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World Journal of Urology

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01-02-2010 | Topic Paper

Complications of laser prostatectomy: a review of recent data

Authors: Malte Rieken, Nicole Ebinger Mundorff, Gernot Bonkat, Stephen Wyler, Alexander Bachmann

Published in: World Journal of Urology | Issue 1/2010

Abstract

Introduction

Laser techniques for the treatment of bladder outlet obstruction (BOO) due to benign prostate enlargement (BPE) have emerged as an alternative to transurethral resection of the prostate (TURP) and open prostatectomy (OP).

Materials and methods

A Medline search over the past 4 years was performed to assess the safety, intra- and postoperative morbidity of various laser techniques.

Results

Data on holmium laser enucleation of the prostate (HoLEP) show the highest grade of evidence with two meta-analyses available and prove the low intra- and postoperative morbidity with reproducible long-term results. Photoselective vaporization of the prostate (PVP) with the Greenlightlaser (potassium titanyl phosphate, KTP or lithium borate, LBO) is characterized by excellent haemostatic properties in patients with or without oral anticoagulation. Long-term results show a reoperation rate comparable with TURP; however, there is a lack of randomized trials. Various types of diode lasers with different wavelengths are available for laser vaporization; despite their favourable haemostatic properties, a higher invasion depth seems to result in necrosis of the tissue leading to a higher rate of reoperation. Thulium-laser resection of the prostate shows promising intra- and postoperative morbidity, but data are limited and initial results need to be confirmed in large-scale trials.

Conclusion

In summary, HoLEP- and KTP-, or LBO-laser vaporization of the prostate are the most mature techniques of laser prostatectomy and treatment alternatives to TURP and OP, whereas the clinical value and durability of procedures with diode laser systems and the thulium laser need to be confirmed in high-quality prospective RCTs.

Arrighi HM, Metter EJ, Guess HA, Fozzard JL (1991) Natural history of benign prostatic hyperplasia and risk of prostatectomy. The Baltimore Longitudinal Study of Aging. Urology 38(1 Suppl):4–8CrossRefPubMed

Madersbacher S, Alivizatos G, Nordling J, Sanz CR, Emberton M, de la Rosette JJ (2004) EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol 46(5):547–554CrossRefPubMed

Rassweiler J, Teber D, Kuntz R, Hofmann R (2006) Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol 50(5):969–979CrossRefPubMed

Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, Lack N, Stief CG (2008) Urology Section of the Bavarian Working Group for Quality Assurance., Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 180(1):246–291CrossRefPubMed

Ho HS, Yip SK, Lim KB, Fook S, Foo KT, Cheng CW (2007) A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Eur Urol 52(2):517–522CrossRefPubMed

Gratzke C, Schlenker B, Seitz M, Karl A, Hermanek P, Lack N, Stief CG, Reich O (2007) Complications and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. J Urol 177(4):1419–1422CrossRefPubMed

Varkarakis I, Kyriakakis Z, Delis A, Protogerou V, Deliveliotis C (2004) Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology 64(2):306–310CrossRefPubMed

Tubaro A, Carter S, Hind A, Vicentini C, Miano L (2001) A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol 166(1):172–176CrossRefPubMed

Levels of Evidence. Centre of Evidence Based Medicine Website. http://www.cebm.net/index.aspx?o=1025

10.

Kuntz R (2006) Current role of lasers in the treatment of benign prostatic hyperplasia (BPH). Eur Urol 49(6):961–969CrossRefPubMed

11.

Naspro R, Bachmann A, Gilling P, Kuntz R, Madersbacher S, Montorsi F, Reich O, Stief C, Vavassori I (2009) A Review of the Recent Evidence (2006–2008) for 532-nm photoselective laser vaporisation and holmium laser enucleation of the prostate. Eur Urol 55(6):1345–1357

12.

Shah HN, Mahajan AP, Hegde SS, Bansal MB (2007) Peri-operative complications of holmium laser enucleation of the prostate: experience in the first 280 patients, and a review of literature. BJU Int 100(1):94–101CrossRefPubMed

13.

Placer J, Gelabert-Mas A, Vallmanya F, Manresa JM, Menéndez V, Cortadellas R, Arango O (2009) Holmium laser enucleation of prostate: outcome and complications of self-taught learning curve. Urology 73(5):1042–1048CrossRefPubMed

14.

Suardi N, Gallina A, Salonia A, Briganti A, Dehò F, Zanni G, Abdollah F, Naspro R, Cestari A, Guazzoni G, Rigatti P, Montorsi F (2009) Holmium laser enucleation of the prostate and holmium laser ablation of the prostate: indications and outcome. Curr Opin Urol 19:38–43CrossRefPubMed

15.

Shah HN, Sodha HS, Kharodawala SJ, Khandkar AA, Hegde SS, Bansal MB (2008) Influence of prostate size on the outcome of holmium laser enucleation of the prostate. BJU Int 101(12):1536–1541CrossRefPubMed

16.

Wilson LC, Gilling PJ, Williams A, Kennett KM, Frampton CM, Westenberg AM, Fraundorfer MR (2006) A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 g: results at 2 years. Eur Urol 50(3):569–573CrossRefPubMed

17.

Naspro R, Suardi N, Salonia A, Scattoni V, Guazzoni G, Colombo R, Cestari A, Briganti A, Mazzoccoli B, Rigatti P, Montorsi F (2006) Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur Urol 50(3):563–568CrossRefPubMed

18.

Mavuduru RM, Mandal AK, Singh SK, Acharya N, Agarwal M, Garg S, Kumar S (2009) Comparison of HoLEP and TURP in terms of efficacy in the early postoperative period and perioperative morbidity. Urol Int 82(2):130–135CrossRefPubMed

19.

Kuntz RM, Lehrich K, Ahyai SA (2008) Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 g: 5-year follow-up results of a randomised clinical trial. Eur Urol 53(1):160–166CrossRefPubMed

20.

Ahyai SA, Lehrich K, Kuntz RM (2007) Holmium laser enucleation versus transurethral resection of the prostate: 3-year follow-up results of a randomized clinical trial. Eur Urol 52(5):1456–1463CrossRefPubMed

21.

Montorsi F, Naspro R, Salonia A, Suardi N, Briganti A, Zanoni M, Valenti S, Vavassori I, Rigatti P (2008) Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center prospective randomized trial in patients with obstructive benign prostatic hyperplasia. J Urol 179(5 Suppl):87–90CrossRef

22.

Gilling PJ, Aho TF, Frampton CM, King CJ, Fraundorfer MR (2008) Holmium laser enucleation of the prostate: results at 6 years. Eur Urol 53(4):744–749CrossRefPubMed

23.

Elzayat EA, Elhilali EM (2007) Holmium laser enucleation of the prostate (HoLEP): long-term results, reoperation rate, and possible impact of the learning curve. Eur Urol 52(5):1465–1471CrossRefPubMed

24.

Vavassori I, Valenti S, Naspro R, Vismara A, Dell’Acqua V, Manzetti A, Hurle R (2008) Three-year outcome following holmium laser enucleation of the prostate combined with mechanical morcellation in 330 consecutive patients. Eur Urol 53(3):599–604CrossRefPubMed

25.

Briganti A, Naspro R, Gallina A, Salonia A, Vavassori I, Hurle R, Scattoni E, Rigatti P, Montorsi F (2006) Impact on sexual function of holmium laser enucleation versus transurethral resection of the prostate: results of a prospective, 2-center, randomized trial. J Urol 175(5):1817–1821CrossRefPubMed

26.

Costello AJ, Johnson DE, Bolton DM (1992) Nd:YAG laser ablation of the prostate as a treatment for benign prostatic hypertrophy. Lasers Surg Med 12(2):121–124CrossRefPubMed

27.

Hoffman RM, MacDonald R, Slaton JW, Wilt TJ (2003) Laser prostatectomy versus transurethral resection for treating benign prostatic obstruction: a systematic review. J Urol 169(1):210–215CrossRefPubMed

28.

Wilson LC, Gilling PJ (2005) From coagulation to enucleation: the use of lasers in surgery for benign prostatic hyperplasia. Nat Clin Pract Urol 2(9):443–448CrossRefPubMed

29.

McAllister WJ, Gilling PJ (2004) Vaporization of the prostate. Curr Opin Urol 14(1):31–34CrossRefPubMed

30.

Te A (2004) The development of laser prostatectomy. BJU Int 93(3):262–265CrossRefPubMed

31.

Ruszat R, Seitz M, Wyler SF, Abe C, Rieken M, Reich O, Gasser TC, Bachmann A (2008) GreenLight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures. Eur Urol 54(4):893–901CrossRefPubMed

32.

Spaliviero M, Araki M, Culkin DJ, Wong C (2009) Incidence, management, and prevention of perioperative complications of GreenLight HPS laser photoselective vaporization prostatectomy: experience in the first 70 patients. J Endourol 23(3):495–502CrossRefPubMed

33.

Choi B, Tabatabaei S, Bachmann A, Collins E, de la Rosette J, Gomez Sancha F, Muir G, Reich O, Woo H (2008) GreenLight HPS 120-W laser for benign prostatic hyperplasia: comparative complications and technical recommendations. Eur Urol Suppl 7(4):384–392CrossRef

34.

Horasanli K, Silay MS, Altay B, Tanriverdi O, Sarica K, Miroglu C (2008) Photoselective potassium titanyl phosphate (KTP) laser vaporization versus transurethral resection of the prostate for prostates larger than 70 mL: a short-term prospective randomized trial. Urology 71(2):247–251CrossRefPubMed

35.

Ruszat R, Wyler S, Seitz M, Lehmann K, Abe C, Bonkat G, Reich O, Gasser TC, Bachmann A (2008) Comparison of potassium-titanyl-phosphate laser vaporization of the prostate and transurethral resection of the prostate: update of a prospective non-randomized two-centre study. BJU Int 102(10):1432–1438PubMed

36.

Tugcu V, Tasci AI, Sahin S, Zorluoglu F (2008) Comparison of photoselective vaporization of the prostate and transurethral resection of the prostate: a prospective nonrandomized bicenter trial with 2-year follow-up. J Endourol 22(7):1519–1525CrossRefPubMed

37.

Bouchier-Hayes DM, Anderson P, Van Appledorn S, Bugeja P, Costello AJ (2006) KTP laser versus transurethral resection: early results of a randomized trial. J Endourol 20(8):580–585CrossRefPubMed

38.

Skolarikos A, Papachristou C, Athanasiadis G, Chalikopoulos D, Deliveliotis C, Alivizatos G (2008) Eighteen-month results of a randomized prospective study comparing transurethral photoselective vaporization with transvesical open enucleation for prostatic adenomas greater than 80 cc. J Endourol 22(10):2333–2340CrossRefPubMed

39.

Rajbabu K, Chandrasekara SK, Barber NJ, Walsh K, Muir GH (2007) Photoselective vaporization of the prostate with the potassium-titanyl-phosphate laser in men with prostates of >100 mL. BJU Int 100(3):593–598CrossRefPubMed

40.

Woo H, Reich O, Bachmann A, Choi B, Collins E, de la Rosette J, Gomez Sancha F, Muir G, Tabatabaei S (2008) Outcome of the GreenLight HPS 120-W laser therapy in specific patient populations: those in retention, on anticoagulants, and with large prostates (≥80 ml). Eur Urol Suppl 7(4):378–383CrossRef

41.

Ruszat R, Wyler S, Forster T, Reich O, Stief CG, Gasser TC, Sulser T, Bachmann A (2007) Safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients on ongoing oral anticoagulation. Eur Urol 51(4):1031–1038CrossRefPubMed

42.

Ruszat R, Wyler S, Seifert HH, Reich O, Forster T, Sulser T, Bachmann A (2006) Photoselective vaporization of the prostate: subgroup analysis of men with refractory urinary retention. Eur Urol 50(5):1040–1049CrossRefPubMed

43.

Hai M (2009) Photoselective vaporization of prostate: five-year outcomes of entire clinic patient population. Urology 73(4):807–810CrossRefPubMed

44.

Te AE, Malloy TR, Stein BS, Ulchaker JC, Nseyo UO, Hai MA (2006) Impact of prostate-specific antigen level and prostate volume as predictors of efficacy in photoselective vaporization prostatectomy: analysis and results of an ongoing prospective multicentre study at 3 years. BJU Int 97(6):1229–1233CrossRefPubMed

45.

Kavoussi PK, Hermans MR (2008) Maintenance of erectile function after photoselective vaporization of the prostate for obstructive benign prostatic hyperplasia. J Sex Med 5(11):2669–2671CrossRefPubMed

46.

Paick JS, Um JM, Kim SW, Ku JH (2007) Influence of high-power potassium-titanyl-phosphate photoselective vaporization of the prostate on erectile function: a short-term follow-up study. J Sex Med 4(6):1701–1707CrossRefPubMed

47.

Wendt-Nordahl G, Huckele S, Honeck P, Alken P, Knoll T, Michel MS, Häcker A (2007) 980-nm diode laser: a novel laser technology for vaporization of the prostate. Eur Urol 52(6):1723–1728CrossRefPubMed

48.

Seitz M, Bayer T, Ruszat R, Tilki D, Bachmann A, Gratzke C, Schlenker B, Stief C, Sroka R, Reich O (2009) Preliminary evaluation of a novel side-fire diode laser emitting light at 940 nm, for the potential treatment of benign prostatic hyperplasia: ex vivo and in vivo investigations. BJU Int 103(6):770–775CrossRefPubMed

49.

Seitz M, Ruszat R, Bayer T, Tilki D, Bachmann A, Stief C, Sroka R, Reich O (2009) Ex vivo and in vivo investigations of the novel 1,470 nm diode laser for potential treatment of benign prostatic enlargement. Lasers Med Sci 24(3):419–424CrossRefPubMed

50.

Ruszat R, Seitz M, Wyler SF, Müller G, Rieken M, Bonkat G, Gasser TC, Reich O, Bachmann A (2009) Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia. BJU Int (Epub ahead of print)

51.

Seitz M, Sroka R, Gratzke C, Schlenker B, Steinbrecher V, Khoder W, Tilki D, Bachmann A, Stief C, Reich O (2007) The diode laser: a novel side-firing approach for laser vaporisation of the human prostate—immediate efficacy and 1-year follow-up. Eur Urol 52(6):1717–1722CrossRefPubMed

52.

Leonardi R (2009) Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique. Prostate Cancer Prostatic Dis (Epub ahead of print)

53.

Rieken M, Wyler S, Müller G, Bonkat G, Gasser T, Bachmann A (2009) Laser vaporization of the prostate: intermediate-term follow-up with the 200 W high-intensity diode (HiDi) laser system. Eur Urol Suppl 8(4):269 Abstract 589

54.

Wendt-Nordahl G, Huckele S, Honeck P, Alken P, Knoll T, Michel MS, Häcker A (2008) Systematic evaluation of a recently introduced 2-μm continuous-wave thulium laser for vaporesection of the prostate. J Endourol 22(5):1041–1045CrossRefPubMed

55.

Bach T, Wendt-Nordahl G, Michel MS, Herrmann TR, Gross AJ (2009) Feasibility and efficacy of Thulium:YAG laser enucleation (VapoEnucleation) of the prostate. World J Urol (Epub ahead of print)

56.

Bach T, Hermann TR, Haecker A, Michel MS, Gross A (2009) Thulium:yttrium-aluminium-garnet laser prostatectomy in men with refractory urinary retention. BJU Int (Epub ahead of print)

57.

Bach T, Bach T, Netsch C, Haecker A, Michel MS, Herrmann TR, Gross AJ (2009) Thulium:YAG laser enucleation (VapoEnucleation) of the prostate: safety and durability during intermediate-term follow-up. World J Urol (Epub ahead of print)

58.

Bach T, Hermann TR, Ganzer R, Burchardt M, Gross AJ (2007) RevoLix vaporesection of the prostate: initial results of 54 patients with a 1-year follow-up. World J Urol 25(3):257–262CrossRefPubMed

59.

Xia SJ, Zhuo J, Sun XW, Han BM, Shao Y, Zhang YN (2008) Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol 53(2):382–389CrossRefPubMed

60.

Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, Lack N, Stief CG (2008) Urology Section of the Bavarian Working Group for Quality Assurance, Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol 180(1):246–249CrossRefPubMed

61.

62.

Madersbacher S, Lackner J, Brössner C, Röhlich M, Stancik I, Willinger M, Schatzl G (2005) Prostate Study Group of the Austrian Society of Urology, Reoperation, myocardial infarction and mortality after transurethral and open prostatectomy: a nationwide, long-term analysis of 23,123 cases. Eur Urol 47(4):499–504CrossRefPubMed

Title: Complications of laser prostatectomy: a review of recent data
Authors: Malte Rieken
Nicole Ebinger Mundorff
Gernot Bonkat
Stephen Wyler
Alexander Bachmann
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 1/2010
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-009-0504-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Complications of laser prostatectomy: a review of recent data

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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