Laser prostatectomy of lower urinary tract symptoms due to benign prostate enlargement

Bachmann, Alexander; Woo, Henry H.; Wyler, Stephen

doi:10.1097/mou.0b013e32834dd0ed

Cited by 31 publications

(18 citation statements)

References 74 publications

(81 reference statements)

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“…Enucleation of the prostate has also been performed using other laser technologies, mainly a holmium laser and thulium laser [11]. Bach et al [12] treated 88 consecutive patients with prostatic enlargement using thulium enucleation of the prostate.…”

Section: Discussionmentioning

confidence: 99%

Tissue Effects Resulting from Eraser Laser Enucleation of the Prostate: In vivo Investigation

Lusuardi

Hager²,

Kloss³

et al. 2013

Urol Int

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Background/Aims/Objectives: To describe the depth of the laser coagulation zone in vivo based on histological examinations and the functional outcome of a 1,318-nm diode laser for enucleation in benign prostatic enlargement (BPE). Methods: A total of 20 patients with BPE were treated by laser Eraser® enucleation of the prostate (ELEP). Prostatic tissue wedges were evaluated to assess the depth of the ELEP coagulation zones. Additionally, patients were assessed preoperatively and 12 months postoperatively. Results: The coagulation zones were 0.36 ± 0.17 mm in epithelial tissue, 0.28 ± 0.15 mm in stromal tissue, and 0.25 ± 0.12 mm in mixed tissue. The coagulation area at the cutting edge completely sealed capillary vessels, reaching a depth of 0.35 ± 0.15 mm. The diameter of the coagulated vessels measured 1.75 ± 0.83 mm. Mean blood loss was 115.54 ± 93.12 ml, catheter time 1.35 ± 0.33 days, and hospital stay 1.89 ± 0.52 days. The International Prostate Symptom Score, maximal flow rate, and quality of life significantly improved 12 months after the procedure. Conclusions: ELEP is safe and effective for BPE treatment and yields good results at a follow-up of 1 year. Because of the limited penetration depth, damage to the urinary sphincter is not expected.

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Section: Discussionmentioning

confidence: 99%

Tissue Effects Resulting from Eraser Laser Enucleation of the Prostate: In vivo Investigation

Lusuardi

Hager²,

Kloss³

et al. 2013

Urol Int

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“…More recently, the diode laser has been used to perform prostate laser enucleation similar to HoLEP [72]. Bachmann et al [73] reported in a systematic review an overall paucity of safety and efficacy data for diode lasers with perioperative dysuria in up to 23.6% of men.…”

Section: Diode Lasersmentioning

confidence: 99%

Current Laser Therapies for the Treatment of Benign Prostatic Hyperplasia

2016

IJSR

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Abstract:The gold standard for symptomatic relief of bladder outlet obstruction secondary to be-nign prostatic hyperplasia has traditionally been a transurethral resection of the pros-tate (TURP). Over the past decade, however, novel laser technologies that are patient friendly as compared to the con-ventional TURP have been developed. As part of the ongoing quest to minimize complica-tions, shorten hospitalization, improve resection time, and most importantly reduce mortality, laser prostatectomy has continually evolved. Today, there are more varia-tions of laser prostatectomy, each with several differing surgical techniques. Although abundant data are available confirming the safety and feasibility of the various laser systems, future randomized-controlled trials will be necessary to verify which techni-que is superior. In this article, we describe the most common modalities used to perform a laser prostatectomy, mainly, the holmium laser and the potassium-titanyl-phosphate lasers. We also highlight the physical and clinical characteristics of each technology with a review of their efficacy.

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“…[8][9][10] However, elderly and more infirm patients are least likely to undergo it; this raises concern about the underutilization of the technique in this population.…”

Section: Introductionmentioning

confidence: 99%

“…7 Laser surgery as a substitute has also been attempted and has a satisfactory short-term efficacy. [8][9][10] However, elderly and more infirm patients are least likely to undergo it; this raises concern about the underutilization of the technique in this population. 11 Therefore, a more effective, safe, and easy treatment strategy for BPH is urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Effects of low-frequency ultrasound combined with microbubbles on benign prostate hyperplasia

Yang

Tang²,

Bai

et al. 2013

CUAJ

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Introduction: Our objective is to assess the effects of low-frequency ultrasound combined with microbubbles on benign prostate hyperplasia (BPH). Methods: Sixteen Beagle dogs with BPH were randomly assigned into 4 groups (n = 4): control group (without treatment), G1 group (injection with 2 mL of microbubble contrast agent); G2 group (21 kHz ultrasound); and G3 group (injection with 2 mL of microbubble contrast agent +21 kHz ultrasound). The histopathological damage to prostate cells was assessed via transmission electron microscopy and optical microscopy. The protein expressions of prostate-specific antigen (PSA), inducible nitric oxide synthase (iNOS), superoxide dismutase (SOD) of vessels were detected by enzyme-linked immunosorbent assay (ELISA). Results: Histopathologically, the prostate cells exhibited nuclear chromatin contraction, mitochondrial swelling, degranulation of rough endoplasmic reticulum, basement membrane rupture and cell apoptosis in the G2 and G3 groups; it was especially obvious in the G3 group, while no changes were observed in the control and G1 groups. Although prostate volume using imaging was not significantly changed in all groups after treatment, PSA was significantly reduced in the G2 and G3 groups, and especially obvious in the G3 group (p < 0.05). The iNOS and SOD, which are important oxidative stress factors, significantly increased after treatment in the G2 and G3 groups, but not in the control and G1 groups (p < 0.05). Conclusions: Low-frequency ultrasound is effective in treating BPH; low-frequency ultrasound combined with microbubbles improves the treatment efficacy. IntroductionBenign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate, ranking among the 10 most common diseases in aging men.1 BPH is characterized by smooth muscle and epithelial proliferation primarily within the prostatic transition zone, which results in a variety of problems for patients. The most frequent problem is lower urinary tract symptoms (LUTS) 2 and 80% of men in their 70s suffer from BPH-related LUTS. 3,4 Currently, the management of BPH involves non-surgical and surgical techniques. Alpha-blockers and 5-alpha reductase inhibitors are common medical options due to their excellent efficacy and convenience of administering without severe adverse effects. 5,6 Although transurethral resection of the prostate (TURP) is the gold standard for BPHrelated LUTS, it has disadvantages. Its potential disadvantages include significant blood loss and operative hyponatraemia, need for hospitalization and possible prolonged catheterization, and low, but real, risks of urinary incontinence, erectile dysfunction, bladder neck contractures, and urethral stricture disease.7 Laser surgery as a substitute has also been attempted and has a satisfactory short-term efficacy. [8][9][10] However, elderly and more infirm patients are least likely to undergo it; this raises concern about the underutilization of the technique in this population.11 Therefore, a more effective, safe, and easy trea...

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Laser prostatectomy of lower urinary tract symptoms due to benign prostate enlargement

Cited by 31 publications

References 74 publications

Tissue Effects Resulting from Eraser Laser Enucleation of the Prostate: In vivo Investigation

Tissue Effects Resulting from Eraser Laser Enucleation of the Prostate: In vivo Investigation

Current Laser Therapies for the Treatment of Benign Prostatic Hyperplasia

Effects of low-frequency ultrasound combined with microbubbles on benign prostate hyperplasia

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