Experience makes quality - gentle laser procedures with benign prostate enlargement

For several years now, modern laser therapy has been providing minimally invasive procedures with which excess prostate tissue can be gently evaporated with minimal bleeding. However, the surgeon should have extensive experience,"emphasizes Dr. Stephan Neubauer, urologist at the West German Prostate Center. Only if the intervention is carried out by a specialist can a high quality of treatment and a low complication rate be guaranteed.

If patients with a Gentle laser procedures with benign prostate enlargement place high demands on the surgeon's know-howGentle laser procedures with benign prostate enlargement place high demands on the surgeon's know-how? benign prostate enlargement procedures no longer address medication adequately or if complications, such as acute urinary retention or repeated urinary tract infections, can in most cases only be alleviated by surgery. Whereas in the past, those affected used to rely on classical peeling by means of an electric wire loop, nowadays gentle laser procedures are increasingly being used. The advantage: The duration of the operation and blood loss are significantly reduced and postoperative bleeding is avoided. This is particularly beneficial for patients who are at increased risk of bleeding due to the use of anticoagulant drugs and for men with a large prostate volume.

Despite the widespread use of laser therapy, the technique still places high demands on the surgeon's experience and skills1:"Removal of the benign prostate tissue is precision work," explains Dr. Neubauer. And this requires a skilled hand,"says the urologist and surgeon. Otherwise, there is a risk of injury to surrounding structures such as the urethra or sphincter muscle. For example, current studies show that the risk of developing stress-related urinary incontinence after laser therapy increases the less patients the treating urologist operates per year and the longer the time between the individual operations is. Experts refer to this as a "learning curve".

This shows us how important it is to be treated in a specialised centre with a high number of cases,"emphasises Dr. Neubauer. Only in this way can the quality of treatment be guaranteed. As one of the few centers in Germany, the West German Prostate Center has all common surgical procedures for the treatment of benign prostate hyperplasia. In addition to TUR-P, TUNA and TURis plasma vaporization, these include state-of-the-art laser procedures (greenlight lasers and life diode lasers), with which about 200 patients are treated annually.

Literature:

Learning LB, Tyson MD, Mendoza PJ.: Stress incontinence during the learning curve of holim laser enucleation of the prostate, JEndourol. 2010 Oct. 24 (10): 1655-8

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