Application of Nd-YAG Lasers in Patients with Bladder Tumor

Kwon, Byoung Jo; Kwon, Sung Won

Abstract

Advances in laser technology have resulted in the creation of a new field of medical therapy. By virtue of the hyperdermic effects that can occur when intense energy of laser light is absorbed and transformed into heat, some lasers can be used to destroy tissue by vaporization or coagulation. The technology to allow extensive use in urology has only been recently perfected with the development of flexible light guides adaptable to standard urologic instruments. The Nd_YAG lasers can be attached to these urologic instruments and transmit through the water or the urine, so it has been prevailed in urologic disease, especially bladder tumor. We used the Nd_YAG lasers for the treatment of 25 patients with bladder tumor that admitted to the department of urology, Ewha Womans University Hospital during the period from October, l984 to July, 1986. The Nd_YAG lasers could be attached to the standard urologic instruments easily, so its use was very convenient and almost all portion of bladder wall could be irradiated. Intraoperative and postoperative bleeding was absent and indwelling of catheter wasn`t needed. During operation the obturator nerve reflex didn`t occur and the Jepth of coagulation could be controlled, so the risk of vesical perforation was almost nil. One year recurrence rate and progression rate to invasive tumor of 21 superficial bladder tumor patients was 28.6% and 4.8%, local recurrence didn`t occur in all patients. The main disadvantage of lasers was the incapability to get the pathologic specimen for staging and grading of tumor. Although laser therapy alone cannot obtain tissue specimen, it has various advantages and concomitant use with TUR increases the effectiveness of tumor therapy. So the lasers will act as an important role in the treatment of bladder tumor.