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Modern laser procedures such as greenlight laser therapy or the diode laser procedure are far gentler than conventional TURP of the prostate. But laser treatment is also superior to TURP in terms of safety. This was proven in a study recently published in the renowned journal "Urology".
Constant urination, a weak urine stream and unpleasant dribbling at night - what becomes a nightmare for many men is usually due to benign enlargement of the prostate. It affects almost every second man over 50 and even every 80-year-old. In so-called benign prostatic hyperplasia (BPH), the glandular tissue of the prostate grows into the area of the urethra. Due to the narrowing of the urethra, the strength of the urine stream decreases and residual urine remains in the bladder. If medication does not lead to the desired success or if there are repeated urinary tract infections or blood in the urine, surgical intervention is usually required to eliminate the urinary flow obstruction. The standard procedure for the surgical treatment of benign prostatic hyperplasia is still the classic excision (transurethral prostate resection/TURP). In this procedure, a special endoscope is inserted into the urethra and an electric loop is used to hollow out the glandular portion of the prostate around the urethra. "Although this method has been significantly improved in recent years thanks to medical progress, complications can occur," explains Dr. Pedram Derakhshani, urologist at the West German Prostate Center. "Particularly in view of the bleeding risks that still exist, gentle laser procedures such as greenlight laser therapy or the diode laser procedure have been used for several years in addition to the classic peeling," says the Cologne urologist. Here, instead of electric current, excess tissue is vaporized by means of laser energy. The advantage here is that the operation is virtually bloodless.
Fewer complications
That laser therapy is superior to conventional peeling in terms of safety is now shown by the results of a recent study1 on 108 patients treated with either a Greenlight laser or TURP: While no significant complications occurred with laser treatment, eight patients in the TURP group required surgery-related blood transfusion, and three patients experienced so-called transurethral resection syndrome. In this case, irrigation fluid enters the bloodstream through opened vessels. As a result, there is a change in the electrolyte situation and thus an enormous strain on the circulation. In five patients, perforation of the prostate capsule occurred. But the laser procedure also offered significant advantages in terms of the length of hospital stay: "A urethral catheter is usually placed for one night after laser therapy, thus shortening the hospital stay from one week to two days. In some cases, even outpatient care is possible," Derakhshani says. Due to the obvious advantages in the side effect profile, patients with an increased risk of surgery and those who have to take anticoagulant medication benefit most from the laser procedure. With the particularly powerful Evolve 150 diode laser, even patients with a large prostate can be treated without problems.
