Lasers in the treatment of benign prostatic hyperplasia: An update

Current Opinion in Urology

Volumn 15, Issue 1, 2005, Pages 55-58

  Tan, Andrew H ^a   Gilling, Peter J ^b,c  

^a ROYAL PERTH HOSPITAL   (Australia)

^b Tauranga Public Hospital   (New Zealand)

^c Promed Urology Tauranga   (New Zealand)

Author keywords

Holmium; Lasers; Prostatectomy; Prostatic hyperplasia

Indexed keywords

BLADDER NECK STENOSIS; BLEEDING; CATHETERIZATION; DYSURIA; HEMATURIA; HOLMIUM LASER; HUMAN; LASER COAGULATION; LOW LEVEL LASER THERAPY; MORBIDITY; NECROSIS; PRIORITY JOURNAL; PROSTATE HYPERTROPHY; REVIEW; TRANSURETHRAL RESECTION; TREATMENT OUTCOME; URINARY TRACT INFECTION;

HUMANS; LASER SURGERY; MALE; PROSTATIC HYPERPLASIA;

EID: 12144272202     PISSN: 09630643     EISSN: None     Source Type: Journal    
DOI: 10.1097/00042307-200501000-00013     Document Type: Review

References (19)

1. Tan AH, Gilling PJ, Kennett KM, et al. A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol 2003; 170:1270-1274. The first randomized controlled trial comparing HoLEP and TURP. Pressure-flow data before and after reveal that HoLEP is better at relieving outflow obstruction than TURP.
2. ••]. Unfortunately no postoperative pressure-flow data was available.
3. Tooher R, Sutherland P, Costello A, et al. A systematic review of holmium laser prostatectomy for benign prostatic hyperplasia. J Urol 2004; 171:1773-1781. Important, as it is a systematic review of the literature on holmium prostatectomy by an independent body which has reviewed many other surgical procedures. Concludes that durability data are lacking.
4. Westenberg A, Gilling P, Kennett K, et al. Holmium laser resection of the prostate: results of a randomized trial with 4-year minimum long-term followup. J Urol 2004; 172:616-619. The 4-year follow up of this FDA study confirmed the durability of holmium prostatectomy which answers the concerns in Ref. [3].
5. Kuntz RM, Lehrich K, Ahyai S. Transurethral holmium laser enucleation of the prostate compared with transvesical open prostatectomy: 18-month follow-up of a randomized trial. J Endourol 2004; 18:189-191. Eighteen-month follow up of a very important study making an appropriate comparison between HoLEP and open prostatectomy. There are few new data however.
6. Kuntz RM, Lehrich K, Ahyai S. Does peri-operative outcome of holmium laser nucleation of the prostate depend on prostate size. J Endourol 2004; 18:183-188.
7. Mebust WK, Holtgrewe HL, Cockett ATK, Peters PC and writing committee. Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol 1989; 141:243-247.
8. Naspro R, Freschi M, Salonia A, et al. Holmium laser enucleation versus transurethral resection of the prostate. Are histological findings comparable? J Urol 2004; 171:1888. Not only is more tissue retrieved with HoLEP than with TURP, but the tissue is similar in terms of the thermal damage and hence it can be used for the diagnosis of prostate cancer. Holmium enucleation is superior to holmium resection in this regard.
9. Seki N, Mochida O, Kinukawa N, et al. Holmium laser enucleation for prostatic adenoma: analysis of the learning curve over the course of 70 consecutive cases. J Urol 2003; 170:1847-1850. A single surgeon learning experience (self-taught) of HoLEP showing that there is improving efficiency still evident at 50 cases. The importance of proper mentoring during learning is obvious.
10. Malek R, Kuntzmann R, Barrert D. High power potassium-titanyl-phosphate laser vaporization prostatectomy. J Urol 2000; 163:1730-1733.
11. Anson K. Could the latest generation potassium titanyl phosphate lasers be the ones to make transurethral resection of the prostate an operation of historical interest only? Curr Opin Urol 2004; 14:27-29.
12. Hai M, Malek RS. Photoselective vaporization of the prostate: initial experience with a new 80W KTP laser for the treatment of benign prostatic hyperplasia. J Endourol 2003; 17:93-96.
13. Barber N, Muir G. High-power KTP laser prostatectomy: the new challenge to transurethral resection of the prostate. Curr Opin Urol 2004; 14:21-25.
14. Bachmann A, Reich O, Wyler S, et al. Vaporization of the prostate with the 80W potassium titanyl phosphate (KTP) laser technique and 6 months follow-up after 70 procedures [in German]. Urologe A 2004; June 15. A clinical series of KTP vaporization with 70 men which confirms the original report in Ref. [12]. Operative times suggest this is a relatively slow and inefficient technique.
15. Reich O, Bachmann A, Schneede P, et al. Experimental comparison of high power (80W) potassium titanyl phosphate laser vaporization and transurethral resection of the prostate. J Urol 2004; 171:2502-2504.
16. Laguna MP, Aliviatos G, De La Rosette JJ. Interstitial laser coagulation of benign prostatic hyperplasia: is it to be recommended? J Endourol 2003; 17:595-600. A review of interstitial laser coagulation is presented. High re-treatment rates, frequent urinary tract infections and irritative symptoms continue to be a problem with this technique.
17. Liedberg F, Adell L, Hagberg G, Palmqvist IB. Interstitial laser coagulation versus transurethral resection of the prostate for benign prostatic enlargement - a prospective randomized study. Scand J Urol Nephrol 2003; 37:494-497. This randomized controlled trial suggests that the complication and re-treatment rate is higher with ILC than TURP; however the number of patients was small.
18. Van Melick HH, van Venrooij GE, Boon TA. Long-term follow-up after transurethral resection of the prostate, contact laser prostatectomy, and electrovaporization. Urology 2003; 62:1029-1034. Each of 141 men had one of the three treatments and no differences were found after a mean follow up of 4.3 years.
19. Tuhkanen K, Heino A, Aaltomaa S, Ala-Opas M. Long-term results of contact laser versus transurethral resection of the prostate in the treatment of benign prostatic hyperplasia with small or moderately enlarged prostates. Scand J Urol Nephrol 2003; 37:487-493. A urodynamically controlled comparison of contact vaporization and TURP which shows inferior relief of obstruction with vaporization, probably due to the difference in the amount of tissue removed between these techniques. Only small prostates (< 40 g) were included.