The use of lasers in benign prostatic enlargement

Abstract

This article reviews the laser techniques available for the treatment of lower urinary tract symptoms. Early data on short-term mortality, morbidity, complication rates, and outcome are available, but information on cost-effectiveness, long-term outcome, and patient preference are as yet unavailable. In the 8 years since laser methods became popular it has become clear that substantial and variably durable flow and symptomatic responses are achieved that do not quite match transurethral resection of the prostate (TURP). Less immediate physiologic stress is balanced by a delay before full response. Same-day surgery may be possible, but an extended period of catheterization may be necessary. Laser methods remain an option for treatment and are particularly applicable to the less fit man. Whether men will choose a less effective but less invasive treatment option for symptom relief is not yet obvious. Limited early data suggest the holmium laser technique most closely approaches the gold standard.

Early Catheter Removal following Transurethral Prostatectomy: A Study of 431 Patients

“…Since laser techniques are less invasive and faster, they can often be performed on an outpatient basis. Laser techniques are not available in many medical centers, and equally important their long-term effects are not known [9] . Hence it was not possible to compare laser techniques of prostatic resection techniques with the current gold standard of TURP which is effective and effi cient in patient management.…”

Comparison of Efficacy of Different Surgical Techniques for Benign Prostatic Obstruction

“…TURP has long been considered the standard treatment option for BPO patients who require surgical intervention. Many other alternatives have been investigated after the introduction of lasers in the field, allowing the development of minimally invasive techniques and reducing the risks of the TURP such as bleeding and transurethral resection syndrome [5,12,13].…”