Photoselective laser ablation of the prostate: a review of the current 2015 tissue ablation options.
نویسندگان
چکیده
INTRODUCTION Transurethral resection of the prostate (TURP) is still considered the gold standard to treat benign prostatic hyperplasia (BPH). However, photoselective vaporization of the prostate (PVP) has gained widespread acceptance as an alternative option requiring preoperative patient selection. Four laser systems are currently in use: holmium, thulium, diode and GreenLight. MATERIALS AND METHODS The goal of this article is to review the physics and the basics behind laser prostatectomies, as well as to present the most current literature concerning the results, advantages, disadvantages and international recommendations for each vaporization procedure. RESULTS Holmium laser ablation of the prostate (HoLAP) and GreenLight photoselective vaporization of the prostate are an alternative to TURP for small to medium-sized prostates, providing equivalent efficacy and safety. GreenLight is also safe and effective in large-sized prostates and especially beneficial in anti-coagulated individuals compared to TURP. Thulium vaporization of the prostate (ThuVAP) and diode vaporization both require additional randomized trials and long term studies before conclusion is made, despite promising initial results. Diode vaporization provides the best hemostasis overall, but at the cost of increased complication and re-treatment rate, and thus is not recommended except in severely anti-coagulated patients. CONCLUSION Laser vaporization is a safe and effective alternative to TURP in the treatment of benign prostatic hyperplasia (BPH) for carefully selected patients. However, further research is still needed to assess the durability of each technology.
منابع مشابه
Holmium laser ablation of the prostate versus photoselective vaporization of prostate 60 cc or less: short-term results of a prospective randomized trial.
PURPOSE We report on the first randomized trial to our knowledge comparing holmium laser ablation and photoselective vaporization of the prostate in patients with a small to moderate size prostate. MATERIALS AND METHODS Between March 2005 and April 2007, 109 patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia and prostate size 60 cc or smaller were randomized ...
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متن کامل
Benign Prostatic Hypertrophy (BPH) Treatments
A. Alpha adrenergic blockers (alfuzosin, doxazosin, silodosin, tamsulosin, and terazosin) B. Hormonal manipulation (including finasteride, dutasteride, and dutasteride plus tamsulosin) C. Interstitial laser coagulation of the prostate (ILCP) D. Laser prostatectomy E. Laser based procedures including contact laser ablation of the prostate (CLAP), holmium laser procedures of the prostate (HoLAP, ...
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In this paper, the laser ablation process based on the irradiation of nanosecond pulsed lasers on a copper target surface in the presence of Helium gas is studied. The dynamical behaviors of the generated plasma in the helium gas and evaporated copper at the atmospheric pressure are examined using a laser pulse, laser wavelength of and intensity of 7×1010W/cm2. A one-dimensional thermal model ...
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ورودعنوان ژورنال:
- The Canadian journal of urology
دوره 22 Suppl 1 شماره
صفحات -
تاریخ انتشار 2015