Partial prostatectomy using Nd:YAG laser for the management of canine prostate carcinoma (THESIS VERSION)

Abstract

Objective—To report a technique for partial prostatectomy by laser dissection and to evaluate outcome and complications in dogs with prostate carcinoma (PCA). Study Design—Experimental and clinical case series. Animals—Four normal dogs and 8 dogs with PCA. Methods—Subcapsular partial prostatectomy, sparing the urethra and the dorsal aspect of the prostatic capsule, using Nd:YAG laser dissection to remove the prostatic parenchyma and control hemorrhage was performed in 4 normal dogs and subsequently in 8 dogs with histologically confirmed PCA. Additional treatment of PCA dogs included local application of interleukin-2 and systemic administration of meloxicam. Prostate size, complications, and survival time were recorded. Laser-associated thermal damage to surrounding tissue was evaluated by histology. Results—In normal dogs, no damage to the dorsal prostatic capsule or urethra was detected. In PCA dogs, median survival was 103 days (range, 5–239 days). Three dogs died from complications within 16 days, whereas 5 (median survival, 183 days; range, 91–239 days) had improvement or resolution of clinical signs. Urinary incontinence did not occur. Conclusion—Laser assisted subcapsular partial prostatectomy can be performed in dogs with PCA without development of postoperative incontinence. Clinical Relevance—Subcapsular partial prostatectomy is a potential palliative treatment for PCA in dogs and may lead to the resolution of clinical signs for several months.Appendix: In order to support findings in Chapter 3, histological evaluation is performed on the prostate and laser-resected tissue parts after in vivo subcapsular laser prostatectomy of the normal dog.