High-power potassium-titanyl-phosphate laser fibres for endovaporization of benign prostatic hyperplasia: how much do they deteriorate during the procedure?

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Study Type – Therapy (case series)Level of Evidence 4OBJECTIVE•To assess the residual power delivered at the tip of a high-power (80 W) potassium-titanyl-phosphate (KTP) laser (80 W Green Light PVTM, Laserscope®; American Medical Systems, Minnetonka, MN, USA) at the end of a photoselective vaporization of the prostate (PVP) procedure, as well as the deflection angle of the laser beam.MATERIALS AND METHODS•In total, 65 laser fibres were collected at the end of PVP procedures indicated for symptomatic benign prostatic hyperplasia over a period of 17 months. PVP was performed by two senior urologists.•The power of laser beam at tip exit was measured for each fibre at the end of the procedures using a photodiode whose signal was amplified, and then quantified by a volt multimeter.•The deflection angle was measured using a graduated sphere.RESULTS•Approximately 70% of fibres delivered less than 40 W at the end of the procedure, which is less than the vaporization threshold.•Some 9% of fibres had lost their diffraction capacity with a significant alteration of laser beam angulation. These values were not operator dependent.CONCLUSIONS•The data show that a large proportion of laser fibers deliver a significantly underpowered beam at the end of the procedures.•This seems to be caused by peroperative destruction of the fibers, which results in a progressive loss of efficacy of PVP during procedures.

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