Laser in urology

Abstract

The Neodymium YAG-laser is particularly suited for endoscopic urologic surgery because the YAG-laser light can be conducted in flexible fibers. Superficial bladder tumours can be treated under local anaesthesia in the outpatient department. The frequency of local recurrences is low, significantly lower than after electroresection or electrocoagulation. Selected cases of T2-muscle invasive bladder tumours can be cured with laser coagulation applied subsequently to transurethral resection. Combined treatment with electroresection and laser coagulation of localized prostatic cancer is a promising method which compares favourably with results obtained by other treatment modalities. Tumours in the upper urinary tract can be laser-treated through ureteroscopes or nephroscopes, but the treatment should be limited to low stage, low grade tumours. Laser is the treatment of choice for intraurethral condylomatas. Laser treatment of pencil carcinoma gives excellent cosmetic and functional results and few local recurrences. Laser lithotripsy is a new technique for treatment of ureteric stones and photodynamic laser therapy is a promising technique for treatment of carcinoma in situ in the bladder epithelium. However, neither of these techniques are available for clinical use in Norway as yet.