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Since April 2010, the West German Prostate Center at the Klinik am Ring in Cologne has been the first center in Germany to use the Evolve 180 system. Since then, over 2,000 patients have been treated with the new system.
A significant advantage over the Greenlight laser is the significantly higher wattage of the diode laser and the associated greater vaporization effect. This means that patients with a large prostate can also undergo gentle laser therapy, who in the past had to rely on classic peeling (TURP). Other plus points: The overall treatment time is shorter and therefore a gentle anesthesia procedure is possible, which puts less strain on the cardiovascular system.
If drug therapy 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. Surgical intervention should also be performed if normal bladder emptying is no longer possible, i.e. in the case of a single or repeated urinary retention. Far gentler than conventional peeling (TUR-P) are modern laser procedures which include the diode laser procedure. In laser resection, the prostate tissue is also removed through the urethra. Instead of electric current, excess tissue is vaporized by laser energy. This has the advantage that postoperative bleeding is almost completely avoided. The latest development in the field of laser technology is the high-power diode laser. The advantage over the greenlight laser is the greater tissue ablation per unit of time. In addition, the overall shorter treatment time allows a gentle anesthesia procedure that puts little strain on the patient's cardiovascular system.
For whom suitable?
In principle, every man with an enlarged prostate benefits from LIFE diode laser therapy. However, especially for patients taking blood-thinning medication, laser treatment should definitely be considered. The state-of-the-art laser with a power of up to 180 watts enables both vaporization of the tissue and effective hemostasis during the procedure. Unlike traditional peeling (TUR-P), intraoperative bleeding is almost completely avoided. With the Evolve 180 diode laser, patients with large prostates weighing up to 150 grams can also be treated without any problems. Until now, the excess prostate tissue in such patients had to be removed by open prostate surgery, which was associated with high blood loss.
Before laser therapy
Before the procedure, the patient is fully informed about the laser treatment procedure and possible side effects. Blood-thinning medications such as aspirin, Marcumar, Xarelto, Lixiana or Plavix® must be discontinued before the operation in consultation with the attending physician.
The intervention
First, the surgeon guides the laser through an endoscope into the patient's urethra. Excess prostate tissue is removed by the laser layer by layer. In the process, the tissue is first heated by the laser beam and then vaporized. Therefore, hardly any bleeding occurs. The doctor can check the procedure on the screen with millimeter precision thanks to the latest video technology. The duration of the operation varies between 30 and 120 minutes, depending on the size of the prostate. After the operation, a bladder catheter is placed, which is usually left in place for two days.
After laser therapy
After removal of the catheter, correct bladder emptying is checked. Patients can usually leave the clinic on the day of catheter removal and go to their local urologist for follow-up care. Usually, patients can resume their professional activities within a few days after the procedure. During the initial period, those undergoing treatment should take it easy on themselves physically and pay attention to the following: Bathing, swimming sauna visits, sexual activities and heavy lifting are prohibited during the first two weeks. Pressure on the prostate and perineum, e.g. from cycling, horseback riding or sitting on hard surfaces, should be avoided for about four weeks.
Diode laser therapy is a minimally invasive procedure that is associated with fewer risks and side effects, shorter catheterization, faster recovery and less pain than conventional peeling (TUR-P). Side effects such as impotence and incontinence are virtually eliminated with laser procedures. However, most patients experience a long-term absence of ejaculation (backward ejaculation into the bladder).
A detailed description of life-diode therapy can be found on the pages of the information portal operation.de.
