Lasers In Urology Research Articles

A Giant Leap toward a Renowned International Journal

Starting with the January issue of 2010, the Korean Journal of Urology became an entirely English-language journal. This was a historical event in the Korean Urological Association, because the official language of the journal changed from Korean to English. The Korean Journal of Urology was first published in 1960. The Korean title of the journal was the 'Taehan Pinyogikwa Hakhoe Chapchi,' but with the August 1979 issue, it was renamed as the 'Taehan Pinyogikwa Hakhoe chi.' In February 2009, the title of the journal was changed to the English 'Korean Journal of Urology' to increase the international recognition of the journal [1]. Owing to the recognition of its scientific excellence, the Korean Journal of Urology (KJU) was indexed in SCOPUS and EMBASE, which are international scientific search engines on the web, in 2008. The KJU is a peer-reviewed, monthly publication covering clinical and basic science information relevant to physicians and researchers in the field of urology. Because the incidences, characteristics, and management of diseases vary according to region and race, the KJU will provide international readers access to Asian data on various urological diseases. The topics of the KJU include urological oncology, laparoscopy/robotics, lasers in urology, voiding dysfunction, female urology, sexual dysfunction, male infertility, pediatric urology, investigative urology, and results of innovative treatments, providing readers with an up-to-date guide to international developments in urology. Starting in 2010, we will publish special features including online video clips and illustrations of newly developed surgical techniques. When the KJU became an entirely English journal, we invited 10 international editorial board members from Asia-Pacific areas who are highly qualified world leaders in each field. We will continuously invite world- renowned editorial board members and reviewers. The Information for Authors of the KJU was revised in January 2010. The Journal publishes original articles, invited review articles, illustrated surgical techniques in urology, case reports, and letters to the editor in the fields of clinical and experimental urology. We reinforced the research and publication ethics. Any research that deals with a clinical trial is recommended to be registered with a primary national clinical trial registration site or other sites accredited by the WHO or the International Committee of Medical Journal Editors. Recently, we were awarded a grant for globalization of the journal from the Korean Federation of Science and Technology Societies. This grant will support the KJU in becoming indexed in Pubmed Central and SCI(E). The KJU is currently a free access journal that opens in Google Scholar and will become an open access journal soon. This coming year, the editorial team of the KJU will apply for our journal to be indexed in Pubmed Central and Medline. We hope that the KJU will soon be recognized among other high-quality, international, peer-reviewed journals.

Thermal lasers in urology

Abstract The thermal effect is the most common effect of tissue–laser interaction in urology. With the widespread use of endoscopic instruments laser applications in urology have dramatically increased. Various urological conditions can nowadays be successfully treated with lasers. In the treatment of benign prostate hyperplasia (BPH), holmium laser enucleation of the prostate (HoLEP) and photoselective vaporization of the prostate (PVP) have proven as reliable, safe and effective treatment alternatives. Urethral strictures, bladder neck sclerosis and ureteropelvic junction (UPJ) obstruction have also been treated successfully with lasers; however their role is limited to selected cases and conditions. For the treatment of malignant diseases, lasers can be applied in early stage upper urinary tract transitional cell carcinoma (UUTTCC) and penile carcinoma. This review summarizes the potential and limitations of thermal lasers in urology.

Complicaciones de la utilización del láser

In this paper we analyze the complications of various applications of laser in urology. The search of a minor aggression trying to diminish complications have lead the development of the use of this energy in the most frequent urologic pathologies. Its use in the fragmentation of ureteral stones has modified the therapeutic algorithms. In prostatic diseases we analyze the various options from enucleation (HoLEP) to green laser photovaporization, reviewing the bibliographic references and comparing them with our experience. There are other therapeutic applications that use this energy as a cutting instruments for urethral, ureteral, ureteropyelic junction stenosis, or bladder neck section.

Urologic laser types and instrumentation

Though the primary role of lasers in urology has always been in the treatment of urolithiasis, there are several other indications for their use. There are many different types of lasers currently available, each with unique properties conducive to treating certain disorders. As such, it is critical that today's urologist understands each laser's characteristics in order to optimize patient selection and treatment. The lasers which are primarily used in urologic applications include the carbon dioxide (CO2) laser; the Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG); the Potassium Titanyl Phosphate (KTP) laser and the Holmium:YAG (Ho:YAG) laser. This review focuses on the unique characteristics of each of these lasers as well as the instrumentation needed utilize and deploy these tools in the urinary tract.

Nuevas perspectivas de la laserterapia

We review the current trends and new perspectives of the use of laser in urology, analyzing different fields in which this energy has been used. In lithotripsy, the laser has modified the therapeutic algorithms for ureteral lithiasis. Moreover, the possibility of using laser with flexible ureteroscopes is enabling the performance of intracorporeal in situ renal lithotripsy. New lasers such as Erbium:yag, more effective and more innocuous than holmium are currently under development. The research in new fibers, more flexible, economic and long-lasting is the next challenge in this field. In BPH, although the KTP laser has obtained and extraordinary diffusion for a certain type of prostate volume, new lasers such as thulium and diode, are in competition with holmium laser in the field of prostatic enucleation due to their precise cut. The application of laser in photodynamic therapy for urological cancers and tissue welding are currently new promising objectives of research.

XXV aniversario del grupo de trabajo de endoscopia-litiasis-laparoscopia (lel)

XXV Anniversary Of The Endoscopy-Lithiasis–Laparoscopy (Lel) Working Group: IntroductionThe purpose of this article is to describe the structural vicissitudes and content changes experienced by our Work Group, LEL over the last twenty-five years. Materials and methodsThe compiled material comes from three sources: the author’s experiences; the iconography provided by the co-ordinators; and the data obtained from programmes, letters, etc.This material has been analyzed and organized into six stages and the following has been highlighted in each of these: specific data from each day; key structural data; and the most relevant facts during the period. ResultsVarious proposals have been made as a result of the Group’s activity: to formally record the endoscopy techniques for the lower urinary tract and extend them to the upper urinary tract: URS and percutaneous surgery, the comprehensive treatment of lithiasis, the defence of our own techniques (such as UTR versus alternatives), as well as to provide an expert opinion on new technologies (laser in urology), and to replace open surgery techniques with others belonging to the Group: PNL and laparoscopy. ConclusionsFor 25 years, the LEL Work Group has stayed active and closely united. It has participated in both internal and external structural changes prompted by the appearance of spectacular new developments that have emerged over this period of time: endoscopic access to the upper urinary tract; comprehensive treatment of lithiasis; and alternatives to traditional surgeries (percutaneous surgery, laparoscopic surgery).

Lasers in urology

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

History of lasers

The developments of laser technology from the cradle of modern physics in 1900 by Planck to its latest medical boundaries is an exciting example of how basic physics finds its way into clinical practice. This article merits the protagonists and their contribution to the steps in this development. The competition between the different research groups finally led to the award of the Nobel Prize to Townes, Basov and Prokhorov in 1964 for the scientific basis on quantum electronics, which led to the construction of oscillators and amplifiers based on the laser-maser principle. Forty-three years after Einstein's first theories Maiman introduced the first ruby laser for commercial use. This marked the key step for the laser application and pioneered fruitful cooperations between basic and clinical science. The pioneers of lasers in clinical urology were Parsons in 1966 with studies in canine bladders and Mulvany 1968 with experiments in calculi fragmentation. The central technological component for the triumphal procession of lasers in urology is the endoscope. Therefore lasers are currently widely used, being the tool of choice in some areas, such as endoscopical lithotriptic stone treatment or endoluminal organ-preserving tumor ablation. Furthermore they show promising treatment alternatives for the treatment of benign prostate hyperplasia.

The future of lasers in urology

The use of laser applications in urology has undergone significant advances over the past 20 years. Laser technology is now used in a wide variety of procedures, and has become the primary treatment modality or standard of care for many urologic conditions. Despite these advances, a number of challenges still face laser utilization in urologic practice. Recent work has illuminated the potential improvement and further optimization of this field. Improvements in types of lasers, the wavelength of energy used, optical fiber delivery systems, precision of laser application and cost reduction have served to further improve laser technology and extend the potential applications.

Technical aspects of lasers in urology

During the course of history a variety of laser principles have been introduced in surgery. Some erroneous developments probably could have been kept out of the market place if not for the magic which accompanies the acronym LASER and with more understanding for the underlying principles governing the process when light meets tissue. The interaction of light with tissue is exemplified on the basis of natural body chromophores when compared with available lasers at different wavelengths and operational modes. Furthermore the meaning of fibre flexibility and durability is elucidated.

Laser in Urology – State of the Art

Abstract A review of the papers presented at the 16th Annual Meeting of Deutsche Gesellschaft fur Lasermedizin (June 17 and 18, 2007 in Munich) and the last two years’ publications show the still raising interest in urological laser applications. Lasers are used for the treatment of various benign and malignant urological disorders such as benign prostatic hyperplasia, stone disease, strictures and tumors of the urinary tract, and intravesical foreign bodies. Laser prostatectomy has successfully entered the era of prospective randomized studies. Ureteroscopic Holmium:YAG Laser lithotripsy has been generally accepted first choice for treatment of upper urinary stones. Regarding the large number and high quality of publications in the field of urological laser application, we are looking forward to an exciting session during our 16th Annual Meeting of DGLM.

Therapeutic applications of lasers in urology: an update

There has been renewed interest in the use of lasers for minimally invasive treatment of urologic diseases in recent years. The introduction of more compact, higher power, less expensive and more user-friendly solid-state lasers, such as the holmium:yttrium–aluminum–garnet (YAG), frequency-doubled neodymium:YAG and diode lasers has made the technology more attractive for clinical use. The availability of small, flexible, biocompatible, inexpensive and disposable silica optical fiber delivery systems for use in flexible endoscopes has also promoted the development of new laser procedures. The holmium:YAG laser is currently the workhorse laser in urology since it can be used for multiple soft- and hard-tissue applications, including laser lithotripsy, benign prostate hyperplasia, bladder tumors and strictures. More recently, higher power potassium–titanyl–phosphate lasers have been introduced and show promise for the treatment of benign prostatic hyperplasia. On the horizon, newer and more effective photosensitizing drugs are being tested for potential use in photodynamic therapy of bladder and prostate cancer. Additionally, new experimental lasers such as the erbium:YAG, Thulium and Thulium fiber lasers, may provide more precise incision of soft tissues, more efficient laser lithotripsy and more rapid prostate ablation. This review provides an update on the most important new clinical and experimental therapeutic applications of lasers in urology over the past 5 years.

Laser in urology – State of the art

Laser in urology – State of the art

Circumcision with the Nd:YAG Laser Contact Technique Compared with Conventional Surgery

Objective: The present study was undertaken to assess the degree of efficacy of the Nd:YAG laser contact technique as compared with conventional surgery in circumcision. Background Data: Neodymium:yttriumaluminum- garnet (Nd:YAG) laser in urology has many advantages over conventional surgical techniques. Clinical comparative studies between the Nd:YAG laser and conventional circumcision in boys have not yet been reported. Methods: This study compared the clinical effects of the Nd:YAG laser contact technique with those of a conventional technique on the grounds of certain perioperative parameters, including operative time, length of hospital stay, postoperative complications and morbidity. Seventy-five patients undergoing circumcision were reviewed retrospectively. Operative time, length of hospital stay, and postoperative morbidity were analyzed. Differences between contact Nd:YAG laser surgery and conventional surgery were compared. Results: Operative time in the Nd:YAG laser treated group was significantly increased compared with conventionally treated patients (31.6 ± 3.6 min vs. 19.8 ± 1.9 min, p < 0.001). The length of hospital stay and early and late postoperative morbidity were significantly decreased in circumcised patients with the Nd:YAG laser contact technique compared with the conventional technique regardless of the indication for surgery (9.71 ± 4.5 h vs. 11.8 ± 5.1 h, p < 0.05 and 2% vs. 9%, p < 0.05 and 0% vs. 7.2%, p < 0.05, respectively). Conclusions: These results indicate that the Nd:YAG laser contact technique is an effective laser-assisted procedure alternative to the conventional technique in circumcision with virtually no significant postoperative morbidity.

The Laser in Urology (State of the Art)

Summary Our 30 year experience of research and development for the use of lasers in medicine have led to novel procedures in tumor diagnosis and therapy and stone destruction, so that the laser nowadays in certain indications in urology is not only an alternative but also the way of choice. In cases of severe inflammations (e. g. interstitial cystitis, bilharziosis) the laser coagulation seems to be very helpful. In the meantime the ILC has been proved as an excellent methode for prostatectomy in adenomas till to 60 cm 3 , avoiding fluid uptake and severe bleeding. In case of prostate cancer or other tumors and metastases the effectiveness of interstitial laser application, possibly combined with a parenterally or orally applicated photosensitizers, must be checked. The experiences with athermic, pulsed micro beam lasers on in vitro fertilisation or in gentechniques are very promising.

HOLMIUM LASER VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE: A RANDOMIZED PROSPECTIVE TRIAL WITH 1-YEAR FOLLOWUP

The high-powered holmium:YAG laser can be used for incision, ablation and resection of the prostate. The technique of holmium laser resection of the prostate is compared to transurethral prostatic resection for surgical management of benign prostatic hyperplasia in this prospective randomized study. A total of 120 urodynamically obstructed cases were randomized to holmium laser or transurethral prostatic resection. All eligible patients were assessed preoperatively and at 3 weeks, and 3, 6 and 12 months postoperatively with an American Urological Association symptom score, peak urinary flow rate, and questionnaires concerning sexual function and continence. Preoperative pressure flow study, ultrasound prostate volume assessment and post-void residual volume measurement were repeated at the 6-month visit. All complications were noted. Holmium laser and transurethral resections resulted in significant improvements in symptom score, quality of life score, peak urinary flow rate and post-void residual urine measurements. Operating time was significantly longer in the holmium group but nursing contact time, catheter time and hospital stay were significantly less compared to the transurethral prostatic resection group. Urodynamic results were equivalent at 6 months. There were fewer side effects in the holmium group. Effects on continence, potency and symptoms were similar with 1-year followup. Holmium and transurethral resections of the prostate appear to be equivalent in surgical management of bladder outflow obstruction due to benign prostate hyperplasia. Perioperative morbidity was less in the holmium group.

Lasers in urology.

BJU InternationalVolume 84, Issue 2 p. 204-211 Lasers in urology Floratos, Floratos University Hospital Nijmegen, The NetherlandsSearch for more papers by this author De La Rosette, De La Rosette University Hospital Nijmegen, The NetherlandsSearch for more papers by this author Floratos, Floratos University Hospital Nijmegen, The NetherlandsSearch for more papers by this author De La Rosette, De La Rosette University Hospital Nijmegen, The NetherlandsSearch for more papers by this author First published: 25 December 2001 https://doi.org/10.1046/j.1464-410x.1999.00163.xCitations: 37 Jjmch de laRosette University Hospital Nijmegen, The Netherlands, PO Box 9101, 6500 HB Nijmegen, The Netherlands. e-mail: J.delarosette@uro.azn.nl. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume84, Issue2July 1999Pages 204-211 RelatedInformation

A systematic review of the clinical efficacy and effectiveness of the holmium:YAG laser in urology.

A systematic review of the clinical efficacy and effectiveness of the holmium:YAG laser in urology.

Guest Editorial: Special Issue: Lasers in Urology

Journal of Clinical Laser Medicine & SurgeryVol. 16, No. 1 Guest Editorial: Special Issue: Lasers in UrologyUNYIME O. NSEYOUNYIME O. NSEYOSearch for more papers by this authorPublished Online:29 Apr 2009https://doi.org/10.1089/clm.1998.16.1AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "Guest Editorial: Special Issue: Lasers in Urology." , 16(1), p. 1FiguresReferencesRelatedDetails Volume 16Issue 1Feb 1998 To cite this article:UNYIME O. NSEYO.Guest Editorial: Special Issue: Lasers in Urology.Journal of Clinical Laser Medicine & Surgery.Feb 1998.1-1.http://doi.org/10.1089/clm.1998.16.1Published in Volume: 16 Issue 1: April 29, 2009PDF download

泌尿器科とレーザー

泌尿器科とレーザー