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Gentle laser procedures for benign prostate enlargement place high demands on the surgeon's know-how
For several years now, minimally invasive procedures have been available in the form of modern laser therapy, with which excess prostate tissue can be gently vaporized with little bleeding. "However, the surgeon should have extensive experience," emphasizes Dr. Stephan Neubauer, urologist at the West German Prostate Center. Only if the operation is performed by a specialist can a high quality of treatment and a low rate of complications be guaranteed.
If patients with benignprostate enlargement no longer respond adequately to medication or if complications arise, such as acute urinary retention or repeated urinary tract infections, only surgery can provide relief in most cases. While those affected used to have to rely on the classic peeling procedure using an electric wire loop, gentle laser procedures are increasingly being used today. The advantage of this is that the duration of the operation and blood loss are significantly reduced and surgical rebleeding is avoided. Patients who are at increased risk of bleeding because they are taking anticoagulant medication and men with a large prostate volume benefit from this in particular.
Despite the now widespread use of laser therapy, the technique still places high demands on the experience and skill of the surgeon1. " Removing benign prostate tissue is millimeter work," explains Dr. Neubauer. "And this requires a practiced hand," says the urologist and surgeon. Otherwise, there is a risk of injuring surrounding structures such as the urethra or sphincter. Current studies show that the risk of developing stress-induced urinary leakage (stress incontinence) after laser therapy increases, for example, the fewer patients the treating urologist operates on per year and the longer the period between the individual operations. Experts speak of a "learning curve" in this context.
"This shows us how important it is to be treated in a specialized center with high case numbers," Dr. Neubauer emphasizes. This is the only way to guarantee the quality of treatment. As one of the few centers in Germany, the West German Prostate Center has all common surgical procedures for the treatment of benign prostate enlargement. In addition to TUR-P, TUNA and TURis plasma vaporization, these include state-of-the-art laser procedures (Greenlight laser and Life diode laser), with which around 200 patients are treated each year.