Safety and Efficacy of Eraser Laser Enucleation of the Prostate: Preliminary Report

Purpose: We ascertained the safety and efficacy of the 1,318 nm diode Eraser laser (Rolle and Rolle, Salzburg, Austria) for transurethral enucleation of the prostate. This laser has been successfully used to resect lung metastasis. It cuts and coagulates vascular rich tissue safely and effectively. We describe a prospective, randomized trial of Eraser laser prostate enucleation vs bipolar transurethral prostate resection. Materials and Methods: A total of 60 patients with lower urinary tract symptoms suggesting bladder outlet obstruction and a mean prostate size of 59.5 ml on transrectal ultrasound were randomized to Eraser laser prostate enucleation or bipolar transurethral prostate resection. Patients were assessed preoperatively, and 1 and 6 months postoperatively. Results: Eraser laser prostate enucleation was equivalent to bipolar transurethral prostate resection in improvement in International Prostate Symptom Score, maximal flow rate and quality of life. Laser enucleation was significantly superior to bipolar transurethral resection for measured blood loss (mean +/- SD 116.83 +/- 97.02 vs 409.83 +/- 148.61 ml), catheter time (mean 32.80 +/- 8.74 vs 65.73 +/- 13.72 hours) and hospital time (mean 45.13 +/- 14.77 vs 91.20 +/- 11.76 hours, each p < 0.05). Using the validated Clavien-Dindo system there were 3 grade Id and 1 grade II complications. Conclusions: Eraser laser prostate enucleation and bipolar transurethral prostate resection were equally safe and effective to relieve bladder outflow obstruction and lower urinary tract symptoms. This laser technique has the advantage of less blood loss, and shorter catheter time and hospital stay.