High-power potassium-titanyl-phosphate or lithium triboride laser photoselective vaporization prostatectomy for benign prostatic hyperplasia: A systematic approach

Background and Purpose: We describe a safe and reproducible technique for potassium-titanyl-phosphate (KTP) and lithium triboride (LBO) laser photoselective vaporization prostatectomy (PVP). Technique: With the patient under anesthesia in the dorsal lithotomy position, cystoscopy is performed. Using a high-power KTP/LBO laser system, a groove is created along the lateral-median lobe junction from the bladder neck to the verumontanum to delineate the margins of vaporization. The remainder of the ipsilateral lobe is vaporized using a series of overlapping passes along the length of the groove. The contralateral lobe is vaporized in a similar manner. Finally, the median lobe is vaporized from lateral to medial. A 20F urethral catheter is placed at the conclusion of the procedure. Results: This technique has been successful in 240 consecutive patients over an 18-month period. Conclusion: This systematic approach has been safe, effective, and reproducible for KTP/LBO laser PVP. It has become our standard technique for this procedure.