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Laser treatment for benign prostatic hyperplasia: a review

Bladder outflow obstruction is commonly caused by benign prostatic hyperplasia (BPH).1The gold-standard treatment for this type of obstruction is transurethral resection of the prostate (TURP). However less invasive alternative therapies using laser technology have been developed, that may carry a lower risk of complications than TURP.1

Nair et al reviewed the laser technologies most commonly used for treatment of BPH and examined the efficacy and side effects of this treatment.1

A variety of techniques are possible, based on the unique properties of different laser types:1

  • Vaporisation
  • Resection
  • Enucleation.

Early generations of laser technologies relieved bladder obstruction by coagulation and ablation.1Ablation techniques, including via the 532-nm GreenLight device, are popular and clinical evidence for their use is being accumulated.1

Holmium Laser Enucleation of the Prostate (HoLEP) and 532-nm ablation therapies are the most commonly used and well established techniques.1The 532-nm ablation techniques show safety and efficacy profiles similar to TURP.1

 

In clinical studies HoLEP shows durable and reproducible results, which rival those of the TURP procedure, with few adverse effects. 1

In general, fewer complications are seen with laser therapies and several exceed the efficacy of TURP.
1
Long-term efficacy studies and random control trial data on the newer laser technologies, including thulium and diode systems, are required in order to compare with TURP. 1

Reference list

  1. Nair SM, Pimentel MA, Gilling PJ. A review of laser treatment for symptomatic
    BPH (benign prostatic hyperplasia). Curr Urol Rep 2016; 17(6): 45.