Micron Continuous Wave Laser Research Articles

Two-Micron Continuous-Wave Laser-Assisted Neuroendoscopy: Clinical Experience of Two Institutions in 524 Procedures

To present the clinical experience of 2 neurosurgical centers with the use of a 2-micron continuous-wave laser (2μ-cwL) system as standard tool in neuroendoscopic procedures and to discuss the safety and efficacy of this system. In total, 469 patients underwent neuroendoscopic procedures using 2μ-cwL between September 2009 and January 2015. All patient data were retrospectively reviewed. In total, 241 (51%) patients were children and 228 (49%) adults. Mean age was 27.5 years (range: 3 days to 83 years). Intraoperative ultrasonography or neuronavigation were used to guide ventricular or cyst puncture and for intraventricular or intracystic orientation if necessary. A total of 524 neuroendoscopic procedures using 2μ-cwL were performed. Laser-assisted endoscopic third ventriculostomy was the most common procedure in 302 (64%) patients. Cyst fenestration was performed in 124 (26%), septostomy in 45, tumor biopsy in 41, tumor resection in 8, and choroid plexus coagulation in 3 patients. There was no intraoperative complication directly attributable to the use of laser and an overall procedural complication rate of 4.8%. This large series of 2μ-cwL as a routine tool in neuroendoscopic procedures demonstrates that 2μ-cwL is safe for endoscopic third ventriculostomy, septostomy, cyst fenestration, and intraventricular tumor biopsy or resection. As a cutting and coagulation tool, it combines the action of mechanical tools like forceps, balloons, and scissors plus those of electric tools. It therefore renders neuroendoscopic procedures more straightforward with a minimum need to change tools.

AB027. Clinical analysis of transurethral vaporesection of the prostate using the 2-micron continuous wave laser for the treatment of benign prostatic hyperplasia

The present study aimed to evaluate the effects of transurethral dividing vaporesection of the prostate in the management of benign prostatic hyperplasia (BPH). From October 2006 to June 2012, a total of 377 patients who met the inclusion criteria with low urinary tract symptom secondary to BPH were treated transurethrally under epidural or sacral anesthesia using the dividing vaporesection technique. Of these 203 had a prostate volume of ≤80 mL and 174 had a prostate volume of >80 mL. Pre- and post-operative data were evaluated for prostate-specific antigen (PSAs, post-void residual volume (PVR), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS) and quality of life (QoL). Out of the 377 cases, 369 cases were followed up to 5 years finally. All the surgical procedures were successfully conducted under epidural or general anesthesia. Mean operation time was 79±21 minutes, and mean retrieved prostatic tissue was 22.7±5.6 g. Resected prostatic tissues could be easily flashed out of the bladder. There were no significant differences in serum sodium concentrations and hemoglobin levels before and after the surgery. Mean catheter time and hospital stay was 121±47 hours and 5.5±2.0 days respectively. During follow up, Qmax increased from 8.1±3.7 mL/s preoperatively to 4.5±3.9 mL/s by the end of the follow up (P<0.05), IPSS and QoL-Score improved from 23.6±4.7 and 3.8±0.9 to 5.7±2.6 and 1.6±1.2 respectively (P<0.05), and PVR decreased from 244±73 to 28±22 mL. The data indicated that transurethral vaporesection of prostate using the 2-micron continuous wave laser system is a safe and effective treatment for BPH.

Efficacy and safety of RevoLix 2 micron continuous wave laser vaporesection in treatment for senile patients with benign prostatic hyperplasia

The clinical efficacy and safety of RevoLix 2 μm continuous wave laser vaporesection in treatment of senile patients with benign prostatic hyperplasia (BPH) were retrospective evaluated. In 291 senile patients with BPH, 213 received 2 μm continuous wave laser vaporesection (group A) and other 78 patients received transurethral resection of prostate (TURP, group B). Compared with group B the intraoperative blood loss was less, the bladder irrigation time, catheter time and hospitalization time were shorter in group A. The subjective or objective indexes were all significantly improved at 3 and 12 months after laser treatment. The improvements of international prostate symptom score (IPSS), IPSS-S, overactive bladder symptom score (OABSS) in patients of 70-79 were more marked than those of 80 or older. Patients with mild overactive bladder (OAB) had less improvement in IPSS and IPSS-S than those with moderate-severe OAB which suggest that the storage symptoms could be improved significantly by removing obstruction. Key words: Lasers therapy; Prostatic hyperplasia; Transurethral resection of prostate

AB056. The use of multi-endoscopic technique combined with cryoscalpel and 2 micron continuous wave laser in treating male urethra stricture

ObjectiveTo discuss the safety and clinical value of multi-endoscopic technique combined with cryoscalpel and 2 micron continuous wave laser in treating male urethra stricture.MethodsWe retrospectively analyzed the clinical effects of multi-endoscopic technique combined with cryoscalpel and 2 micron continuous wave laser in the treatment of 32 cases of male urethra stricture. Patients were followed up 6-24 months after operation and the effects were observed.ResultsAll the operations were successfully accomplished and urethra was unobstructed after the catheter was removed. After the operations, the urinary flow rate was remarkably increased from (3.9±2.5) mL/s to (29.5±9.3) mL/s (P<0.05).ConclusionsMulti-endoscopic technique combined with cryoscalpel and 2 micron continuous wave laser is safe and effective for treatment of male urethra stricture.

Comparative Study of 2um Laser versus Ho lmium Laser for the Resection of Non-Muscle Invasive Bladder Cancer

Objective: To compare the safety and efficacy of conventional monopolar transurethral resection of bladder tumor (TURBT), 2-micron continuous-wave laser and holmium laser resection techniques in the management of primary nonmuscle invasive bladder tumor (NMIBT). Methods: From January 2009 to January 2013, patients newly diagnosed primary NMIBC were enrolled in this study. The patients were divided into conventional TURBT group (n=70), holmium laser group (n=70) and 2-micron laser group (n=70) randomly. Operative time, postoperative bladder irrigation, catheterization time, hospitalization time, complications included obturator nerve reflex, bladder perforation, blood transfusion, and 2-year tumor recurrence rate were documented in all patients. Results: Characteristics of patients and tumors in all three groups were compared before surgery. There was no significant difference in operative time among the three groups. Compared with the conventional TURBT group, both 2-micron and holmium groups had less intra operative and postoperative complications, including obturator nerve reflex, bladder perforation, and postoperative bladder irritation. There were no significant differences among the three groups in the blood transfusion rate and incidence of urethral stricture. Patients in the 2-micron and holmium groups had less catheterization and hospitalization time than those in the conventional TURBT group. There was no significant difference in the 2-year tumor recurrence rate among the three groups. Conclusion: Our results demonstrated that the use of 2-micron (thulium) laser and holmium laser in the management of NMIBT were superior to conventional monopolar TURBT, while there were no significant differences between 2-micron laser and holmium laser. However, 2-micron laser and holmium laser did not have an obvious advantage over conventional TURBT in 2-year tumor recurrence rate. A longer follow-up period and larger numbers of patients are necessary to demonstrate the present result in the future.

En bloc transurethral resection with 2-micron continuous-wave laser for primary non-muscle-invasive bladder cancer: a randomized controlled trial

To evaluate the practicability of en bloc transurethral resection with 2-micron continuous-wave laser as treatment for primary non-muscle-invasive bladder cancer (NMIBC). This was a single-center, randomized, controlled trial involving 142 patients with newly diagnosed NMIBC. All patients were randomly assigned in a 1:1 ratio to receive either laser treatment or conventional transurethral resection of bladder tumor (TURBT). All patients received intravesical chemotherapy. Follow-up was performed in 18 months. Primary outcome measure was difference of tumor recurrence rate at the end of study. Baseline characteristics did not differ between patients in two groups. Operation time was longer in laser group than in TURBT group (56.5 ± 37.4 vs. 41.0 ± 29.4 min, P = 0.017). Obturator nerve reflection was noted during TURBT in 18 patients, whereas none was noted during laser resection. Number of T1 tumors was higher in the laser group (25 vs. 15, P = 0.047). According to Kaplan-Meier survival curves, there was no statistical difference in the rate of recurrence in 18 months (P = 0.383). All recurrences were out of the site of first resection, and there was no progression in tumor grade. Two-micron continuous-wave laser did not diminish tumor recurrence rate in primary NMIBC for 18-months observation. However, T1 tumors were significantly higher among laser group. Clear and complete tumor bases were easily conserved by laser resection, which may enable pathologists to distinguish the T stages of bladder cancer more easily. Further studies need to be done in future.

Comparison of the safety and efficacy of conventional monopolar and 2-micron laser transurethral resection in the management of multiple nonmuscle-invasive bladder cancer

To compare the safety and efficacy of conventional monopolar transurethral resection of bladder tumour (TURBT) and 2-micron continuous-wave laser resection (2-µm laser) techniques in the management of multiple nonmuscle-invasive bladder cancer (NMIBC), and to investigate long-term effects on tumour recurrence. Patients with multiple NMIBC were randomized to receive TURBT or 2-µm laser in a nonblinded manner. All patients received intravesical chemotherapy with epirubicin (40 mg/40 ml) for 8 weeks, beginning 1 week after surgery, followed with monthly maintenance therapy for 12 months. Three-year follow-up data of preoperative, operative and postoperative management were recorded. In total, 120 patients were included: 56 in the TURBT group and 64 in the 2-µm laser group. Intra- and postoperative complications (including bladder perforation, bleeding and irritation) were less frequently observed in the 2-µm laser group compared with the TURBT group. There were no significant differences in first time to recurrence, overall recurrence or occurrence of urethral strictures. The 2-µm laser resection method was more effective than TURBT in reducing rates of intra- and postoperative complications, but offered no additional benefit regarding tumour recurrence.

Efficacy of transurethral bladder neck incision with 2-micron continuous wave laser (RevoLix) for the management of bladder outlet stricture in women.

To report the short-term outcome of transurethral bladder neck incision with 2-micron continuous wave laser (RevoLix) in the management of bladder outlet stricture in women. In a prospective study, between January 2011 and February 2012, a total of 14 patients with the complaint of difficulty in voiding underwent transurethral bladder neck incision with 2-micron 120-W continuous wave laser (RevoLix) using low energy setting (24 W). Pre-operative investigations included international prostate symptom score (IPSS) and quality of life index evaluation, multi-channel urodynamic study, and urethrocystoscopy. Postoperative clinical and urodynamic improvement were compared with the pre-operative data. Of 14 patients, 4 and 10 subjects suffered from chronic urinary retention and difficulty in voiding, respectively. The mean age of the patients was 55.1 years (range, 40 to 67 years). Mean operation time and postoperative follow-up period were 23.8 minutes (range, 15 to 30 minutes) and 10.2 months (range, 6 to 18 months), respectively. Median IPSS improved significantly from 28 points at baseline to 11 points postoperatively (P = .005). Median quality of life score also improved from 4.2 points to 1.5 points (P = .005). None of the patients needed re-operation. Median post void residual urine decreased significantly after the procedure (101 mL versus 17 mL; P = .003). No significant complications and de-novo incontinence were noted in this study. Transurethral bladder neck incision with 2-micron continuous wave laser (RevoLix) may be used safely in the management of bladder outlet stricture in women with satisfactory short-term clinical outcomes.

Evaluation of Endoscopic Laser Excision of Polypropylene Mesh/Sutures Following Anti-Incontinence Procedures

We reviewed our experience with and outcome of the largest series to our knowledge of patients who underwent endoscopic laser excision of eroded polypropylene mesh or sutures as a complication of previous anti-incontinence procedures. A total of 12 female patients underwent endoscopic laser excision of suture/mesh erosions at 1 center during a 10-year period. Primary outcome variables were the requirement of additional endoscopic or open surgery to remove mesh/sutures. Secondary outcome variables were persistence of urinary symptoms, postoperative complications, continence status and requirement of additional anti-incontinence procedures. The mean interval from previous surgery to erosion was 59 months (range 7 to 144) and the duration of presenting symptoms ranged from 3 to 84 months (mean 19). Ten patients underwent endoscopic excision of the mesh/suture with the holmium:YAG laser and 2 underwent excision with the thulium laser. Mean operative duration was 19 minutes (range 10 to 25) and followup was 65.5 months (range 6 to 134). Postoperatively 6 patients remain asymptomatic and 2 required a rectus fascial sling for recurrent stress urinary incontinence. Four patients underwent a second endoscopic excision due to minor persistence of erosion. Only 1 patient ultimately required open cystotomy to remove the eroded biomaterial. No intraoperative complications were recorded and all patients are currently asymptomatic. Endoscopic laser excision is an acceptable first line approach for the management of eroded biomaterials due to its high long-term success rate and minimally invasive nature.

The RevoLix 2 Micron Continuous Wave Laser Vaporesection for the Treatment of High-Risk Patients with Benign Prostatic Hyperplasia

To evaluate the safety and efficacy of the RevoLix 70W 2 micron continuous wave laser vaporesection in the treatment of high-risk patients with benign prostatic hyperplasia (BPH). Forty-six high-risk patients (mean age, 82.6 y old) with BPH underwent 2-μm continuous wave laser vaporesection. The operative time, drop in hemoglobin, drop in serum sodium, indwelling catheterization time, operative complications, international prostatic symptom scores (IPSS), quality of life (QoL), urinary flow rate (Qmax), and post voiding residual urine volume (PVR) were observed. All 46 patients recovered without incident. The mean operative time was 68 ± 16.3 min. Occasional venous hemorrhage occurred during the operation, but no arterial hemorrhage was observed. Hemoglobin decreased from preoperative 15.0 g/dL to postoperative 14.3 g/dL, serum sodium decreased from preoperative 142.4 mmol/L to postoperative 141.6 mmol/L. IPSS decreased from preoperative 22 ± 6.2 to postoperative 9 ± 3.3, QoL scores decreased from 5.1 ± 0.7 to 2.1 ± 0.7, Qmax increased from 8.4 ± 5.2 to 21.2 ± 12.3 mL/sec, PVR decreased from 94.2 ± 60.2 to 21.6 ± 6.4 mL. The parameters were significantly different between pre- and postoperative results. The RevoLix 70W 2-μm continuous wave laser vaporesection is safe and effective in the treatment of high-risk patients with BPH.

Clinical observation on 2 micron laser for non-muscle-invasive bladder tumor treatment: single-center experience

To evaluate the efficacy and safety of 2 micron continuous wave laser resection of non-muscle-invasive bladder tumor (NMIBT) compared with holmium laser resection of bladder tumor (HoLRBT) and standard transurethral resection of bladder tumor (TURBT). Since April 2006 to August 2007, 97 patients with NMIBT were retrospectively collected in this study. All of them were classified into 3 groups, which were treated with 2 micron continuous wave laser resection, holmium laser resection and TURBT, respectively. The preoperative, intraoperative and postoperative clinical data were recorded and compared using SAS 6.12 statistical software. There were no differences with the preoperative characteristics among the three groups, except the diameter of the tumors. The maximum diameter of the tumors in 2 micron laser group was larger than the other two groups (P < 0.05). Two micron laser group was associated with less hemoglobin decrease compared with TURBT group (P < 0.05). All of the patients were followed and the recurrence rate of the three groups indicated no statistical significance (P > 0.05). In conclusion, 2 micron continuous wave laser resection of non-muscle-invasive bladder tumor is a safe and reliable treatment. With the distinguished hemostasis, it is an available optional treatment.

Histopathologic analysis of 2 micron continuous wave laser for the partial cystectomy of bladder urothelial carcinoma

To observe the histopathologic characteristics of 2 micron continuous wave laser transurethral partial cystectomy for the treatment of bladder tumor. A total of 54 patients with 65 bladder tumors underwent 2 micron laser via transurethral by caudal or surface anesthesia from October 2007 to December 2008. It included 41 male and 13 female cases, and the age ranged from 27 to 81 years old with a mean of (66.2 +/- 12.4) years old. The operation evaporated and exsected the wall of urinary bladder, including tumor, submucosa and all muscular layers. Specimens were sent for pathology examination. The histomorphologic changes of raw surfaces were observed 1 week, 1 month, 3 months, 6 months and 1 year postoperation by cystoscopic and pathologic examinations. All the patients tolerated in the operation. Clinical stages of the tumor: T1 for 42 cases, T2 for 12 cases. All cases were followed-up for 1 to 14 months, with a mean of 8.5 months. Tumor recurrences were found in 2 cases, no one had recurrence in situ. The tumor, submucosa and all muscular layers can be resected completely by 2 micron continuous wave laser transurethral partial cystectomy. Pathologic staging can be judged correctly. The umbilication raw surface were infiltrated by fibrous connective tissue and chronic inflammatory cells 1 week postoperation. The umbilication changed shallow and transitional epithelial cells began to cover it 1 month postoperation. The umbilication disappeared and transitional epithelial cells cover the raw surface 3 months postoperation. There was no difference between the raw surface and normal bladder mucosa. 2 micron continuous wave laser for the treatment of bladder tumor can get the same clinical result as partial cystectomy. The pathologic staging can be judged correctly by the specimens.

Comparison of the nursings after transurethral partial cystectomy with two micron continuous wave laser and transurethral resection of bladder tumor (TURBT)

Objective To compare the postoperative nursing between transurethral partial cystectomy with 2 micron continuous wave laser and transurethral resection of bladder tumor (TURBT). Methods The patients who accepted operations for bladder tumor were divided into 2 micron laser group and TURBT group according to different operation methods. The following variables were statistically analyzed; the operation time, duration of bladder rinse, frequency of vesical hyperkinesia, the time of off-bed early ambulant and post operational hospital stay, etc. Results The 2 micron laser group was better than the TURBT group in the following aspects, including duration of bladder rinse, frequency of vesical hyperkinesia, the time of off-bed early ambulant and post operational hospital stay. Conclusions The transurethral partial cystectomy with 2 micron continuous wave laser has advantages in the following aspects; smaller wound, less hemorrhage and earlier recovery, etc. With the hypothesis of same therapy effect, it may reduce the pains of patients and the difficulty of nursing, which may improve the working efficiency of medical treatment and nursing. Key words: Bladder Tumor; Nursing; TURBT; 2 Micron Laser

MP-08.03: 2 Micron Continuous Wave Laser Vaporesection for Treatment of Large Volume Benign Prostatic Hyperplasia

2 micron laser vaporesection for the treatment of BPH is a new minimally invasive technique developed recently with the advantages of delicate operation, little hemorrhage and fast postoperative recovery. Proper incision sequence and enucleation technique can improve the efficiency and safety of excision. Forty-five patients with large BPH (>80g) were treated with 2 micron laser transurethral treatment during May 2007-February 2008 in our hospital, and good clinical effects were obtained. Our objective is to evaluate the safety and clinical effect of the RevoLix 70 Watt 2 micron continuous wave laser vaporesection for treatment of large volume benign prostatic hyperplasia (>80g).

Development and application of a porcine heart tissue model for 2 micron continuous wave laser endoscopic technique training

Objective To develop and evaluate a porcine heart tissue model for 2 micron continuous wave laser endoscopic technique training. Methods Defrozen porcine heart was used as the training tissue model and fixed in the training box. Ten junior surgeons without laser benign prostatic hyperplasia (BPH) treatment experience were involved in the evaluation training study. The training program was in 2 stages. In each stage, the trainees used 26 F laser resectoscope and performed laser resection and vaporization of left ventricle chorda tendineae cordis separately. The continuous irrigation with physiologic saline solution en-sured good visibility. Before the 1st and 2nd training stage, the trainees were trained with theory and technique by an experienced trainer. Time consumed in each technique and sum of resection and vaporization time was recorded for further analysis. Results This animal model had plentiful space in porcine left ventricle for precise resection and vaporization technique training. The training model was friendly used by trainees. The 2 stage training was conducted smoothly without risk event. There were 2 trainees who missed the second stage training and 8 groups of comparative data were collected. The first stage resection time, vaporization time and sum of resection and vaporization time were (166±94)s, (224±81)s, (390±145)s;those of the second stage were (75±28)s,(105±28)s, (180±46)s. Compared with the first stage, there was significant improvement in terms of resection time, vaporization time and sum of resection and vaporization time (P<0.01) in the second stage. Conclusious The establishment and application of defozen porcine heart as the 2 micron continuous wave laser endoscopic technique animal tissue training model is feasible. By using this model, trainees could improve their basic techniques, such as resection and vaporization technique. Key words: Laser surgery; 2 micron laser; Endoscopic technique; Models, animal

A Two Micron Continuous Wave Laser System Is Safe and Effective for Peritoneal Access & High Precision Dissection During NOTES® Procedures

Thulium lasers (TLs) have a 2 μm wavelength that matches the water absorption peak allowing efficient tissue cutting with limited thermal damage but have not been evaluated in the gastrointestinal tract. TLs are very flexible with an outer diameter of 365 to 550 μm enabling use as a guide wire. Objective: To evaluate the safety and efficacy of TLs for transcolonic and transgastric access for NOTES and to determine the ability to dissect tissue during NOTES procedures. Methods: Six acute animal experiments. Group 1 (3 animals): TL was used for transcolonic access to the peritoneal cavity by puncture of the colonic wall with insertion of the TL probe as a guide wire followed by balloon dilation over TL probe. Group 2 (3 animals): TL was used for transgastric access to the peritoneal cavity (similar technique as group 1) followed by laser-assisted dissection of the caudal pole of the kidney. In one animal of group 2 a therapeutic target (hematoma) was created by percutaneous puncture trauma of the kidney. Results: Translumenal access to the peritoneal cavity was achieved in 2 to 3 minutes in group 1 and in 7 to 10 minutes in group 2. In group 2, laser dissection of the parietal peritoneum & perinephric connective tissue was quick and efficient allowing easy access to the retroperitoneum with complete removal of a blood collection in the animal with puncture trauma. TL dissection demonstrated clean and rapid cutting, and excellent hemostasis. Peritoneoscopy and necropsy showed no damage to adjacent tissue and surrounding organs. Conclusions: The 2 μm continuous wave laser system was safe and effective for peritoneal access with ability to perform precise and safe dissection during NOTES procedures.

Two micron continuous wave laser vaporesection for treatment of large volume benign prostatic hyperplasia

Objective To evaluate the efficacy of the RevoLix 70 Watt 2 micron continuous wave laser vaporesection for treatment of large volume benign prostatic hyperplasia(BPH,＞80 g).Methods Forty-five patients with obstructive BPH were treated with 2 micron continuous wave laser vaporesection.The age ranged from 57 to 88 years with a mean of 69 years.Nine patients had acute urinary retention.Mean prostatic volume was(96±1 3)ml(ranged from 80 to 128 m1).Eight cases were given suprapubic puncture.All cases were successfully anesthetized by using epidural anesthesia.At the beginning of the operation,the distal resection border close to the verumontanum was marked and laser incisions were performed at 5 and 7 o'clock lithotomy position.Firstly,median lobe was vaporeseeted closely along capsule from bladder neck to verumontanum.Secondly,prostate at 12 o'clock was vaporesected until the capsule was reached,and both lateral lobes were dissected downward.Thirdly,the apical position was enucleated by sheath,and then prostate was vaporesected from the tissue in 12 o'clock position to the tissue at 6.It was important to follow the 2 principles:inner to extra,up to down.Transfusion rate,resection time,time of indwelling catheter,improvement in urinary flow rate(Qmax),international prostate symptom score(IPSS)and quality of life(QOL)were measured.Results AIl cases were successfully operated.except one whose left lateral lobe was left due to heavy fluctuation of heart rate and blood pressure in operation.The mean operation time was (104±12)min.Transfusions were not necessary in any patients.The catheter was indwelled for 3 to 5 d postoperatively.One case had urethral stricture 3 weeks after operation,and urinated free after 22 times urethral sounding disj unctively.All cases were followed up for 3-1 2 months.All patients were satisfied with voiding outcome,none had incontinence.Mean Qmax increased from(3.3±0.5)ml/spreoperatively to(16.5±1.5)ml/s postoperatively.IPSS decreased from 28.6±5.5 to 8.3±2.3 and QOL score decreased from 4.5±0.4 to 2.7±0.2.respectively(P＜0.01).No hemorrhage occurred after the operation.Conclusion RevoLix 2 micron continuous wave laser vaporesection for treatment of large volume BPH is a safe and effective relief therapy,and that in combination with enucleation could improve the efficiency of vaporesection. Key words: Vaporesection; Benign prostatic hyperplasia; 2 micron lasers

Two micron continuous wave laser vaporesection for the treatment of benign prostatic hyperplasia

Two micron continuous wave laser vaporesection for the treatment of benign prostatic hyperplasia

MP-20.18: Three-year review of 170 patients treated for BPH with RevoLix 2 micron continuous wave laser

MP-20.18: Three-year review of 170 patients treated for BPH with RevoLix 2 micron continuous wave laser

Bladder neck incision using a 70 W 2 micron continuous wave laser (RevoLix)

Postoperative bladder neck contracture continues to be a frequently occurring problem. Bladder neck incision (BNI) continues to be the standard mode of treatment. However, the recurrence rate appears to be high. Therefore alternative treatment options are still needed. We report about initial experience with the RevoLix 2 micron continuous wave laser for BNI after a 1-year follow-up. Fourteen patients with a second or third recurrence of bladder neck contracture after primary surgery were included into the trial. All patients reported high-grade obstruction and residual urine. BNI was performed using a 70 W 2-micron continuous wave laser (RevoLix). This laser utilizes the thulium as an active ion. Laser incisions were applied in 5 and 7o'clock lithotomy position. Remaining tissue was vaporized. Assessed outcomes were improvement in AUA-symptom-score, quality of life index and uroflowmetry, measured preoperatively, after 2 and 12 months postoperatively. Mean operating time was 7 min, mean catheterization time was 6.5 h. The mean maximum uroflow-rate improved from 9 ml/s preoperatively to 23 ml/s. AUA-symptom score improved from 22 to 8 points and quality of life index improved from four to one. Two patients developed restenosis so far. Although longer follow-up and larger sample size are needed, BNI with the RevoLix laser is a fast, safe and promising procedure in recurrent bladder neck sclerosis.