Skip to main content

Advertisement

SpringerLink
Log in

Lasers for median lobe hyperplasia

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Laser treatment encompases a variety of techniques using different laser wavelengths, application systems, and surgical techniques to achieve contrasting tissue effects such as incision, resection, vaporization, or coagulation. Many studies have proven the clinical efficacy of the various laser techniques for the treatment of benign prostatiuc hyperplasia, including randomized studies versus transurethral prostatectomy (TURP). Recently, long-term follow-up of up to 5 years has demonstrated the durability of the results, although in some of the studies, retreatment rates were higher than after TURP. Median lobes were never seen as a contraindication for treatment in the laser based procedures. Technically, laser treatment techniques such as side-firing transurethral coagulation, contact- and free-beam laser vaporization, interstitial laser coagulation, and the holmium laser-based resection and enucleation are fully suitable for treatment of median lobes. Surprisingly, no studies focussing specifically on laser treatment of median lobes have been published.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Koshiba K, Miki M, Terachi T, Uchida T: Treatment of Benign Prostatic Hyperplasia. Tokyo: Springer; 2000.

    Google Scholar 

  2. Marberger M: Application of Newer Forms of Therapeutic Energy in Urology. Oxford: Isis Medical Media; 1995.

    Google Scholar 

  3. Miller PD, Eardley I, Kaplan SA: Benign Prostatic hyperplasia. In Laser and Heat Therapy. London: Martin Dunitz; 2001.

    Google Scholar 

  4. Smith JA Jr, Milam DF: Techniques for Ablation of Benign and Malignant Prostate Tissue. New York, Tokyo: Igaku-Shoin; 1996.

    Google Scholar 

  5. Muschter R, Hofstetter A: Die interstitielle laserkoagulation mit dem diodenlaser der wellenlänge 830 nm zur therapie der benignen prostatahyperplasie—High versus low volume-koagulation [German]. Lasermedizin 2000, 15:72–80.

    Google Scholar 

  6. Muschter R, Whitfield H: Interstitial laser therapy of benign prostatic hyperplasia. Eur Urol 1999, 35:147–154.

    Article  PubMed  CAS  Google Scholar 

  7. de la Rosette JJMCH, Muschter R, Lopez MA, Gillatt D: Interstitial laser coagulation in the treatment of benign prostatic hyperplasia using a diode-laser system with temperature feedback. Br J Urol 1997, 80:433–438.

    PubMed  Google Scholar 

  8. Shingleton WB, Terrell F, Renfroe LD, et al.: Low-power v high-power KTP laser: improved method of laser ablation of prostate. J Endourol 1999, 13:49–52.

    PubMed  CAS  Google Scholar 

  9. Gilling PJ, Cass CB, Cresswell M, Fraundorfer MR: Holmium laser resection of the prostate: preliminary report of a new technique for benign prostatic hyperplasia. Urology 1996, 47:48–51.

    Article  PubMed  CAS  Google Scholar 

  10. Gilling PJ, Cass CB, Cresswell MD, et al.: The use of the holmium laser in the treatment of benign prostatic hyperplasia. J Endourol 1996, 10:459–461.

    PubMed  CAS  Google Scholar 

  11. Gilling PJ, Cass CB, Malcolm AR, Fraundorfer MR: Combination holmium and Nd:YAG laser ablation of the prostate: initial clinical experience. J Endourol 1995, 9:151–153.

    PubMed  CAS  Google Scholar 

  12. Fraundorfer MR, Gilling PJ: Holmium YAG laser enucleation of the prostate combined with mechanical morcellation: preliminary results. Eur Urol 1998, 33:69–72.

    Article  PubMed  CAS  Google Scholar 

  13. Gilling PJ, Kennett KM, Das A, et al.: Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol 1998, 12:457–459.

    PubMed  CAS  Google Scholar 

  14. Donovan JL, Peters TJ, Neal D, et al.: A randomized trial comparing transurethral resection of the prostate, laser therapy and conservative treatment of men with symptoms associated with benign prostatic enlargement: the CLasP study. J Urol 2000, 164:65–70. Randomized comparison of TURP, laser therapy and watchful waiting with long-term follow-up.

    Article  PubMed  CAS  Google Scholar 

  15. Gujral S, Abrams P, Donovan JL, et al.: A prospective randomized trial comparing transurethral resection of the prostate and laser therapy in men with chronic urinary retention: the CLasP study. J Urol 2000, 164:59–64.

    Article  PubMed  CAS  Google Scholar 

  16. Shingleton WB, Renfroe LD, Kolski JM, Fowler JE Jr: A randomized prospective study of transurethral electro-vaporization vs laser ablation of the prostate in men with benign prostatic hypertrophy. Scand J Urol Nephrol 1998, 32:266–269.

    Article  PubMed  CAS  Google Scholar 

  17. Shingleton WB, Terrell F, Renfroe LD, et al.: A randomized prospective study of laser ablation of the prostate versus transurethral resection of the prostate in men with benign prostatic hyperplasia. Urology 1999, 54:17–21.

    Article  Google Scholar 

  18. Stein BS: Neodymium:yttrium-aluminum-gamet laser prostatectomy. Mayo Clin Proc 1998, 73:787–791.

    PubMed  CAS  Google Scholar 

  19. Tuhkanen K, Heino A, Ala-Opas M: Contact laser prostatectomy compared to TURP in prostatic hyperplasia smaller than 40 ml. Six-month follow-up with complex urodynamic assessment. Scand J Urol Nephrol 1999, 33:31–34. Randomized study of TURP versus contact laser with pressure flow evaluation

    Article  PubMed  CAS  Google Scholar 

  20. Tuhkanen K, Heino A, Ala-Opas M: Hybrid laser treatment compared with transurethral resection of the prostate for symptomatic bladder outlet obstruction caused by a large benign prostate: a prospective, randomized trial with a 6-month follow-up. BJU Int 1999, 84:805–809.

    Article  PubMed  CAS  Google Scholar 

  21. Zom BH, Bauer JJ, Ruiz LIE, Thrasher JB: Randomized trial of safety and efficacy of transurethral resection of the prostate using contact laser versus electrocautery. Tech Urol 1999, 5:198–201.

    Google Scholar 

  22. Krautschick AW, Köhrnann KU, Henkel TO, et al.: Interstitial laser coagulation in benign prostatic hyperplasia: A critical evaluation after 2 years of follow-up. Urol Int 1999, 62:76–80. Long-term follow-up including pressure flow studies of a series of poor-risk patients treated with interstitial laser.

    Article  PubMed  CAS  Google Scholar 

  23. Shingleton WB, Kolski J, Renfroe DL, Fowler JE Jr: Electro-vaporization of the prostate versus laser ablation of the prostate in men with benign prostatic hypertrophy: a pressureflow analysis. Urol Int 1998, 60:224–228.

    Article  PubMed  CAS  Google Scholar 

  24. Muschter R, de la Rosette JJMCH, Whitfield H, et al.: Initial human clinical experience with diode laser interstitial treatment of benign prostatic hyperplasia. Urology 1996, 48:223–228.

    Article  PubMed  CAS  Google Scholar 

  25. Costello AJ, Kabalin JN: Side-firing neodymium:yag laser prostaetectomy. Eur Urol 1999, 5:138–146.

    Article  Google Scholar 

  26. Chertin B, Moriel EZ, Hadas-Halperin I, et al.: Laser prostatectomy—long-term follow-up of 303 patients. Eur Urol 1999, 35:285–288. A large series of long-term follow-up.

    Article  PubMed  CAS  Google Scholar 

  27. Schatzl G, Madersbacher S, Djavan B, et al.: Two-year results of transurethral resection of the prostate versus four ‘less invasive’ treatment options. Eur Urol 2000, 37:695–701.

    Article  PubMed  CAS  Google Scholar 

  28. Floratos DL, de la Rosette JJMCH: The value of urodynamics in laser prostatectomy. Eur Urol 2000, 37:509–516.

    Article  PubMed  CAS  Google Scholar 

  29. Keoghane SR, Lawrence KC, Gray AM, et al.: A double-blind randomized controlled trial and economic evaluation of transurethral resection vs contact laser vaporization for benign prostatic enlargement: a 3-year follow-up. BJU Int 2000, 85:74–78.

    Article  PubMed  CAS  Google Scholar 

  30. Keoghane SR, Sullivan ME, Doll HA, et al.: Five-year data from the Oxford laser prostatectomy trial. BJU Int 2000, 86:227–228. Five-year follow-up of a randomized study of TURP versus contact laser vaporization showing equivalent retreatment rates.

    Article  PubMed  CAS  Google Scholar 

  31. Carter A, Sells H, Speakman M, et al.: Quality of life changes following KTP/Nd:YAG laser treatment of the prostate and TURP. Eur Urol 1999, 36:92–98.

    Article  PubMed  CAS  Google Scholar 

  32. Kuntzman RS, Malek RS, Barrett DM: High-power potassium titanyl phosphate laser vaporization prostatectomy. Mayo Clin Proc 1998, 73:798–801.

    PubMed  CAS  Google Scholar 

  33. Malek RS, Barrett DM, Kuntzman RS: High-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 hours later. Urology 1998, 51:254–546.

    Article  PubMed  CAS  Google Scholar 

  34. Costello AJ, Agarwal DK, Crowe HR, Lynch WJ: Evaluation of interstitial diode laser therapy for treatment of benign prostatic hyperplasia. Tech Urol 1999, 5:202–206.

    PubMed  CAS  Google Scholar 

  35. Daehlin L, Hedlund H: Interstitial laser coagulation in patients with lower uninary tract symptoms from benign prostatic obstruction: treatment under sedoanalgesia with pressure flow evaluation. BJU Int 1999, 84:628–636. Complete pressure-flow evaluation of a series of patients treated with interstitial laser in sedoanalgesia only.

    Article  PubMed  CAS  Google Scholar 

  36. Greenberger M, Steiner MS: The University of Tennessee experience with the Indigo 830e laser device for the minimally invasive treatment of benign prostatic hyper-plasia: interim analysis. World J Urol 1998, 16:386–391.

    Article  PubMed  CAS  Google Scholar 

  37. Lynch WJ, Williams JC Physician’s dialogue: interstitial laser coagulation technique clinical research updates. World J Urol 2000, 18(suppl 1):S14-S15.

    Article  PubMed  Google Scholar 

  38. Steiner MS: Physician’s dialogue: interstitial laser coagulation technique—executive summary. World J Urol 2000, 18(suppl 1):S4-S5.

    Article  PubMed  Google Scholar 

  39. Williams JC: Interstitial laser coagulation of the prostate: introduction of a volume-based treatment forrnula with 12-month follow-up. World J Urol 1998, 16:392–395.

    Article  PubMed  CAS  Google Scholar 

  40. Arai Y, Okubo K, Okada T, et al.: Interstitial laser coagulation for management of benign prostatic hyperplasia: a Japanese experience. J Urol 1998, 159:1961–1965.

    Article  PubMed  CAS  Google Scholar 

  41. Perlmutter AP, Muschter R: Interstitial laser prostatectomy. Mayo Clin Proc 1998, 73:903–907.

    Article  PubMed  CAS  Google Scholar 

  42. Chilton CP, Mundy IP, Wiseman O: Results of holmium laser resection of the prostate for benign prostatic hyperplasia. J Endourol 2000, 14:533–534.

    PubMed  CAS  Google Scholar 

  43. Gilling PJ, Kennett KM, Fraundorfer MR: Holmium laser enucleation of the prostate for glands larger than 100 g: an endourologic alternative to open prostatectomy. J Endourol 2000, 14:529–530.

    PubMed  CAS  Google Scholar 

  44. Gilling PJ, Mackey M, Cresswell M, et al.: Holmium laser versus transurethral resection of the prostate: a randomized prospective trial with 1year followup. J Urol 1999, 162:1640–1644. First randomized study comparing TURP to holmium laser enucleation.

    Article  PubMed  CAS  Google Scholar 

  45. Kabalin JN, Gilling PJ, Fraundorfer MR: Holmium-yttrium-aluminum-gamet laser prostatectomy. Mayo Clin Proc 1998, 73:792–797.

    PubMed  CAS  Google Scholar 

  46. Mackey MJ, Chilton CP, Gilling PJ, et al.: The results of holmium laser resection of the prostate. Br J Urol 1998, 81:518–519.

    PubMed  CAS  Google Scholar 

  47. Matsuoka K, Ilda S, Tomiyasu K, et al.: Holmium laser resection of the prostate. J Endourol 1998, 12:279–282.

    PubMed  CAS  Google Scholar 

  48. Gilling PJ, Cass CB, Malcolm AR, et al.: Holmium laser resection of the prostate versus neodymium:yttrium-aluminum-gamet visual laser ablation of the prostate: a randomized prospective comparison of two techniques for laser prostatectomy. Urology 1998, 51: 573–577.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Diakoniekrankenhaus Academic Teaching Hospital, Elise-Averdieck-Strasse 17, D-27356, Rotenburg, Germany

    Rolf Muschter MD, PhD

Authors
  1. Rolf Muschter MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Gilling MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Muschter, R., Gilling, P. Lasers for median lobe hyperplasia. Curr Urol Rep 2, 306–310 (2001). https://doi.org/10.1007/s11934-001-0069-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-001-0069-x

Keywords

Search

Navigation