Laser therapy in the treatment of urological diseases

Applications of lasers (light amplification by stimulated emission of radiation) in various disciplines of medicine including Urology are well developed. Urology is among the medical specialties that apply many different types of laser systems to treat a broad spectrum of clinical conditions ranging from genital, bladder and urethral tumors to the treatment of benign prostate hyperplasia (BPH), urethral strictures, and stones. The specific application of various laser systems depends on the characteristics of the laser itself, delivery media for the beams, laser-tissue interaction and the desired effect. These complex conditions require an intensive and continuous exchange of information between non-medical researchers and physicians to verify "what is currently technically possible and what is medically needed". Only this exchange can lead to the development of new laser systems. While lasers have become the treatment of choice in some conditions, they could not, despite excellent clinical results, replace conventional therapy options in others. Nonetheless, the use and the introduction of lasers of different wavelengths forces urologists to keep step with the fast developing laser technology. This paper reviews current indications for clinical laser applications relevant to urology and the advantages and disadvantages of using lasers for the management of various urological lesions.

[1]  A. Hofstetter.  Laser in der Urologie , 1995 .

[2]  A. Shanberg,et al.  Treatment of interstitial cystitis with the neodymium-YAG laser. , 1987, The Journal of urology.

[3]  P. Tan,et al.  Cystoscopic diagnosis of bladder cancer by intravesical instillation of 5-aminolevulinic acid induced porphyrin fluorescence--the Singapore experience. , 2000, Annals of the Academy of Medicine, Singapore.

[4]  Martin Kriegmair,et al.  CELLULAR FLUORESCENCE OF THE ENDOGENOUS PHOTOSENSITIZER PROTOPORPHYRIN IX FOLLOWING EXPOSURE TO 5‐AMINOLEVULINIC ACID , 1995, Photochemistry and photobiology.

[5]  L. Kiemeney,et al.  Predictability of recurrent and progressive disease in individual patients with primary superficial bladder cancer. , 1993, The Journal of urology.

[6]  H Stepp,et al.  Fluorescence cystoscopy following intravesical instillation of 5-aminolevulinic acid: a new procedure with high sensitivity for detection of hardly visible urothelial neoplasias. , 1995, Urologia internationalis.

[7]  P. Alken,et al.  Der Wert der transurethralen Nachresektion beim oberflächlichen Harnblasenkarzinom , 1994 .

[8]  J. Bowman.  Reaction pathways. , 1991, Science.

[9]  N. Schmeller,et al.  New aspect of photodynamic diagnosis of bladder tumors: fluorescence cytology. , 2002, Urology.

[10]  Martin Kriegmair,et al.  5-Aminolevulinic Acid-Induced Fluorescence Endoscopy for the Detection of Lower Urinary Tract Tumors , 1999, Urologia Internationalis.

[11]  G. Jakse,et al.  Role of lasertripsy in the management of ureteral calculi: experience with alexandrite laser system in 232 patients. , 1996, Journal of endourology.

[12]  A. Schilling,et al.  Use of the neodymium-YAG laser in the treatment of ureteral tumors and urethral condylomata acuminata. Clinical experience. , 1986, European urology.

[13]  U. Nseyo,et al.  Photodynamic therapy using porfimer sodium as an alternative to cystectomy in patients with refractory transitional cell carcinoma in situ of the bladder. Bladder Photofrin Study Group. , 1998, The Journal of urology.

[14]  Popken,et al.  Kidney‐preserving tumour resection in renal cell carcinoma with photodynamic detection by 5‐aminolaevulinic acid: preclinical and preliminary clinical results , 1999, BJU international.

[15]  J. Parrish,et al.  The pulsed dye laser for fragmenting urinary calculi. , 1987, The Journal of urology.

[16]  U. Engelmann,et al.  Significance of Fluorescence Cystoscopy for Diagnosis of Superficial Bladder Cancer after Intravesical Instillation of Delta Aminolevulinic Acid , 2001, Urologia Internationalis.

[17]  W P Mulvaney,et al.  The laser beam in urology. , 1968, The Journal of urology.

[18]  J. Wickham,et al.  INITIAL EXPERIENCE WITH A PULSED DYE LASER FOR URETERIC CALCULI , 1986, The Lancet.

[19]  P Schneede,et al.  Predictability of the size of laser-induced lesions in T1-Weighted MR images obtained during interstitial laser-induced thermotherapy of benign prostatic hyperplasia. , 1998, Journal of magnetic resonance imaging : JMRI.

[20]  Tao Shen,et al.  Spectroscopic Studies and Photodynamic Actions of Hypocrellin B in Liposomes¶ , 2001, Photochemistry and photobiology.

[21]  S. Iinuma,et al.  A mechanistic study of cellular photodestruction with 5-aminolaevulinic acid-induced porphyrin. , 1994, British Journal of Cancer.

[22]  M. Curwen,et al.  The site of recurrence of non-infiltrating bladder tumours. , 1978, British journal of urology.

[23]  A. Hofstetter,et al.  The pulsed dye laser versus the Q‐switched Nd:YAG laser in laser‐induced shock‐wave lithotripsy , 1988, Lasers in surgery and medicine.

[24]  W Roessler,et al.  5-aminolevulinic acid-induced fluorescence endoscopy applied at secondary transurethral resection after conventional resection of primary superficial bladder tumors. , 1999, Urology.

[25]  J. Hong,et al.  Diagnostic efficacy of fluorescence cystoscopy for detection of urothelial neoplasms. , 2001, Journal of endourology.

[26]  D. Jocham,et al.  Long-term experience with integral photodynamic therapy of TIS bladder carcinoma. , 1989, Ciba Foundation symposium.

[27]  D. Phillips,et al.  Fluorescence distribution and photodynamic effect of ALA-induced PP IX in the DMH rat colonic tumour model. , 1992, British Journal of Cancer.

[28]  C. De Nunzio,et al.  Role of 5-aminolevulinic acid in the diagnosis and treatment of superficial bladder cancer: improvement in diagnostic sensitivity. , 2001, Urology.

[29]  J. Pensel.  Dosimetry of the neodymium-YAG laser in urological applications. , 1986, European urology.

[30]  A. Hofstetter.  Treatment of urological tumors by neodymium-YAG laser. , 1986, European urology.

[31]  Z. Malik,et al.  Inactivation of erythrocytic, lymphocytic and myelocytic leukemic cells by photoexcitation of endogenous porphyrins. , 1989, Journal of photochemistry and photobiology. B, Biology.

[32]  K. Berg,et al.  The influence of iron chelators on the accumulation of protoporphyrin IX in 5-aminolaevulinic acid-treated cells. , 1996, British Journal of Cancer.

[33]  H. O. Beisland,et al.  Laser in the treatment of localized prostatic carcinoma. , 1984, The Journal of urology.

[34]  R. Benson,et al.  Laser photodynamic therapy for bladder cancer. , 1986, Mayo Clinic proceedings.

[35]  H. Huland,et al.  Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder. , 1991, The Journal of urology.

[36]  B. Pogue,et al.  PHOTODYNAMIC THERAPY OF CANCER , 2022 .

[37]  H. Klocker,et al.  Photodynamic Diagnosis with 5–Aminolevulinic Acid in the Treatment of Secondary Urethral Tumors: First in vitro and in vivo Results , 2001, European Urology.

[38]  T. Dougherty,et al.  HOW DOES PHOTODYNAMIC THERAPY WORK? , 1992, Photochemistry and photobiology.

[39]  J Moan,et al.  PHOTOCHEMOTHERAPY OF CANCER: EXPERIMENTAL RESEARCH , 1992, Photochemistry and photobiology.

[40]  R Baumgartner,et al.  Early clinical experience with 5-aminolevulinic acid for the photodynamic therapy of superficial bladder cancer. , 1996, British journal of urology.