Against the motion: Lasers are superfluous for the surgical management of benign prostatic hyperplasia in the developing world
Identifieur interne : 000327 ( Pmc/Checkpoint ); précédent : 000326; suivant : 000328Against the motion: Lasers are superfluous for the surgical management of benign prostatic hyperplasia in the developing world
Auteurs : Anil Varshney [Inde] ; Anshuman Agarwal [Inde]Source :
- Indian Journal of Urology : IJU : Journal of the Urological Society of India [ 0970-1591 ] ; 2009.
Abstract
Lasers have arrived in a big way for the management of benign prostatic hyperplasia. The most common ones in use are holmium, potassium titanyl phosphate (KTP) and thulium. They remove the prostatic adenoma either by way of enucleation or ablation. Backed by numerous studies that prove their safety, efficacy and durability, lasers score over TURP in several ways. Their use is associated with less blood loss, shorter catheter time and decreased hospital stay. The fluid absorption during laser prostatectomy is negligible and thus makes it safer for use in cardiac patients. Also there is no chance of a transurethral resection syndrome, the incidence of which is approximately 2% with TURP. Due to superior hemostatic capabilities and non interference lasers can be used in patients on anti coagulants, cardiac pacemaker. Another advantage of laser over TURP is its ability to deal with prostates that are larger in size especially holmium laser which has been used to enucleate glands more than 300 g in size thus completely avoiding the need for open prostatectomy. The amount of tissue removed with enucleation is more thus retreatment rates are less than that of TURP. The initial cost of laser is higher but its capability to treat stones, its use in high risk situations, less morbidity, short hospital stay, and durable results make it an attractive option to treat BPH even in the developing world.
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DOI: 10.4103/0970-1591.56188
PubMed: 19881144
PubMed Central: 2779973
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Against the motion: Lasers are superfluous for the surgical management of benign prostatic hyperplasia in the developing world</title><author><name sortKey="Varshney, Anil" sort="Varshney, Anil" uniqKey="Varshney A" first="Anil" last="Varshney">Anil Varshney</name><affiliation wicri:level="1"><nlm:aff id="AF0001">RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065</wicri:regionArea><wicri:noRegion>New Delhi - 110 065</wicri:noRegion></affiliation></author><author><name sortKey="Agarwal, Anshuman" sort="Agarwal, Anshuman" uniqKey="Agarwal A" first="Anshuman" last="Agarwal">Anshuman Agarwal</name><affiliation wicri:level="1"><nlm:aff id="AF0001">RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065</wicri:regionArea><wicri:noRegion>New Delhi - 110 065</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19881144</idno><idno type="pmc">2779973</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779973</idno><idno type="RBID">PMC:2779973</idno><idno type="doi">10.4103/0970-1591.56188</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000211</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000211</idno><idno type="wicri:Area/Pmc/Curation">000211</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000211</idno><idno type="wicri:Area/Pmc/Checkpoint">000327</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000327</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Against the motion: Lasers are superfluous for the surgical management of benign prostatic hyperplasia in the developing world</title><author><name sortKey="Varshney, Anil" sort="Varshney, Anil" uniqKey="Varshney A" first="Anil" last="Varshney">Anil Varshney</name><affiliation wicri:level="1"><nlm:aff id="AF0001">RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065</wicri:regionArea><wicri:noRegion>New Delhi - 110 065</wicri:noRegion></affiliation></author><author><name sortKey="Agarwal, Anshuman" sort="Agarwal, Anshuman" uniqKey="Agarwal A" first="Anshuman" last="Agarwal">Anshuman Agarwal</name><affiliation wicri:level="1"><nlm:aff id="AF0001">RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065, India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065</wicri:regionArea><wicri:noRegion>New Delhi - 110 065</wicri:noRegion></affiliation></author></analytic><series><title level="j">Indian Journal of Urology : IJU : Journal of the Urological Society of India</title><idno type="ISSN">0970-1591</idno><idno type="eISSN">1998-3824</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Lasers have arrived in a big way for the management of benign prostatic hyperplasia. The most common ones in use are holmium, potassium titanyl phosphate (KTP) and thulium. They remove the prostatic adenoma either by way of enucleation or ablation. Backed by numerous studies that prove their safety, efficacy and durability, lasers score over TURP in several ways. Their use is associated with less blood loss, shorter catheter time and decreased hospital stay. The fluid absorption during laser prostatectomy is negligible and thus makes it safer for use in cardiac patients. Also there is no chance of a transurethral resection syndrome, the incidence of which is approximately 2% with TURP. Due to superior hemostatic capabilities and non interference lasers can be used in patients on anti coagulants, cardiac pacemaker. Another advantage of laser over TURP is its ability to deal with prostates that are larger in size especially holmium laser which has been used to enucleate glands more than 300 g in size thus completely avoiding the need for open prostatectomy. The amount of tissue removed with enucleation is more thus retreatment rates are less than that of TURP. The initial cost of laser is higher but its capability to treat stones, its use in high risk situations, less morbidity, short hospital stay, and durable results make it an attractive option to treat BPH even in the developing world.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="John M, Fitzpatrick" uniqKey="John M F">Fitzpatrick John M</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mulligan, Ed" uniqKey="Mulligan E">ED Mulligan</name></author><author><name sortKey="Lynch, Th" uniqKey="Lynch T">TH Lynch</name></author><author><name sortKey="Mulvin, D" uniqKey="Mulvin D">D Mulvin</name></author><author><name sortKey="Greene, D" uniqKey="Greene D">D Greene</name></author><author><name sortKey="Smith, Jm" uniqKey="Smith J">JM Smith</name></author><author><name sortKey="Fitzpatrick, Jm" uniqKey="Fitzpatrick J">JM 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Urol</journal-id><journal-id journal-id-type="publisher-id">IJU</journal-id><journal-title-group><journal-title>Indian Journal of Urology : IJU : Journal of the Urological Society of India</journal-title></journal-title-group><issn pub-type="ppub">0970-1591</issn><issn pub-type="epub">1998-3824</issn><publisher><publisher-name>Medknow Publications</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19881144</article-id><article-id pub-id-type="pmc">2779973</article-id><article-id pub-id-type="publisher-id">IJU-25-409</article-id><article-id pub-id-type="doi">10.4103/0970-1591.56188</article-id><article-categories><subj-group subj-group-type="heading"><subject>Point-Counter-Point</subject></subj-group></article-categories><title-group><article-title>Against the motion: Lasers are superfluous for the surgical management of benign prostatic hyperplasia in the developing world</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Varshney</surname><given-names>Anil</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author"><name><surname>Agarwal</surname><given-names>Anshuman</given-names></name><xref ref-type="aff" rid="AF0001"></xref><xref ref-type="corresp" rid="cor1"></xref></contrib></contrib-group><aff id="AF0001">RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065, India</aff><author-notes><corresp id="cor1"><bold>For correspondence:</bold> Dr. Anshuman Agarwal, RG Stone Urology and Laparoscopy Hospital, F 12, East of Kailash, New Delhi - 110 065, India. E-mail: <email xlink:href="dranshuman.agarwal@gmail.com">dranshuman.agarwal@gmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><season>Jul-Sep</season><year>2009</year></pub-date><volume>25</volume><issue>3</issue><fpage>409</fpage><lpage>412</lpage><permissions><copyright-statement>© Indian Journal of Urology</copyright-statement><copyright-year>2009</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Lasers have arrived in a big way for the management of benign prostatic hyperplasia. The most common ones in use are holmium, potassium titanyl phosphate (KTP) and thulium. They remove the prostatic adenoma either by way of enucleation or ablation. Backed by numerous studies that prove their safety, efficacy and durability, lasers score over TURP in several ways. Their use is associated with less blood loss, shorter catheter time and decreased hospital stay. The fluid absorption during laser prostatectomy is negligible and thus makes it safer for use in cardiac patients. Also there is no chance of a transurethral resection syndrome, the incidence of which is approximately 2% with TURP. Due to superior hemostatic capabilities and non interference lasers can be used in patients on anti coagulants, cardiac pacemaker. Another advantage of laser over TURP is its ability to deal with prostates that are larger in size especially holmium laser which has been used to enucleate glands more than 300 g in size thus completely avoiding the need for open prostatectomy. The amount of tissue removed with enucleation is more thus retreatment rates are less than that of TURP. The initial cost of laser is higher but its capability to treat stones, its use in high risk situations, less morbidity, short hospital stay, and durable results make it an attractive option to treat BPH even in the developing world.</p></abstract><kwd-group><kwd>Benign prostatic hyperplasia</kwd><kwd>HoLep</kwd><kwd>lasers</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Varshney, Anil" sort="Varshney, Anil" uniqKey="Varshney A" first="Anil" last="Varshney">Anil Varshney</name></noRegion><name sortKey="Agarwal, Anshuman" sort="Agarwal, Anshuman" uniqKey="Agarwal A" first="Anshuman" last="Agarwal">Anshuman Agarwal</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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