Patients with benign prostatic hyperplasia (BPH), a nonmalignant enlargement of the prostate, benefit from a laser therapy. This was shown by a current study recently published in the European Journal of Urology. Modern laser therapies are not only resulting in fewer side effects, such as urinary retention, incontinence and impotence, but they also prevent postoperative blood loss.
The classical transurethral resection of the prostate (TURP) still considered the standard procedure for the treatment of benign prostatic hyperplasia (BPH), Using a wire loop loaded with electricity, excessive tissue is sliced away layer by layer. The disadvantage of this treatment is often postoperative blood loss, which in some cases necessitates a blood transfusion or a homeostasis in a second surgical intervention. In rare cases, patients suffer from serious complications, such as the TURP syndrome. Here excess fluid passes through open blood vessels into the blood stream. The consequences are reduced concentration of sodium in the bloodstream. In the worse cases scenario, this can lead to pulmonary or cerebral edema.
As an alternative to the conventional treatment of BPH, modern laser treatments, such as greenlight laser and life-diode laser therapy have firmly been established as successful treatments during recent years. With the help of laser energy, the prostate tissue is being less evasive and with minimal bleeding vaporized. “Through a simultaneous sclerotherapy, blood loss during the intervention is decreased to almost zero”, explains Dr. Pedram Derakhshani, urologist at the West German Prostate Center. In addition, postoperative bleeding is generally not present. Although, there have been excellent results in the clinical practice, up to now there have only been a few long-time analysis.
Clearly more complications after transurethral resection of the prostate (TURP)
For the first time, a randomized comparative three-year study has now been conducted. In this study, a total of 120 patients with benign prostate hyperplasia (prostate enlargement) were administered either a TURP or a greenlight laser therapy. The therapies were administered randomly. Patients who were treated with TURP experienced clearly more complications, both, during the treatment and after the treatment. 12 persons required a blood transfusion, ten persons evidenced an injury of the prostate gland, and six of the study participants who were treated with TURP, developed blood coagulation in the bladder. In three of 60 cases, a TUR syndrome was diagnosed. None of these complications was recorded in the patient group that was treated with laser. Instead, after laser therapy, initial bladder irritations were noted.
Shorter hospital stay
Another advantage of this innovative laser technique is the shorter period of hospitalization. “The patients can proceed with their lives already one or two days after the surgery”, underlines Derakhshani. According to Derakhshani, however, the success of the BPH therapy is due to not only its innovative technique, but also the competence and experience of the surgeon plays a significant role.
Al-Ansari A. et. al: GreenLight HPS 120-W Laser Vaporization Versus Transurethral Resection of the Prostate for Treatment of Benign Prostatic Hyperplasia: A Randomized Clinical Trial with Midterm Follow-up, 13, EurUrol May 27, 2010