Visual Laser Coagulation of the Prostate Using Intraurethral Gel Anesthesia and Light Intravenous Analgesia and Sedation

Twenty-eight patients with symptomatic bladder outlet obstruction secondary to benign prostatic hyperplasia were treated as outpatients by visual laser coagulation of the prostate using only intraurethral gel anesthesia and light intravenous sedation and analgesia. No premedication was administered. Laser coagulation was performed with the Myriadlase side-firing fiber using a standard Sharplan neodymium: YAG laser source at 40 W power setting, and 650 (516-1000) J/g of prostate tissue was delivered. Patient acceptance was favorable. All remained relaxed, cooperative, and without pain during the procedure. None of the patients required any further anesthesia. There was no significant change in blood pressure, pulse rate, or peripheral oxygen saturation measurements during the procedure. Any patient who feels comfortable with a diagnostic cystoscopy being performed using intraurethral gel anesthesia should find this anesthesia protocol acceptable for laser coagulation of the prostate.