Benign prostate enlargement: laser treatment safer than TURP
Patients with benign prostate hyperplasia benefit from laser therapy. This was shown by a recent study recently published in the renowned European Journal of Urology. Modern laser procedures not only cause fewer side effects such as urethral congestion, incontinence and impotence, but also prevent secondary bleeding.
The standard procedure for the treatment of benign prostatic hyperplasia (BPH) is still the classical peeling (transurethral prostate resection/TURP). Excess tissue is removed layer by layer with the help of a wire sling, through which an electric current flows. The disadvantage: Postoperative bleeding often occurs, which sometimes requires blood transfusions or hemostasis in the course of a second operation. In rare cases, TUR syndrome can also occur. Flushing fluid enters the bloodstream via opened blood vessels, which in the worst case leads to pulmonary or cerebral edema.
As an alternative to the treatment of BPH, modern laser methods such as green light laser or diode laser therapy have become established in recent years. With the help of laser energy, the prostate tissue is gently and bloodlessly evaporated. Simultaneous loss of blood vessels reduces blood loss during the procedure to almost zero,"explains Dr. Pedram Derakhshani, urologist at the West German Prostate Center. Postoperative bleeding also does not occur as a rule. Despite the excellent results in clinical practice, there have been few long-term studies so far.
Significantly more complications after TURP
For the first time, a randomized comparative study was conducted over a period of three years. A total of 120 patients with benign prostate enlargement received either TURP or green light laser therapy. The allocation to the respective treatment technique was randomized at random. Patients treated with TURP showed significantly more complications both during and after treatment: 12 patients needed a blood transfusion, 10 showed an injury to the prostate capsule and six of the TURP-treated patients developed blood clot formation in the bladder. Three out of 60 cases were diagnosed with TUR syndrome. However, none of these complications occurred in the group of patients who were treated with laser procedures. Instead, more frequent initial bladder irritation with increased urination was observed after laser therapy.
Shorter lay times
Another advantage of the innovative laser procedures is the shorter hospital stay:"Patients can resume their accustomed daily routine one or two days after the operation," emphasizes Derakhshani. However, according to the urologist, the success of BPH therapy depends not only on the technique but also on the experience and competence of the surgeon.
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