Much more gentle than the conventional resection of the prostate (TURP) are modern laser techniques such as the Greenlight laser therapy or diode laser procedures. But in terms of safety, the laser treatment is superior to TURP. This could be proven by a study that was recently published in the prestigious journal "Urology".
Constant urination, weak flow and uncomfortable dribbling - a nightmare for many men - is usually due to benign enlargement of the prostate. It affects almost every other man over the age of 50 and even every man over 80 years of age. In the so-called benign prostatic hyperplasia (BPH), the glandular tissue of the prostate grows into the area of the urethra. Due to the narrowing of the urethra the strength of the urine stream decreases and residual urine remains in the bladder. If medications do not lead to the desired result or if there are repeated urinary tract infections or blood in the urine, usually a surgery to eliminate the urinary obstruction is required.
The classical resection (transurethral prostatic resection / TURP) is still considered as a standard procedure for the surgical treatment of benign prostate enlargement. In this case a special endoscope is inserted into the urethra and with an electrical loop the glandular portion of the prostate around the urethra is hollowed out. "Although this method has been improved significantly in recent years thanks to medical progress, complications can still occur," said Dr. Pedram Derakhshani, urologist at the West German Prostate Center. "Particularly in view of the still-existing risk factors such as continued bleeding for several years, gentle laser treatments such as the Greenlight laser therapy or laser diode are performed in addition to the classical enucleation", so the Cologne urologist. Instead of electric currents, laser energy is used to evaporate excess tissue. The advantage consists of an almost blood-free operation.
Laser: fewer complications during the procedure
That the laser therapy of conventional enucleation is superior in terms of safety, is now shown by the results of a recent study1 of 108 patients who were treated either with a GreenLight laser or TURP: While in the laser treatment, no significant complications occurred, in eight patients of the TURP group a surgery-related, blood transfusion was necessary, three patients experienced a so-called transurethral resection syndrome. Here irrigation solution passes via opened vessels into the bloodstream. As a result, there is a change in the electrolyte status which leads to hypernatremia. Five patients evidenced a perforation of the prostatic capsule.
But considering the length of the hospital stay, the laser procedure offers significant advantages: "Generally, after a laser therapy a urethral catheter is set for one night and thus the hospital stay is shortened from one week to two days. In some cases, treatment is possible in the form of out-patient care." says Derakhshani.
Because of the obvious advantages in the side effect profile, particularly patients at increased surgical risk and those who need to take anticoagulant medication, benefit from the laser procedure. With the especially powerful laser Evolve 150 even patients with a large prostate can be treated without any problem.
1Chen J, Wang M, Wang S, Sun P, Zhao Y, Zhang L, Jin X. : 160-Watt Lithium Triboride Laser Vaporization Versus Transurethral Resection of Prostate: A Prospective Nonran-domized Two-center Trial. Urology. 2012 Mar; 79(3):650-4.