photoselective Vaporization of the Prostate (GLL PVP) Surgery for an Enlarged Prostate.

Objective We aimed to assess the success rate of the GreenLight laser photoselective vaporization of the prostate (GLL PVP) procedure for enlarged prostates in patients with and without preoperative long-term catheters. Methodology A retrospective data analysis was conducted on 46 patients. Data were collected from clinical health records and radiology images. The parameters studied in this analysis included the patient's age, prostate volume, medical management before surgery, and whether the patient had a catheter or not prior to the surgery. Results A total of 46 GLL PVP surgeries were performed over a 12-month period from May 2023 to May 2024 at West Middlesex University Hospital in London. Patients had a mean age of 73.2 ± 8.12 years, and their prostate volume was 57.7 ± 25.96 cc. Before the surgery, 14 cases (30%) were using long-term catheters, and 32 cases (70%) were not. Additionally, 40 cases (87%) were receiving medical management for lower urinary tract symptoms (LUTS). After the surgery, 39 cases (85%) passed their first trial without catheter (TWOC), and seven cases (15%) failed it, regardless of whether they had used catheters before the surgery. Patients using long-term catheters before the operation had a 71% success rate in passing their first TWOC and a 29% failure rate. Conclusion Our study found that GLL PVP has a significant positive impact on elderly individuals with a large prostate volume, regardless of whether they had long-term catheters or not prior to the operation. Additionally, our findings indicate that patients without preoperative long-term catheters experience significantly better outcomes.

Successful Treatment of Bladder Outlet Obstruction With GreenLight Laser Photoselective Vaporization of Prostate Operation for a High-Risk Patient With a Very Large Prostate Volume

Successful Treatment of Bladder Outlet Obstruction With GreenLight Laser Photoselective Vaporization of Prostate Operation for a High-Risk Patient With a Very Large Prostate Volume

Extra-Skeletal Osteosarcoma of the Prostate After Treated Prostatic Acinar Adenocarcinoma: A Case Report and Review of the Literature.

Extra-skeletal osteosarcoma is a rare form of malignant soft tissue sarcoma. Its occurrence in the prostate gland is particularly uncommon. In this case report, we present a patient diagnosed with osteosarcoma arising within the prostatic gland. A 58-year-old man was initially diagnosed with Gleason 8 prostate acinar adenocarcinoma following a transurethral resection (TUR) of the prostate. This diagnosis was accompanied by locoregional involvement and multiple bone metastases. The patient underwent a treatment regimen including complete androgen blockade, chemotherapy, greenlight laser prostate vaporization, and palliative radiotherapy. After treatment, he achieved a complete biochemical response, and his bone metastases remained stable. However, at 16 months post-diagnosis, clinical follow-up by means of radiological examinations revealed an increase in the size of the prostatic lesion, along with additional infiltration of the tumor into the rectum and bladder walls. Remarkably, a mesenchymal tumor proliferation with intratumor calcifications was observed. A subsequent TUR biopsy of the prostate showed a malignant tumor spindle and ovoid cell proliferation with high-grade nuclear atypia, necrosis, and islets of osteoid formation, leading to a final diagnosis of high-grade prostatic extra-skeletal osteosarcoma. Despite undergoing chemotherapy, the patient's condition progressed with the development of pulmonary and liver metastases, culminating in his demise.

Evaluation of transurethral GreenLight laser-selective vaporization for refractory overactive bladder in women.

Refractory overactive bladder (OAB) in women is a common yet challenging condition for which traditional treatments have been unsatisfactory. This study aimed to evaluate the efficacy and safety of transurethral bladder mucosal GreenLight laser-selective vaporization for treating refractory OAB in women. The female patients with refractory OAB who were admitted to the Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University between May 2022 and July 2023 were examined retrospectively in this study. Transurethral bladder mucosal GreenLight laser-selective vaporization was used to treat the patients, and the perioperative and postoperative parameters were reviewed and compared. Bladder mucosa was examined by immunohistochemical staining to explore the expressions of TRPV1, P2X3, tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) before and after treatments. Surgeries were performed successfully for all 32 patients in 57.38±11.22 minutes with minimal intraoperative bleeding. Twelve weeks post-surgery, there was a significant decrease (P<0.05) in the patients' Overactive Bladder Symptom Score (OABSS), 3-day bladder diary (daytime frequency, nocturia, urgency, and urgency incontinence), and Overactive Bladder questionnaire Short Form (OAB-qSF) score. After treatments, both first desire to void (FDV) and maximum bladder pressure capacity (MCBC) increased significantly (P<0.05). The immunohistochemical analysis revealed that the GreenLight laser significantly reduced the expressions of TRPV1, P2X3, TNF-α, and IL-6 in the bladder mucosa (P<0.05). No severe complications were observed after interventions. For female patients with refractory OAB who have shown poor response to conventional treatment approaches, transurethral bladder mucosal GreenLight laser-selective vaporization may represent a promising alternative treatment option.

"Five-Step" Vaporization of the Prostate Using 180-W XPS Greenlight Laser in Patients with Benign Prostatic Hyperplasia of Large Volume: Improved Efficacy and Safety.

Objective: To evaluate the safety and efficacy of 180-W XPS Greenlight laser "Five-step" photoselective vaporization of the prostate (PVP) in patients with benign prostatic hyperplasia (BPH) with prostate volume (PV) > 80 mL. Background: In patients with BPH with large PV, PVP often results in bleeding, unclear visual field, additional damage, and insufficient tissue vaporization. Methods: This single-center, retrospective study enrolled patients with BPH with PV > 80 mL treated with the Five-step PVP or the Conventional PVP from January 2018 to June 2021. Comorbidities, high-risk habits, and operative parameters were analyzed and compared. The short-term functional outcomes and postoperative complications were recorded over the 24-month follow-up. Results: Two hundred eligible patients were divided into the Five-step PVP and Conventional PVP groups (n = 100 each). These groups showed no differences in comorbidities, living habits, baseline perioperative parameters, operative time, lasing time, or energy use. However, a higher energy density (3.95 [interquartile range (IQR) 3.37, 4.52] vs 3.68 [IQR 3.17, 4.20] kJ/mL) and energy-time ratio (7.23 [IQR 6.12, 8.52] vs 6.72 [IQR 5.51, 7.87] kj/min p = 0.034)were obtained in the Five-step PVP group. Subgroup analysis of patients with PV ≥120 mL showed similar results. The short-term functional outcomes were similar between the two study groups with significant improvement from baseline, but the total prostate-specific antigen levels at 1 and 6 months were lower in the Five-step PVP group. Further, incidences of intraoperative bleeding, bladder mucosa injury, postoperative hematuria, and urinary tract infection were lower in the Five-step PVP group. In the Conventional PVP group, four patients required conversion to transurethral resection of the prostate in surgery and two patients required retreatment during the 24-month follow-up. Conclusions: The 180-W XPS Greenlight laser Five-step PVP has advantages of less bleeding, high vaporization efficiency, and low rates of perioperative complications, and, therefore, it is a promising treatment to improve short-term functional outcomes for patients with BPH with large PV.

The effects of laser cane cues on the freezing of gait of Parkinson's disease patients: can increasing the laser light beam width play a role?

Freezing of gait can be seen in a significant number of people with Parkinson's disease. Disappointingly, the classic standard treatment of Parkinson's disease with dopamine replacement has not shown promising results in improving the freezing of gait. Hence the approach have shifted towards using non-invasive methods to address this problem. To assess the effect of laser cane as a visual cue on the freezing of gait of people with Parkinson's disease and further determine the effect of laser light beam width and color on the freezing of gait. 7 known Parkinson's Disease patients were enrolled in this study, all of whom had at least one episode of freezing at at least one clinical visit. These patients underwent gait analysis in 4 stages: walking without a cane, walking with a thin red light laser cane, a thick red light laser cane, and a green light laser cane. Using laser canes effectively improved nearly all parameters of walking, including right and left stride length, step length, the velocity of movement, and rotation time, compared to walking without a stick. Using different colors of laser cane didn't make any significant difference in improving the freezing of gait of our patients. Nevertheless, increasing the laser light beam width significantly improved almost all walking parameters. This is the first study assessing the effect of laser light beam width on freezing of gait in Parkinson's disease patients and shows promising results in regards to increasing the thickness of laser lights in order to improve walking parameters in Parkinson's disease patients more effectively. Furthermore, this is the second study to evaluate the effect of laser light color, contradicting the previous results by showing no significant correlation between the color of laser light and improvements in walking parameters.

Are adverse events during surgery for benign prostatic hyperplasia device related? A review of the MAUDE database.

The Manufacturer and User Facility Device Experience database contains anonymous, voluntary medical device reports. A review of device-related adverse events associated with Benign Prostatic Hyperplasia surgeries was completed. The objective was to evaluate the occurrence and contributing factors to clinically significant complications in a cohort of patients electing to undergo surgical intervention for Benign Prostatic Hyperplasia. The Manufacturer and User Facility Device Experience database was queried for "Aquablation, Greenlight Laser, Holmium Laser, Morcellator, Water Vapor Thermal Therapy, Loop Resection, and Prostatic Urethral Lift" from 2018 through 2021. A complication classification system (Level I-IV) based on the Clavien-Dindo system was used to categorize events. These events were then correlated with procedural technology malfunctions and classified as "device related" and "non-device related." Chi squared analysis was performed to identify associations between procedural technology and complication classification distribution. A total of 873 adverse events were identified. The adverse events were classified into level I (minimal harm) versus levels II-IV (clinically significant). Aquablation (p < 0.017) and Water Vapor Thermal Therapy (p < 0.012) were associated with a higher proportion of reports with Level II-IV complications compared with other procedure types. Level II-IV complications were not associated with a reported device related malfunction. Aquablation and water vapor thermal therapy demonstrated noteworthy clinically significant complications which were not driven by device-related malfunctions.

Therapeutic efficacy of 180-W GreenLight laser photoselective vaporization of the prostate for storage symptoms concomitant with benign prostatic obstruction and a search for outcome predictors.

Benign prostatic obstruction (BPO) is the most common cause of lower urinary tract symptoms among men. GreenLight photoselective vaporization of the prostate (GL-PVP) using a 180-W Xcelerated performance system (XPS) laser is a well-established method for treating BPO-induced voiding symptoms. However, its therapeutic effects on storage symptoms remain unclear. This study aimed to analyze the storage outcomes in patients who underwent 180-W XPS GL-PVP for BPO and to identify outcome predictors. Patients who underwent 180-W XPS GL-PVP for BPO between May 2018 and May 2021 were retrospectively reviewed. Data on clinical characteristics, prostate volume, preoperative and postoperative International Prostate Symptom Scores (IPSS), and preoperative urodynamic parameters were collected. A favorable storage outcome was defined as ≥50% reduction in the IPSS storage subscore. Ninety-nine male patients were included, with a mean age of 69.4 ± 9.6 years and a baseline prostatic volume of 75.9 ± 33.1 mL. The IPSS total, storage, and voiding subscores significantly decreased after GL-PVP (all p < 0.001). Seventy-two patients achieved favorable storage outcome at 6 months. Multivariate analysis revealed that detrusor underactivity was predictive of unfavorable storage outcomes (p = 0.022), while IPSS voiding-to-storage subscore ratio >1.25 and the presence of detrusor overactivity were predictive of favorable storage outcomes (p = 0.008 and 0.033, respectively). 180-W XPS GL-PVP provided excellent outcomes in both voiding and storage lower urinary tract symptoms concomitant with BPO. Preoperative IPSS and multichannel urodynamic parameters including detrusor overactivity and underactivity are valuable predictors of postoperative storage outcomes.

(221) Outcomes of Transurethral Surgery After IPP

Abstract Introduction Inflatable penile prosthesis (IPP) effectively restores erectile function with very high patient satisfaction rates. However, some patients may require subsequent treatments for urethral stricture, enlarged prostate and bladder tumors. These underlying conditions oftentimes coexist with erectile dysfunction (ED). Transurethral surgery (TUS) treatment of coexisting conditions in patients with IPP can be challenging and associated with a theoretical risk of mechanical injury and infection of the implant. There is a lack of literature reporting on IPP issues after TUS. Objective The aim of this study was to evaluate postoperative outcomes in patients who underwent TUS following IPP placement. Methods After IRB approval, we reviewed the medical records of all patients who underwent Greenlight laser enucleation of the prostate (GLEP)(Wolf© 26 Fr cystoscope), Rezum© vaporization ( 21 Fr delivery device), transurethral bladder tumor resection (TURBT)(21 and 22 Fr cystoscopes) and Optilume balloon dilation surgeries (19 Fr cystoscope and 24 Fr balloon) after IPP placement at our institution from 2014 to 2023. We excluded patients who underwent TUS prior to IPP placement and only included patients who had an in situ IPP at the time of the TUS procedure. Parameters such as IPSS score, PSA, postvoid residual volume (PVR) and transrectal ultrasound were used for assessment before and after surgery. All surgeries were performed by a single surgeon. Postoperative progress was assessed at multiple follow-up visits. Results Seven patients with IPP underwent eight TUS. Four patients (71%) received surgical BPH treatment, one patient was treated for bladder tumors and one patient developed a bladder neck contracture (BNC) after GLEP and required a second TUS. One patient developed a pendulous stricture after erosion from an IPP cylinder placed by a different surgeon 23 years prior. The patient underwent IPP removal and replacement at our facility 63 months prior to Optilume® balloon dilation. The mean time between IPP placement and TUS was 34.86 ± 30.96 months. The average prostate volume was 41.3 ± 25.9 mL, and the mean parameters of PVR, Maximum flow rate (Q max), IPSS, and PSA before surgery were 140.6 ± 100.8 mL, 8.4 ± 7.2 ml/s, 16.3 ± 4.3, and 2.7± 2.7 ng/ml, respectively. An average of 31.6 ± 26.7 grams of prostate tissue was resected during GLEP. Postoperative parameters of PVR, Q max and PSA were 35.5 ± 31.3 ml, 17.2 ± 8.8 ml/s and 0.8 ± 0.65 ng/dl, respectively. There were no cases of postoperative infections or IPP malfunctions reported during a mean follow-up of 34.14±36 months. Conclusions Our experience shows that TUS performed after IPP placement is effective and safe in addressing underlying conditions such as BPH, bladder tumors and urethral strictures. Our findings indicate favorable postoperative outcomes in terms of PVR and PSA levels, without any reported infections or malfunctions of the IPP. However, it is important to consider the limitations of this study, including the small sample size. Further research with larger sample sizes would be beneficial to validate these findings and provide more comprehensive insights into the outcomes of TUS following IPP placement. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Irrisept.

Water-Soluble Star Polymer as a Potential Photoactivated Nanotool for Lysozyme Degradation.

The development of nanotools for chemical sensing and macromolecular modifications is a new challenge in the biomedical field, with emphasis on artificial peptidases designed to cleave peptide bonds at specific sites. In this landscape, metal porphyrins are attractive due to their ability to form stable complexes with amino acids and to generate reactive oxygen species when irradiated by light of appropriate wavelengths. The issues of hydrophobic behavior and aggregation in aqueous environments of porphyrins can be solved by using its PEGylated derivatives. This work proposes the design of an artificial photo-protease agent based on a PEGylated mercury porphyrin, able to form a stable complex with l-Tryptophan, an amino acid present also in the lysozyme structure (a well-known protein model). The sensing and photodegradation features of PEGylated mercury porphyrin were exploited to detect and degrade both l-Trp and lysozyme using ROS, generated under green (532 nm) and red (650 nm) light lasers. The obtained system (Star3600_Hg) and its behavior as a photo-protease agent were studied by means of several spectroscopies (UV-Vis, fluorescence and circular dichroism), and MALDI-TOF mass spectrometry, showing the cleavage of lysozyme and the appearance of several short-chain residues. The approach of this study paves the way for potential applications in theranostics and targeted bio-medical therapies.

Studies on structural, optical and microwave dielectric properties of double perovskite Sr2Fe1+xNb1-xO6, ceramics synthesized by solid state route

The solid solution of Sr2Fe1+xNb1-xO6, 0.015 ≤ x ≤ 0.030 double perovskite ceramics has been synthesized by mixed oxide route. In this paper, X-ray powder diffraction (XRD), scanning electron microscopy (SEM), and Fourier transform infrared (FTIR) spectroscopy have been used to investigate the structure stability of double perovskite ceramics, Sr2Fe1+xNb1-xO6, 0.015 ≤ x ≤ 0.030 Impedance analysis and photoluminescence (PL) spectroscopy were used to investigate the ceramic's dielectric and optical properties respectively. The XRD pattern revealed the single phase tetragonal structure along with space group I4/m. The findings demonstrate that the binding strength and stability of double perovskite increase with increasing contents (x). Increasing frequency may encourage carrier hopping and mobility, but the free carrier may also be expected to conduct the bound charge at a high frequency. Fe3+ and Nb5+ replace smaller cations at the B-site, causing a cationic disorder that causes oxygen vacancies in the lattice skeleton and boosts conductivity. Tangent loss decreases with increasing frequency, which is reported in this work. According to the PL analysis, an excitation energy of 2.22 eV at a wavelength of 560 nm was measured, which is appropriate for the generating of green light lasers.

Effect of saline perfusion before catheter removal in patients with BPH treated with GreenLight laser photoselective vaporization of the prostate.

To investigate the effect of saline perfusion before catheter removal in patients with benign prostatic hyperplasia (BPH) treated with GreenLight laser photoselective vaporization of the prostate (PVP). Patients (n=200) with BPH treated with PVP were divided into perfusion (n=100) and control (n=100) groups. For the perfusion group, saline (200 mL or the maximum capacity tolerated) was irrigated into the bladder after standardized external urethral disinfection, and the catheter was removed. Catheter removal was routinely performed in the control group. Perioperative adverse events and clinical outcomes were compared between the groups. Patients in the perfusion group had a shorter waiting time [3 (0-4) vs. 15 (8.75-26) min; P<0.001] and a better satisfaction grade [24 (21.75-26) vs. 23 (20-25); P=0.016] for first urination than those in the control group. The perfusion group exhibited lower anxiety levels regarding first urination than the control group [1 (1-2) vs. 1.5 (1-2), respectively; P=0.012]. Urinalysis revealed that the perfusion group had significantly lower white blood cell (WBC) count than the control group on the day [25.5 (8-37.75) vs. 43.5 (24.0-64.75); P<0.001] and 2 weeks [20.5 (11-27) vs. 31.0 (20-42); P<0.001] after catheter removal. No significant differences in treatment-related adverse events were observed [perfusion (n=15), control (n=20)]. Saline perfusion before catheter removal in patients with BPH treated with PVP could shorten the waiting time for first urination, improve patient anxiety and satisfaction and reduce postoperative urinary WBC levels.

Efficacy of GreenLight laser prostatectomy in urinary retention.

The objective of our study was to evaluate the efficacy and durability of GreenLight laser prostatectomy for the management of acute urinary retention (AUR) and chronic urinary retention (CUR) and to determine outcomes compared to patients without preoperative urinary retention (UR). We conducted a retrospective study of prospectively collected data from individuals who underwent GreenLight laser prostatectomy at our institution from May 2018 to July 2022. Patient demographics and outcome measures were recorded, including indications for the procedure, median urinary volume drained, or median postvoid residual urine volume (PVR) before catheterization or GreenLight laser prostatectomy. CUR was defined as PVR >300 mL in males able to void and initial catheter drainage >1000 mL in males unable to void in the absence of pain. All patients had postoperative followup visits at one, three, six, and 12 months. Our evaluation included the International Prostate Symptom Score (IPSS), quality-of-life (QoL) assessment, maximum urinary flow rate (Qmax), PVR, and catheter-free status. One hundred sixty-eight males who underwent GreenLight laser prostatectomy were included in our study. The UR group consisted of 88 patients (50 AUR and 38 CUR), and the lower urinary tract symptoms (LUTS) group was comprised of 80 individuals. There were no statistically significant differences between the AUR and CUR subgroups regarding demographics. The UR group had a significantly higher age and a significantly higher postoperative catheterization time compared to the LUTS cohort. The CUR subgroup had a significantly higher PVR at one, three, and six months compared to the AUR subgroup, although other outcome measures were similar between the two cohorts. During three- and six-month followup visits, the UR group had a significantly higher PVR than the LUTS cohort. At 12 months postoperative, the LUTS group had a higher catheter-free rate than the UR group (p=0.001). The successful first trial of void (TOV) rate for the UR and LUTS groups were 83% and 80%, respectively. At 12-month followup, the catheter-free rate for the UR and LUTS cohorts was 87.5% and 100%, respectively. GreenLight laser prostatectomy is an effective and durable treatment for UR, with a high catheter-free rate and comparable outcomes when performed to manage LUTS.

Search trends in the treatment for benign prostatic hyperplasia: A twenty-year analysis

ObjectiveMinimally invasive treatments for benign prostatic hyperplasia (BPH) have seen an increase in usage in recent years. We aimed to determine what types of events may influence patient search habits related to surgical BPH treatments. MethodsGoogle Trends was used to determine the frequency of searches for different minimally invasive and prostatic ablative treatments for BPH in the United States. The procedures including transurethral resection of the prostate (TURP), Aquablation therapy (Aquablation), Greenlight laser therapy (Greenlight), transurethral needle ablation, transurethral microwave thermotherapy, Urolift (prostatic urethral lift [PUL]), Rezum, iTind, holmium laser enucleation of the prostate, simple prostatectomy, and prostatic artery embolization were compared. ResultsFrom January 1, 2004 to February 28, 2023, the number of internet search queries have increased for TURP, PUL, Rezum, prostatic artery embolization, and holmium laser enucleation of the prostate. There has been a slight decrease in searches for Greenlight, transurethral needle ablation, transurethral microwave thermotherapy, iTind, simple prostatectomy, and Aquablation. ConclusionsDespite increased searches of alternatives, TURP remains the most searched BPH procedure. Additionally, search habits may be influenced by several factors including government approval, corporate acquisition, and marketing campaigns. It is important for physicians to understand the types of events that may cause patients to inquire about certain treatments for better quality health information and clinical visits.

Safety and clinical outcomes of GreenLight laser prostatectomy in octogenarians.

We evaluated the impact of age on perioperative morbidity and clinical outcomes in patients undergoing GreenLight laser prostatectomy for benign prostatic hyperplasia (BPH). We conducted a retrospective study of prospectively collected data from individuals who underwent GreenLight laser prostatectomy from May 2018 to July 2022. Patient demographics and outcome measures were recorded, including indications for the procedure and American Society of Anesthesiology (ASA) scores. All patients had postoperative followup visits at one, three, six, and 12 months. Our evaluation included the International Prostate Symptom Score (IPSS ), quality of life (QoL) assessment, maximum urinary flow rate (Qmax), postvoid residual volume (PVR), and catheter-free status. One-hundred-sixty-eight males who underwent GreenLight laser prostatectomy were included. The non-octogenarian group consisted of 111 patients and the octogenarian group comprised 57 individuals. Based on ASA scores, most octogenarians were deemed high-risk (ASA III: 91.2%), while over half of non-octogenarians were lower-risk (ASA II: 53.2%) (p<0.001). Intraoperative parameters, including operative time, vaporization time, lasing time, and energy did not differ significantly between groups. There was no difference in the proportion of intraoperative complications between non-octogenarians and octogenarians (0.9% vs. 3.5%). Postoperative complications were not statistically significant between the two groups (p=0.608). There was also no observed difference in the proportion of patients requiring readmission (p=0.226) or retreatment (p=1.0). GreenLight laser prostatectomy is a safe and effective treatment for BPH regardless of age. It provides similar surgical and functional outcomes as younger men while maintaining the QoL of octogenarians.

450-nm blue diode laser: a novel medical apparatus for upper tract urothelial lesions

ObjectiveTo explore the feasibility, safety and effectiveness of the 450-nm blue diode laser (BL), novel blue laser in the treatment of upper tract urothelial carcinomas (UTUCs) and other lesions in a porcine model.Material and methodsFor in vitro experiment, the ureter tissue was vaporised and coagulated with BL, green-light laser (GL) and Ho:YAG laser (Ho). The efficiency, width and depth of vaporisation, and depth of coagulation were recorded and compared. For in vivo experiments, four swines weighing 70 kg were used. In the acute group, different modes of operations were performed to evaluate the thermal damage, perforation and bleeding. In the chronic group, the overall appearance of the ureter and laser wound healing were observed by the naked eyes and H&E staining 3 weeks after surgery.ResultsIn in vitro study, the BL showed a higher efficiency of tissue vaporisation and less tissue coagulation for fresh ureter compared to GL and Ho. In the in vivo study, the power of BL set at 7 W was better, and the thickness of thermal damage varied with different surgery types in the range of 74–306 μm. After 3 weeks, the wound healed well static in vaporisation (SV), moving vaporisation (MV) and H&E staining indicated mucosal healing rather than scar healing.Conclusion5–10W blue diode laser achieved a higher efficiency of tissue vaporisation and less tissue coagulation in a porcine model, indicating its potential application in the endoscopic surgery of UTUC as an optional device with high performance and safety.

Salvage Greenlight Laser Prostatectomy Following Previous Failed Urolift

Salvage Greenlight Laser Prostatectomy Following Previous Failed Urolift

Bright Green Emission of Tb3+ Doped Lithium Sodium Potassium Borate Glasses for Photonic Application

The melt-quenching approach was implemented to create terbium-doped lithium sodium potassium borate glasses (LNKBTb). Archimedes’ principle, absorption and luminescence spectra, including CIE chromaticity were used to characterize the properties of glasses. Terbium in glasses absorbs photon in the visible and near infrared ranges. The intense green emission at 544 nm was generated by the terbium 5D4 to 7F5 transition when excited with ultraviolet–visible (UV–Vis) light. The emission intensities of LNKBTb glasses increased with increasing terbium concentrations up to 4 mol%, after which they decreased, resulting in the concentration quenching effect, whereas decay time decreases as Tb2O3 content increases. In CIE 1931, the overall color of emission is green. May bring can continue to develop to use as a photonic material in green light sources and lasers.

827 Greenlight Laser Prostatectomy: A Safe and Effective Day Case Option for Bladder Outlet Obstruction in the Elderly Population

Abstract Aim Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction. In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Method Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results 305 patients were included in this study with a median age of 74 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and 21.3% of patients discharged on the next day. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions Our study shows that GLLP is a safe and effective day case treatment, and that with appropriate anaesthetic input it can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.

High-power green-light laser endoscopic submucosal dissection for non-muscle-invasive bladder cancer: A technical improvement and its initial application.

The technique of laser en bloc resection of bladder tumor (ERBT) has been a valuable alternative technique to transurethral resection of bladder tumor (TURBT). However, the combination of laser ERBT and endoscopic submucosal dissection (ESD) technique has not been well studied. Here, a novel technique integrating a high-power green-light laser with ESD was presented. This study aimed to evaluate the safety and efficacy of high-power green-light laser endoscopic submucosal dissection (HPL-ESD) for the treatment of primary non-muscle-invasive bladder cancer (NMIBC). From January 2015 to December 2018, a total of 56 patients with NMIBC underwent HPL-ESD. All tumors were transurethral en bloc resected in the ESD technique. Perioperative clinical data were retrospectively collected and analyzed. All operations were safely performed by the technique of HPL-ESD without blood transfusion. The mean tumor diameter was 2.04 ± 0.65 cm, ranging from 0.5 to 3.5 cm. The mean operative time was 28.39 ± 16.04 min. The average serum hemoglobin decrease was 0.88 ± 0.54 g/dL. The mean postoperative catheterization time was 2.88 ± 0.94 days. The pathologic stages included pTa (32 cases), and pT1 (24 cases). Double-J stent indwelling was not performed for four patients whose tumors were adjacent to the ureteral orifice and no postoperative hydronephrosis was observed. Only one case of ectopic bladder tumor recurred due to irregular bladder irrigation during the 36-month follow-up. HPL-ESD is a safe and effective alternative for the treatment of primary NMIBCs, especially for tumors adjacent to the ureteral orifice.