Critical review of lasers in benign prostatic hyperplasia (BPH).
Identifieur interne : 000444 ( PubMed/Corpus ); précédent : 000443; suivant : 000445Critical review of lasers in benign prostatic hyperplasia (BPH).
Auteurs : Stavros Gravas ; Alexander Bachmann ; Oliver Reich ; Claus G. Roehrborn ; Peter J. Gilling ; Jean De La RosetteSource :
- BJU international [ 1464-410X ] ; 2011.
English descriptors
- KwdEn :
- MESH :
- chemical : Aluminum, Yttrium.
- complications : Prostatic Hyperplasia.
- etiology : Prostatism.
- methods : Laser Therapy, Prostatectomy.
- surgery : Prostatic Hyperplasia, Prostatism.
- Epidemiologic Methods, Humans, Lasers, Solid-State, Male, Treatment Outcome.
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 • Coagulation-based techniques have been abandoned; holmium ablation/resection of the prostate has been superseded by the enucleation technique Ho-laser enucleation of the prostate (HoLEP).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.
DOI: 10.1111/j.1464-410X.2010.09954.x
PubMed: 21438974
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pubmed:21438974Le document en format XML
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<author><name sortKey="Gravas, Stavros" sort="Gravas, Stavros" uniqKey="Gravas S" first="Stavros" last="Gravas">Stavros Gravas</name>
<affiliation><nlm:affiliation>Department of Urology, University of Thessaly, Larissa, Greece. sgravas2002@yahoo.com</nlm:affiliation>
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<author><name sortKey="Bachmann, Alexander" sort="Bachmann, Alexander" uniqKey="Bachmann A" first="Alexander" last="Bachmann">Alexander Bachmann</name>
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<author><name sortKey="Reich, Oliver" sort="Reich, Oliver" uniqKey="Reich O" first="Oliver" last="Reich">Oliver Reich</name>
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<author><name sortKey="Roehrborn, Claus G" sort="Roehrborn, Claus G" uniqKey="Roehrborn C" first="Claus G" last="Roehrborn">Claus G. Roehrborn</name>
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<author><name sortKey="Gilling, Peter J" sort="Gilling, Peter J" uniqKey="Gilling P" first="Peter J" last="Gilling">Peter J. Gilling</name>
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<author><name sortKey="De La Rosette, Jean" sort="De La Rosette, Jean" uniqKey="De La Rosette J" first="Jean" last="De La Rosette">Jean De La Rosette</name>
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<author><name sortKey="Gravas, Stavros" sort="Gravas, Stavros" uniqKey="Gravas S" first="Stavros" last="Gravas">Stavros Gravas</name>
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<author><name sortKey="Bachmann, Alexander" sort="Bachmann, Alexander" uniqKey="Bachmann A" first="Alexander" last="Bachmann">Alexander Bachmann</name>
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<author><name sortKey="Reich, Oliver" sort="Reich, Oliver" uniqKey="Reich O" first="Oliver" last="Reich">Oliver Reich</name>
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<author><name sortKey="Roehrborn, Claus G" sort="Roehrborn, Claus G" uniqKey="Roehrborn C" first="Claus G" last="Roehrborn">Claus G. Roehrborn</name>
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<author><name sortKey="Gilling, Peter J" sort="Gilling, Peter J" uniqKey="Gilling P" first="Peter J" last="Gilling">Peter J. Gilling</name>
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<author><name sortKey="De La Rosette, Jean" sort="De La Rosette, Jean" uniqKey="De La Rosette J" first="Jean" last="De La Rosette">Jean De La Rosette</name>
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<series><title level="j">BJU international</title>
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<term>Epidemiologic Methods</term>
<term>Humans</term>
<term>Laser Therapy (methods)</term>
<term>Lasers, Solid-State</term>
<term>Male</term>
<term>Prostatectomy (methods)</term>
<term>Prostatic Hyperplasia (complications)</term>
<term>Prostatic Hyperplasia (surgery)</term>
<term>Prostatism (etiology)</term>
<term>Prostatism (surgery)</term>
<term>Treatment Outcome</term>
<term>Yttrium</term>
</keywords>
<keywords scheme="MESH" type="chemical" xml:lang="en"><term>Aluminum</term>
<term>Yttrium</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Prostatic Hyperplasia</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Prostatism</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Laser Therapy</term>
<term>Prostatectomy</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Prostatic Hyperplasia</term>
<term>Prostatism</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Epidemiologic Methods</term>
<term>Humans</term>
<term>Lasers, Solid-State</term>
<term>Male</term>
<term>Treatment Outcome</term>
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<front><div type="abstract" xml:lang="en">• 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.</div>
</front>
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<ArticleTitle>Critical review of lasers in benign prostatic hyperplasia (BPH).</ArticleTitle>
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<Abstract><AbstractText>• 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.</AbstractText>
<CopyrightInformation>© 2010 THE AUTHORS; BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.</CopyrightInformation>
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