Critical review of lasers in benign prostatic hyperplasia (BPH)

Stavros Gravas, Alexander Bachmann, Oliver Reich, Claus Roehrborn, Peter J. Gilling, Jean De La Rosette

Research output: Contribution to journalReview article

109 Scopus citations

Abstract

• Laser treatment of benign prostatic hyperplasia has challenged transurethral resection of the prostate (TURP) due to advances in laser technology, better understanding of tissue-laser interactions and growing clinical experience. • Various lasers have been introduced including neodymium: yttrium aluminium garnet (YAG), holmium (Ho): YAG, potassium titanyl phosphate: YAG, thulium(Tm) and diode laser. Based on the different wave-length dependent laser-prostatic tissue interactions, the main techniques are coagulation, vaporization, resection and enucleation. • The present review aims to help urologists to distinguish and to critically evaluate the role of different laser methods in the treatment by using an evidence-based approach. It also details further evidence for use in specific patient groups (in retention, on anticoagulation) and addresses the issues of cost and learning curve. • Coagulation-based techniques have been abandoned; holmium ablation/resection of the prostate has been superseded by the enucleation technique Ho-laser enucleation of the prostate (HoLEP). The short-term efficacy of the emerging laser treatments such as diode and Tm prostatectomy has been suggested by low quality studies. HoLEP and photoselective vaporization of the prostate (PVP) represent valid clinical alternatives to TURP. HoLEP is the most rigorously analysed laser technique with durable efficacy for any prostate size and low early and late morbidity. PVP has grown in acceptance and popularity but long-term results from high quality studies are pending.

Original languageEnglish (US)
Pages (from-to)1030-1043
Number of pages14
JournalBJU international
Volume107
Issue number7
DOIs
StatePublished - Apr 1 2011

Keywords

  • KTP laser
  • benign prostatic hyperplasia
  • diode laser
  • holmium (Ho) laser
  • laser prostatectomy
  • thulium (Tm) laser

ASJC Scopus subject areas

  • Urology

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  • Cite this

    Gravas, S., Bachmann, A., Reich, O., Roehrborn, C., Gilling, P. J., & De La Rosette, J. (2011). Critical review of lasers in benign prostatic hyperplasia (BPH). BJU international, 107(7), 1030-1043. https://doi.org/10.1111/j.1464-410X.2010.09954.x