Three-dimensional sonographic guidance for interstitial laser therapy in benign prostatic hyperplasia

In recent years, interstitial laser therapy was introduced to provide a new treatment of benign prostatic hyperplasia (BPH). However, the precise positioning of the laser fibers has remained a major unsettled issue. Three-dimensional (3-D) transrectal ultrasound scanning permits precise differentiation of the prostatic zones, in particular the transition zone, which is enlarged in BPH. Initially, a volume scan of the prostate is obtained. On the monitor, three sections of the prostate in the coronal, sagittal, and horizontal planes are displayed simultaneously. This new 3-D technology enables precise and reproducible positioning of the laser fibers at any selected site in the adenoma under sonographic guidance, thus providing the basis for complete laser prostatectomy. Placement of the laser fibers proved to be precise, quick, and uncomplicated.