Since April 2010, the Evolve 180 system has been in use at the WPZ, the first center in Germany, and more than 2000 patients have already been operated successfully with the system by Dr. Neubauer.
Diode lasers - even more precise and effective
While Green-Light laser therapy is still being carried out in many hospitals, the West German Prostate Center also has another laser technology, the so-called LIFE laser therapy with the Evolve diode laser system. Since April 2010, the Evolve 180 system has been in use at the WPZ, the first center in Germany, and more than 2000 patients have already been operated successfully with the system by Dr. Neubauer.
A significant advantage over the Greenlight laser is the significantly higher wattage of the diode laser and the associated greater evaporation effect. In this way, patients with a large prostate can also undergo gentle laser therapy, which in the past had to rely on classical peeling (TURP). Further advantages: The duration of the treatment is shorter and therefore a gentle anaesthesia procedure is possible, which places less strain on the cardiovascular system.
Laser - Indication
If the drug therapy does not lead to the desired success, or if repeated urinary tract infections or blood infections occur in the urine, surgery is usually required to eliminate the urinary flow disorder. Even if a normal emptying of the bladder is no longer possible, i. e. with a single or repeated urinary retention, surgery should be performed. Modern laser processes are far more gentle than conventional peeling (TUR-P) and include the diode laser process. During laser resection, the prostate tissue is also ablated through the urethra. Instead of the electrical current, excess tissue is evaporated by means of laser energy. This has the advantage that postoperative bleeding is almost completely avoided. The latest developments in the field of laser technology are the high-power diode lasers. The advantage compared to the Greenlight laser is the larger tissue ablation per time unit. In addition, the shorter duration of treatment enables a gentle anaesthesia procedure, which places little strain on the cardiovascular system of the patient.
Suitable for whom?
In principle, every man with an enlarged prostate benefits from LIFE diode laser therapy. However, especially in patients who take blood thinning drugs, laser treatment should be considered. The ultra-modern laser with a power of up to 180 watts enables both tissue evaporation and effective hemostasis during the procedure. In contrast to classical peeling (TUR-P), intraoperative bleeding is almost completely avoided. With the Evolve 180 diode laser, patients with a large prostate of up to 200 grams can be treated without any problems. Up to now, the excessive prostate tissue of such patients had to be removed by an open prostate surgery involving high blood loss.
Before laser therapy
Before the operation, the patient is fully informed about the procedure of the laser treatment as well as about possible side effects. Blood thinning drugs such as aspirin, Marcumar, Xarelto, Lixiana or Plavix® must be discontinued in consultation with the treating physician before surgery.
First, the surgeon leads the laser through an endoscope into the patient's urethra. Excess prostate tissue is removed in layers by the laser. The tissue is first heated by the laser beam and then evaporated. Therefore, there is hardly any bleeding. Thanks to state-of-the-art video technology, doctors can check the procedure on the screen with millimetre accuracy. The duration of the operation varies between 30 and 120 minutes, depending on the size of the prostate gland. After the operation, a bladder catheter is inserted, which is usually only left for one to two days.
After laser therapy
After removing the catheter, the correct emptying of the bladder is checked. As a rule, patients can leave the clinic on the same day and go to the urologist on site for aftercare. Patients can normally resume their professional activities within a few days of surgery. At first, the patients should take physical care and pay attention to the following: During the first two weeks bathing, swimming, sauna visits, sexual activities and heavy lifting are forbidden. Compressive stress on the prostate and perineum, e. g. caused by cycling, riding or sitting on hard surfaces, should be avoided for about four weeks.
Laser - Side effects
Diode laser therapy is a minimally invasive procedure that involves fewer risks and side effects, shorter catheterization, faster recovery and less pain than conventional peeling (TUR-P). Side effects such as impotence and incontinence can be virtually ruled out with laser procedures. In most patients, however, there is a long-term lack of ejaculation (reverse ejaculation of the sperm into the bladder).