The introduction of lasers into operative medicine and advances in fiberoptic technology have made a significant contribution to minimally invasive surgery. This book was written to raise awareness of the capabilities and advant ages of lasers in urological surgery and to make this tech nology more widely accessible. The book reflects the cumulative experience of 25 years of laser research and clinical application, starting in 1972 with studies on laser tissue interactions, endoscopic studies with fiberoptic "sutures;' and the first clinical use of lasers in 1975 and 1976. These early efforts were followed by the develop ment oflaser lithotripsy in the early 1980 s and a Lubeck based research program leading to the development of a "smart" laser lithotriptor (Lithognost) in the late 1980s. There have been recent advances in the field of photo dynamic diagnosis based on the use of locally adminis tered photo sensitizers, a development that will redefine the role of the Nd:YAG laser in the treatment of bladder cancer. Perhaps the most interesting concept is the inter stitiallaser therapy of prostatic hyperplasia and, perhaps one day, certain forms of prostatic cancer. We have also developed a technique, first described in 1986, for the laser treatment of schistosomal bladder lesions. I dedicate this book to the many pioneers oflaser medi cine and to all the colleagues and research assistants who accompanied me on this journey. I cannot name them all; their names can be found in more than 300 publications.

Theoretical Principles

1 Laser Physics
2 Safety Aspects of Laser Surgery
3 User Certification, Equipment Safety, and Laser Safety Officer
Clinical Laser Use
4 Thermal Effects of Lasers
4.1 External Genitalia
4.1.1 Condylomata Acuminata and Other Viral Skin Lesions
4.1.2 Penile Carcinoma
4.2 Urethra
4.2.1 Laser Treatment of Urethral Strictures
4.3 Bladder
4.3.1 Bladder Cancer
4.3.2 Urinary Schistosomiasis
4.3.3 Interstitial Cystitis (Hunner's Ulcer, Submucous Fibrosis)
4.4 Ureter
4.4.1 Ureteral Tumors
4.5 Pyelocaliceal System
4.5.1 Pyelocaliceal Tumors
4.6 Laparoscopic Pelvic Lymphadenectomy
4.7 Laser-Assisted Vasovasostomy
4.8 Prostate
4.8.1 Benign Prostatic Hyperplasia
4.8.2 Prostatic Carcinoma
5 Photodynamic Diagnosis and Therapy of Superficial Bladder Cancer
5.1 Theoretical Principles
5.2 Photodynamic Diagnosis
5.3 Photodynamic Therapy
6 Laser Lithotripsy of Ureteral Stones
7 Future Prospects
Instrumentation.