Introduction: Our preclinical study confirmed that compared with the commonly used 532nm, 980nm and 1470nm lasers, under the same power, the 450nm laser has the advantages of higher vaporization efficiency, thinner coagulation layer and lower noise, theoretically it’s more suitable for BPH surgery. In this study, we reported the initial experience of transurethral blue laser vaporization of prostate (BLVP). Methods: The novel blue laser surgical system is a dual wavelength laser system, which output 450nm laser (Max: 200W) and 976nm laser (Max: 50W), which are respectively used for tissue vaporization and coagulation by foot switch. Between May and September 2022, four centers were selected to perform BLVP using this novel blue laser surgical system and photo-selective prostate vaporization (PVP) was served as control with the patients ratio of 1:1. The international prostate symptom score (IPSS), Quality of life (QoL), maximum urinary flow rate (Qmax) before and 1 month after operation were collected, and also the operation time and bleeding. The evaluation of blue and green laser surgery from 8 operators was also collected. Results: Total 101 BPH patients were enrolled and 51 received BLVP, 50 received PVP, 8 cases of PVP and 3 cases of BLVP convert to transurethral resection of prostate (TURP) mainly due to uncontrollability bleeding, the other 90 patients completed the follow-up. The novel 200W 450nm laser vaporized visible more rapidly than PVP. In surgeons with PVP experience, they found it’s easier to perform BLVP than PVP duo to the reliable hemostatic function by 976nm laser. In surgeons with no PVP experience, it took 3-5 operations to overcome the desire of "TURP conversion" for BLVP and 5-10 operations for PVP. There was no significant difference between the two groups in baseline data, IPSS, QoL, Qmax and bleeding before and after operation, however, there were no difference of the operation time between two groups. The mainly reason was the power of the blue laser is very strong, which can lead to "bursting" of optical fiber once touch the tissue. It took about 10-20 operations to adapt to this "non-contact" vaporization mode. Conclusions: The novel blue laser surgical system has high vaporization efficiency, rapid and reliable hemostasis, therefore safe and effectiveness, and easy to learn. SOURCE OF Funding: None
