Transurethral Electrovaporization Research Articles

Comparison of the short-term efficacy and safety of bipolar transurethral electro vaporization and holmium laser enucleation of the prostate for moderate and large benign prostatic enlargement

BackgroundTo compare the efficacy and safety of bipolar transurethral vaporization of the prostate (B-TUVP) with holmium laser enucleation of the prostate (HoLEP) for moderate [prostate volume (PV) 30–80 ml] and large (≥ 80 ml) benign prostatic enlargement (BPE).Materials and methodsMale patients with lower urinary tract symptom (LUTS) or urinary retention who underwent B-TUVP or HoLEP treatment in two regional centers were respectively enrolled. Patient characteristics and treatment outcomes were retrospectively compared between B-TUVP and HoLEP.ResultsIn patients with moderate and large prostate volume,B-TUVP showed shorter operative time (P < 0.001) and less hemoglobin decrease (P < 0.001) than in HoLEP. In uncatheterised patients, voiding symptoms and patients’ quality of life improved after B-TUVP and HoLEP, but these improvement rates were consistently bigger in HoLEP than in B-TUVP. In catheterised patients, the rate of achieving catheter-free status after surgery was higher in HoLEP than in B-TUVP for patients with PV > 80 ml.(P < 0.001) The incidence of postoperative fever was higher in B-TUVP than in HoLEP for patients with PV 30–80 ml (P < 0.001) but not for those with PV > 80 ml.(P=0.08) The Incidence of postoperative stress incontinence(SUI) was higher in HoLEP than in B-TUVP for patients with moderate and large prostate volume.ConclusionsThere are few studies that investigated the short-term efficacy and safety of second-generation B-TUVP in comparison with HoLEP for moderate and large BPE. Improvement in LUTS and achievement of catheter-free status were predominant in HoLEP, and these outcomes were more prominent in patients with large BPE of PV > 80 ml. However, B-TUVP resulted in less blood loss, shorter operative duration, and less SUI suggesting that B-TUVP is also well-tolerated surgical modality.

Short-term efficacy and safety of second generation bipolar transurethral vaporization of the prostate (B-TUVP) for large benign prostate enlargement: Results from a retrospective feasibility study.

BackgroundTo investigate the efficacy and safety of a second-generation bipolar transurethral electro vaporization of the prostate (B-TUVP) with the new oval-shaped electrode for large benign prostatic enlargement (BPE) with prostate volume (PV) ≥100ml.Materials and methods100 patients who underwent second-generation B-TUVP with the oval-shaped electrode for male lower urinary tract symptom (LUTS) or urinary retention between July 2018 and July 2020 were enrolled in this study. The patients’ characteristics and treatment outcome were retrospectively compared between patients with PV <100ml and ≥100ml.Results17/41 (41.5%) cases of PV ≥100ml and 24/59 cases (40.7%) of PV <100ml were catheterised due to urinary retention. The duration of post-operative catheter placement and hospital-stay of PV ≥100ml (3.1±1.3 and 5.6±2.3 days) were not different from PV <100ml (2.7±1.2 and 5.0±2.4 days). In uncatheterised patients (N = 59), post-void residual urine volume (PVR) significantly decreased after surgery in both groups, however, maximum uroflow rate (Qmax) significantly increased after surgery only in PV <100ml but not in PV ≥100ml. Voiding symptoms and patients’ QoL derived from International Prostate Symptom Score (IPSS), IPSS-QoL (IPSS Quality of Life Index) and BPH Impact Index (BII) scores, significantly improved after B-TUVP in both groups. Catheter free status after final B-TUVP among patients with preoperative urinary retention was achieved in 18/24 (75.0%) and 14/17 (82.1%) cases in patient with <100ml and ≥100ml, respectively. There was no significant difference in post-operative Hb after B-TUVP, which was 97.0±5.4% of baseline for PV <100ml and 96.9±6.1% for PV ≥100ml and no TUR syndrome was observed.ConclusionsThis is the first study investigating short-term efficacy and safety of second-generation B-TUVP with the oval-shaped electrode on large BPE. B-TUVP appears to be effective and safe for treating moderate-to-severe lower urinary tract symptoms and urinary retention in patients with large BPE.

Determining the correlation between transition zone index with international prostate symptom score and peak flow rate on clinical outcome after transurethral resection of the prostate in benign prostatic hyperplasia

Background: Benign prostatic hyperplasia (BPH) is a pathologic process which has common contribution to lower urinary tract symptoms (LUTS) in aging men. International Prostate Symptom Score (IPSS) is an important means of assesment in the clinical research of LUTS and BPH. Free flow rates (peak flow rate or Qmax) give an indirect measure for the probability of obstruction whereas subvesical obstruction only can be measured by invasive pressure-flow studies. Among the various surgical or minimally invasive techniques available for BPH like Intraprostatic stents (temporary/permanent), transurethral needle ablation (TUNA), transurethral microwave thermotherapy (TUMT), transurethral electrovaporization of prostate (TUVP), Transurethral incision of prostate (TUIP), lasers (Nd: YAG (Neodymium-doped yttrium aluminium garnet), Ho: YAG (Holmium yttrium aluminium garnet), potassium titanyl phosphate (KTP), diode, thulium laser) etc, transurethral resection of the prostate (TURP) is a safe and effective procedure. Comparison of difference in the pre and postoperative ultrasonic prostatic volume with amount of tissue resected at operation has established the accuracy of the method. The aims of present study are to determine the correlation between transition zone index with international prostate symptom score (IPSS) and peak flow rate (Qmax) on clinical outcome after TURP in BPH patients.Methods: A prospective study was conducted to determine the effect of the extent of tissue resection on symptom improvement after TURP in men and to evaluate any potential correlation between prostate size and outcome.Results: Total of 52 patients studied prospectively. Transitional zone (TZ) index was found to have a significant correlation with the clinical outcome.Conclusions: Symptomatic improvement after TURP will depend on the amount of tissue resected in terms of IPSS and peak flow rates.

Effects of cluster nursing in bladder spasm patients after TURP

Objective To investigate the risk factors of bladder spasm after transurethral resection of the prostate (TURP) and the intervention effect of cluster nursing. Methods From January 2011 to December 2012, the clinical data of 120 cases of TURP patients were analyzed for the risk factors of bladder spasm after TURP. According to the results of the analysis, cluster nursing plan was constructed. The 150 TURP patients from January 2013 to December 2014 were selected as the control group and given routine nursing care. The 150 TURP patients from January 2015 to December 2016 were recruited as the observation group and given cluster nursing. The postoperative bladder spasm, catheter blockage and patients satisfaction were compared between the two groups. Results The results of the multivariate regression analysis indicated that the score of Self-rating Anxiety Scale, air bag water injection, unstable bladder or low compliance bladder, and postoperative constipation were independent factors of bladder spasm after TURP (OR=1.427, 0.092, 13.263, 27.437; P<0.01) . After the implementation of cluster nursing, the postoperative bladder spasm rate was 6.0%, and the catheter blockage rate was 5.3%, which were both lower than those of the control group (28.4%, 29.3%) , and the differences were statistically significant (χ2=25.726, 30.149; P<0.01) . The patient postoperative satisfaction of the observation group was (95.21±4.63) , which was higher than that of the control group (85.76±4.23) , and the difference was statistically significant (t=14.469, P<0.01) . Conclusions Cluster nursing can reduce the rate of bladder spasm and catheter blockage after TURP, and increase patients' satisfaction after surgery. Key words: Risk factors; Transurethral electrovaporization of the prostate; Bladder spasm; Cluster nursing

A comparative evaluation of Transurethral Electro-Vaporisation of Prostate (TUEVP) versus Transurethral Resection of Prostate (TURP) for Benign Prostatic Hyperplasia (BPH)

Background: Transurethral Resection of Prostate (TURP) has been gold standard of surgical treatment of BPH but nonetheless it is associated with many complications. Transurethral Electro-Vaporisation of Prostate (TUEVP) is a new promising modality which has similar results and better side effect profile.Methods: A prospective, randomised, comparative study was conducted on seventy patients with symptomatic BPH in the Surgery department of Sanjay Gandhi Memorial Hospital, Delhi over two years starting from December 2014. These patients were randomly assigned to two groups- A and B using online random number generator. Patients of group A underwent TUEVP and those of group B underwent TURP. Overall patient satisfaction, patient safety, procedural efficacy and operative ease of the surgeon were compared.Results: Mean operative time (42.1 min in TUEVP and 38.4 min in TURP) and complication rates (14.3% in TUEVP and 11.4% in TURP) were comparable in both groups. Intra-operative bleeding was significantly less (2.9% in TUEVP; 22.9% in TURP) and visual clarity of operative field was significantly better in TUEVP (persistently clear in 97.1% in TUEVP; 77.1% in TURP). The mean catheterisation time (1.14 days in TUEVP and 2.51 days in TURP) and hospitalisation time (2.14 days in TUEVP and 3.1 days in TURP) were significantly shorter in TUEVP.Conclusions: TUEVP is comparable to TURP in terms of patient satisfaction, safety, operative time and procedural efficacy. TUEVP has shorter duration of catheterisation and hospitalisation and is better than TURP in terms of intra-operative bleeding and operative ease of the surgeon.

Recurrent symphysitis culminating in pelvic ring fracture after hyperextended transurethral prostate resection and vaporization with symphysis erosion: a case report

BackgroundShort-term and long-term complications of transurethral prostate resection can be different in nature. Capsule perforation and subsequent fistulation after resection and electrovaporization is seldom reported in the literature.Case presentationHere we report the case of a 79-year-old caucasian man with capsule perforation after transurethral prostate resection and electrovaporization resulting in a severe and recurrent symphysitis and subsequent pelvic ring fracture. The bladder-symphysis fistulation was surgically removed and additional orthopedic surgery could be avoided after definitely solving the urological problem.ConclusionsUrologists should be aware of rare complications after transurethral resection and electrovaporization of the prostate.

MPC1 and MPC2 expressions are associated with favorable clinical outcomes in prostate cancer.

BackgroundCancer cells exhibit an altered metabolism, which is characterized by a preference for aerobic glycolysis more than mitochondrial oxidation of pyruvate. Mitochondrial pyruvate carrier 1 (MPC1) and mitochondrial pyruvate carrier 2 (MPC2) play a bottleneck role by transporting pyruvate into mitochondrial through the mitochondrial inner membrane. Therefore, their protein expression in cancers may be of clinical consequences. There are studies showing low levels of MPC1 expression in colon, kidney and lung cancers, and the expression of MPC1 correlates with poor prognosis. However, the expression status of MPC1 and MPC2 in prostate cancer (PCA) is unclear.MethodsIn this study, expression of MPC1 and MPC2 in LNCaP and DU145 prostate cancer cell lines was examined by immunocytochemistry (ICC) and Western blotting. Compared to the LNCaP cells, lower levels of MPC1 and MPC2 expression in the DU145 cell line was identified. We then extended our study to 88 patients with prostate cancer who underwent transurethral electro-vaporization of prostate or radical prostatectomy at the First Affiliated Hospital of Zhengzhou University, Henan, China. Patient-derived paraffin embedded PCA specimens were collected for immunohistochemistry (IHC). Correlations with clinicopathologic factors were evaluated by Chi-square or Fisher´s exact probability tests. Overall survival (OS) rates were determined using the Kaplan-Meier estimator. The Cox proportional hazard regression model was used in univariate analysis and multivariate analysis to identify factors significantly correlated with prognosis.ResultsLinear regression analysis revealed that MPC1 expression level was positively correlated with MPC2 expression (r = 0.375, P = 0.006) in the prostate cancers. MPC1 expression was negatively associated with UICC stage (P = 0.031). While UICC stage (P < 0.001) and lymph node metastasis (P = 0.002) were negatively associated with MPC2 expression. Positive MPC1 or MPC2 expression in cancer tissues was significantly associated with higher OS (P < 0.05). The multivariate analysis showed that both MPC1 and MPC2 expressions in PCA were independent prognostic factors for higher OS (For MPC1: RR = 0.654, 95% CI: 0.621-0690, P < 0.001; For MPC2: RR = 0.696, 95% CI: 0.660-0.734, P < 0.001).ConclusionsOur study indicates that MPC1 and MPC2 expressions are of prognostic values in PCAs and that positive expression of MPC1 or MPC2 is a predictor of favorable outcome.

The research progress of bladder spasm after the transurethral electrovaporization of prostate

Transurethral electrovaporization of prostate(TUVP) is generally carried out in recent years, which is a method for the treatment of benign prostatic hyperplasia, with less bleeding, short operation time, rapid recovery. The results of clinical treatment show it is more safe and effective. But the problem on the occurrence of bladder spasm after the operation has been plagued by the medical staff. In order to offer references for clinical nursing work, the paper reviewed the influencing factors of bladder spasm and nursing progress of this field after the TUVP. Key words: TUVP; Benign prostatic hyperplasia; Bladder spasm

Outcome of the TURP-TUVP sandwich procedure for minimally invasive surgical treatment of benign prostatic hyperplasia with volume larger than 40cc over a 4-year period in Nigeria

Transurethral resection of the prostate (TURP) remains the reference standard for the surgical treatment of infravesical obstruction due to benign prostatic hyperplasia (BPH). While TURP has proven long-term efficacy, it has some associated morbidities. This has fuelled the drive to develop alternative cost-effective options with comparable functional outcomes and a superior safety profile. The aim of this study was to evaluate transurethral electro-vaporization of the prostate (TUVP) combined with TURP as a “sandwich” procedure in relieving the obstruction caused by BPH with volume of 40-80cc. The medical notes of 57 consecutive patients with moderate to severe bladder outflow symptoms due to BPH who underwent TURP-TUVP as a sandwich procedure from April 2007 to March 2011 were reviewed for prostatic volume, duration of surgery, volume of irrigation fluid used intra-operatively and post-operative hospital stay. Similarly, the patients IPSS, Qmax and PVR were evaluated pre- and postoperatively. The mean patient age was 64.1 years (SD = 9.1), mean prostatic volume was 56.8 cc (SD = 8.9), mean resection time was 69.5 minutes (SD = 23.9) and mean volume of irrigation fluid (1.5% Glycine) used was 21.5 L (SD = 4.9).The mean post-operative hospital stay was 3.5 days (range 3- 4 days). Overall, 11 (19%) patients had blood transfusion, there was no incidence of TUR syndrome and one mortality was recorded from primary plasminolysis. Compared with baseline values, on follow-up at 3 months the IPSS, Qmax and PVR had improved significantly. Bladder neck stenosis occurred in 3 patients and was successfully treated with bladder neck incision. The sandwich combination of TURP and TUVP for the surgical treatment of BPH with volume larger than 40cc had satisfactory patient safety profile and resulted in significant improvement in IPSS, Qmax and PVR on follow-up at 3 months.

Thulium Laser Vaporesection Versus Transurethral Electrovaporization of the Prostate in High-Risk Patients with Benign Prostatic Hyperplasia

The purpose of this study was to compare the safety and efficacy of the thulium laser vaporesection and transurethral electrovaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia. From September 2009 to March 2011, 98 consecutive patients with symptomatic bladder outlet obstruction caused by benign prostatic hyperplasia received either thulium laser vaporesection of the prostate (n=42) or transurethral electrovaporization of the prostate (n=56) at our institution. Functional follow-up included measurement of International Prostate Symptom Score, quality of life score, maximal urinary flow rate, and post-voiding residual urine volume. All complications were recorded. Thulium laser vaporesection of the prostate was slightly superior to transurethral electrovaporization of the prostate in catheterization time (2.1±0.9 vs. 4.5±1.3 days, p<0.0001) and postoperative hospital stay (4.4±1.8 vs. 6.6±2.0 days, p<0.0001). Within the observation period, both groups had a significant improvement from baseline in subjective or objective success rates; however, no significant difference was found between the two groups. Peri- and postoperative complications were fewer in the thulium laser group. Thulium laser vaporesection of the prostate is as effective as transurethral electrovaporization of the prostate in managing high-risk patients, with sufficient tissue ablation and acceptable hemostasis, and has the advantage of less morbidity and shorter catheter time and postoperative hospital stay.

The Impact of Transurethral Procedures for Benign Prostate Hyperplasia on Male Sexual Function: A Meta‐Analysis

The effect of transurethral procedures for benign prostate hyperplasia (BPH) on male sexual function is still controversial, and we conducted this meta-analysis to compare the effects of different transurethral surgical procedures for the treatment of symptomatic BPH on male erectile function (EF) and ejaculatory function (EJF). Databases, including MEDLINE, EMBASE, and the Cochrane Controlled Trial Register, were searched to identify randomized controlled trials (RCT) that compared watchful waiting, transurethral electrovaporization (TUEVP) or holmium laser treatment (HLT) with transurethral resection of the prostate (TURP). Trials were included if they were RCTs, contained fully available data, compared with conventional TURP for BPH, and referred to male EF and EJF. A total of 12 RCTs involving a total of 1889 subjects were selected for analysis, including 2 trials comparing TURP and watchful waiting, 6 comparing TURP with TUEVP, and 4 comparing TURP with HLT. TURP was associated with a higher occurrence of retrograde ejaculation compared with watchful waiting but not to TUEVP (P = .95) or HLT (P = .37) and associated with a lower incidence of male erectile dysfunction compared with TUEVP (P = .04) but not HLT. According to the analysis, TURP lead to a higher prevalence of retrograde ejaculation compared with watchful waiting but had less of an effect on EF than TUEVP. TURP did not have a significantly different effect on EF or EJF compared with HLT.

Comparison on the nursing effect of different nursing modes in patients with dysuria after transurethral electrovaporization of the prostate

Objective To study and compare the nursing effect of different nursing modes in patients with dysuria after transurethral electrovaporization of the prostate. Methods 50 patients with dysuria after transurethral electrovaporization of the prostate from January 2007 to March 2011 were selected as research objects,and they were randomly divided into group A and group B with 25 cases in each group,group A was taken care with routine nursing method,group B adopted evidence-based nursing mode,then the rate of self- maturate,usage rate of catheter,time of indwelling catheter,maximum flow rate,relapse of dysuria,satisfaction degree,treatment compliance and quality of life before and after the nursing of two groups were analyzed and compared. Results The rate of self-maturate and satisfaction degree of group B were higher than those of group A,usage rate of catheter and relapse of dysuria were lower than those of group A,time of indwelling catheter was shorter than that of group A,treatment compliance and quality of life were all better than those of group A,there were significant differences. Conclusions The nursing effect of evidence-based nursing mode in patients with dysuria after transurethral electrovaporization of the prostate is good,it can significantly improve the quality of life and is popular among patients. Key words: Evidence-based nursing; Transurethral electrovaporization of the prostate; Dysuria; Effect

The Efficacy of Transurethral Electrovaporisation in Management of Benign Prostatic Hyperplasia: Results of 3rd Year

The Efficacy of Transurethral Electrovaporisation in Management of Benign Prostatic Hyperplasia: Results of 3rd Year

MP-05.06 Transurethral Electrovaporization of the Prostate (TUVP) Using the Olympus Button Vaporization Electrode: A Comparative Study

MP-05.06 Transurethral Electrovaporization of the Prostate (TUVP) Using the Olympus Button Vaporization Electrode: A Comparative Study

The clinical efficacy and safety of transurthral electrovaporization of the prostate (TUVP) for benign prostatic hyperplasia( BPH) at high risk

Objective To investigate the clinical efficacy and safety of transurthral electrovaporization of the prostate(TUVP) for benign prostatic hyperplasia( BPH) at high risk.Methods Forty-eight patients with BPH at high risk were treated with transurthral electrovaporization of the prostate(TUVP).The clinical data and therapeutic results were measured.Results All patients went through the perioperiative period safely and had been followed up for 3 to 14 months.Postvoid residual ( PVR) , the International Prostate Symptom Score (IPSS) and quality of life (QOL) before operations were (97.5 ± 16.9) ml, ( 28.4 ± 2.3 ) score and (5.5 ±0.6) score respectively.Three months after operation ,PVR ,IPSS and QOL were( 30.2 ± 12.3 ) ml, (8.2 ± 1.3 ) score and( 1.9 ±0.5) score respectively,there was significant difference between them(t =22.31,53.16,31.94,all P<0.05).Conclusion TUVP is an effective and safe method in treating BPH patients at high risk. Key words: Prostatic hyperplasia; Transurethral electrovaporization of prostate

The Effect of 5-alpha Reductase Inhibitors on the Efficacy of Photoselective Vaporization of the Prostate with 120 W GreenLight HPS Laser

Purpose: To evaluate the effect of preoperative 5-alpha reductase inhibitor (ARI) administration on the operative results of photoselective vaporization of prostate with 120W GreenLight HPS laser. Materials and Methods: Data were collected from 98 benign prostatic hyperplasia (BPH) patients who underwent transurethral electrovaporization of prostate by 120W Greenlight HPS laser between Jan. 2010 and Dec. 2010. We compared the time of operation, the energy required in lasering, postoperative maximum uroflow velocity, change in residual urine volume and complications between 5-ARI administrating group and control group. Results: 56 patients administrated 5-ARI at least 3 months before surgery. 30 and 26 patients administrated finasteride and dutasteride, respectively. Mean follow up period was 4.1±1.8 months. Mean age of the subjects and mean prostate volume were not different. Mean change of postoperative hemoglobin, lasing time and energy required in lasering were greater in 5-ARI administrating group. There were 3 and 1 cases of acute urinary retension in 5-ARI administrating group and control group, respectively. Conclusions: The mean change of hemoglobin and mean energy required in lasering were greater and mean lasing time was longer in the patients who administrated 5-ARI before photoselective vaporization of prostate by 120W Greenlight HPS laser. Further investigation and extensive study will be needed to confirm these results. 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Pneumatic lithotripsy and transurethral electrovaporization of the prostate in bladder calculus with benign prostate hyperplasia

Objective To evaluate the effective therapy methods in bladder calculi with benign prostatic hyperplasia. Methods Using pneumatic lithotripsy and transurethral electrovaporization of the prostate in 10cases with bladder stones and benign prostatic hyperplasia. Results The average operative time was 100 minutes(range 60-120 minutes). All patients were withdrawn Foley catheter and voiding easy and smooth. None had complications such as transurethral resection syndrome, hemorrhea and vesical perforation. Conclusion Combination of pneumatic and transurethral electrovaporization of the prostate that is safe and effective in the treatment of bladder calculi with benign prostate hyperplasia. Key words: Benign prostatic hyperplasia; Bladder calculi; Transurethral electrovaporization of the prostate; Pneumatic lithotripsy

Clinical Analysis of Cystitis Gandularis(Report of 47 Cases)

Objective To study the clinical features and the efficacy of transurethral electrovaporization for the treatment of cystitis glandularis.Methods 47 cases were treated with transurethral electrovaporization and bladder instillation of medicine.Results Among 46 cases followed up for 6 to 60 months,the mean time was 22 months,39 cases were cured,4 cases imp roved,and 3 cases recurred 10～19 months after treatment.Conclusion Transurethral electrovaporization combined with bladder instillation of medicine is effective in treatment of cystitis glandularis,Cystitis glandularis correlated with carcinoma of bladder,So these patients must abide by a long term follow-up,reexamination and subsequent treatment. Key words: Cystitis Gandularis; Diagnosis; Treatment

Ambulante Holmiumlaserenukleation und mechanische Morcellierung der Prostata

Holmium laser enucleation of the prostate (HoLEP) is increasingly being used as an alternative to transurethral resection of the prostate (TURP) and transurethral electrovaporisation of the prostate (TVP), the"gold standard" procedures for treating symptomatic benign prostatic hyperplasia. Mechanical tissue morcellation was introduced in 1998, and its efficiency could be improved. We investigated the efficiency and complication rate of a morcellator in a day-case setting. From 2004 to 2008, 137 men were treated with an 80W holmium:YAG laser and subsequent tissue morcellation. The average patient age was 68.0+/-7.1 (51-86) years. Morcellation time was 8.6+/-6.8 (1-35) min. The weight of the resected tissue was 36.6+/-30.0 (2-175) g. The total time for the procedure was 69.6+/-28.7 (29-150) min, and the efficiency of morcellation was 5.0+/-2.6 (0.2-11.5) g/min. The complication rate due to morcellation was 4.3%. HoLEP with mechanical morcellation is safe even in a day-case setting. The total procedure time approximates that for TURP, so a longer theatre time loses significance as an argument against the method. Complications are rare and not severe. Further technical improvement is desirable.

Transurethral Partial Cystectomy With Continuous Wave Laser for Bladder Carcinoma

To our knowledge we established a new technique to vaporize and incise the full-thickness bladder wall and peel off the entire muscular layers with a 2 microm continuous wave laser to treat bladder carcinoma. Nine patients were treated transurethrally with a 2 microm laser under sacral block. This 2 microm laser was used to incise the full-thickness bladder wall around the tumors. The entire bladder wall was peeled between the detrusor muscle layer and outer connective tissues. Tumors with full-thickness detrusor muscle layers at the base were removed together and sent for pathological examination. Intraoperative hemorrhage and postoperative complications were observed, and pathological staging and postoperative followup were performed. All operations were successful. Mean +/- SD operative time was 8.7 +/- 2.6 minutes (range 7 to 15) per patient. Perioperative blood loss was minimal. There was no obturator nerve reflection and no hemorrhage was detected after surgery. Bladder perforation occurred in 1 case. Pathological stage of the tumors was T1 and T2a. Patients were followed for 6 to 9 months postoperatively with no recurrence at the resection site. This series included highly selected patients treated by a single high volume surgeon. To our knowledge this is the first report of a 2 microm laser used to treat bladder carcinoma. It can be applied to precisely vaporize and incise the full-thickness bladder wall and peel it between detrusor muscle layers and outer loose connective tissues, thus completing partial cystectomy for bladder carcinoma.