Skip to main content

Advertisement

SpringerLink
Log in

Laser treatment of symptomatic benign prostatic hyperplasia

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

The treatment of lower urinary symptoms secondary to benign prostatic hyperplasia (BPH) after failure of medical therapies remains controversial for most urologic surgeons. The complications of traditional surgery are the driving force behind the development of several minimally invasive treatments of symptomatic BPH. Laser prostatectomy is one of the most investigated such modalities. In this article we reviewed the results of the most common types of lasers used in prostatic surgery.

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

  1. Aho TF, Gilling PJ (2003) Laser therapy for benign prostatic hyperplasia: a review of recent developments. Curr Opin Urol 13:39–44

    Article  PubMed  Google Scholar 

  2. Arai Y, Ishitoya S, Okubo K, Suzuki Y (1996) Transurethral interstitial laser coagulation for benign prostatic hyperplasia: treatment outcome and quality of life. Br J Urol 78:93–98

    PubMed  CAS  Google Scholar 

  3. AUA Practice Guidelines Committee: AUA guideline on management of benign prostatic hyperplasia (2003) Diagnosis and treatment recommendations, chap 1. J Urol 170:530–547

    Google Scholar 

  4. Bachmann A,Ruszat R, Wyler S, Reich O, Seifert H, Muller A, Sulser T (2005) Photoselective vaporization of the prostate: the basel experience after 108 procedures. Eur Urol 47:798–804

    Article  PubMed  Google Scholar 

  5. Barber NJ, Muir GH (2004) High-power KTP laser prostatectomy: the new challenge to transurethral resection of the prostate. Curr Opin Urol 14:21–25

    Article  PubMed  Google Scholar 

  6. Borboroglu PG, Kane CJ, Ward JF, Roberts JL, Sands JP (1999) Immediate and postoperative complications of transurethral prostatectomy in the 1990s. J Urol 162:1307

    Article  PubMed  CAS  Google Scholar 

  7. Cornford PA, Biyani CS, Powell CS (1998) Transurethral incision of the prostate using the holmium: YAG laser: a catheterless procedure. J Urol 159:1229–1231

    Article  PubMed  CAS  Google Scholar 

  8. Corvin S, Schneede P, Siakavara E, Frimberger D, Zaak D, Siebels M, Reich O, Hofstetter A (2002) Interstitial laser coagulation combined with minimal transurethral resection of the prostate for the treatment of benign prostatic hyperplasia. J Endourol 16:387–390

    Article  PubMed  Google Scholar 

  9. Costello AJ, Bowsher WG, Bolton DM, Braslis KG, Burt J (1992) Laser ablation of the prostate in patients with benign prostatic hypertrophy. Br J Urol 69:603–608

    PubMed  CAS  Google Scholar 

  10. Cowles RS 3rd, Kabalin JN, Childs S, Lepor H, Dixon C, Stein B, Zabbo A (1995) A prospective randomized comparison of transurethral resection to visual laser ablation of the prostate for the treatment of benign prostatic hyperplasia. Urology 46:155–160

    Article  PubMed  Google Scholar 

  11. Cresswell MD, Cass CB, Fraundorfer MR, Gilling PJ (1997) Holmium:YAG laser resection of the prostate: preliminary experience with the first 400 cases. N Z Med J 110:76–78

    PubMed  CAS  Google Scholar 

  12. Cummings JM, Parra RO, Boullier JA, Crawford K, Petrofsky J, Caulfield JJ (1995) Evaluation of fluid absorption during laser prostatectomy by breath ethanol techniques. J Urol 154:2080–2082

    Article  PubMed  CAS  Google Scholar 

  13. Das A, Erhard MJ, Bagley DH (1997) Intrarenal use of the holmium laser. Lasers Surg Med 21:198–202

    Article  PubMed  CAS  Google Scholar 

  14. Das A, Fraundorfer M, Gilling P (1999) The holmium laser for the treatment of benign prostatic hyperplasia: a brief review. Lasers Med Sci 14:86–90

    Article  Google Scholar 

  15. Das A, Kennett K, Fraundorfer M, Gilling P (2001) Holmium laser resection of the prostate (HoLRP): 2-year follow-up data. Tech Urol 7:252–255

    PubMed  CAS  Google Scholar 

  16. Das A, Kennett KM, Sutton T, Fraundorfer MR, Gilling PJ (2000) Histologic effects of holmium:YAG laser resection versus transurethral resection of the prostate. J Endourol 14:459–462

    PubMed  CAS  Google Scholar 

  17. El-Hakim A, Elhilali MM (2002) Holmium laser enucleation of the prostate can be taught: the first learning experience. BJU Int 90:863–869

    Article  PubMed  CAS  Google Scholar 

  18. Elzayat E, Elhilali M (2005) Holmium laser enucleation of the prostate (HoLEP): the endourologic alternative to open prostatectomy. Eur Urol 49(1):87–91

    Article  PubMed  Google Scholar 

  19. Elzayat E, Enmar I, Elhilali M (2005) Holmium laser enucleation of the prostate: a size-independent new “gold standard”. Urology 66(5 Suppl):108–113

    Article  PubMed  Google Scholar 

  20. Floratos DL, Sonke GS, Francisca EA, Kiemeney LA, Debruyne FM, de la Rosette JJ (2000) Long-term follow-up of laser treatment for lower urinary tract symptoms suggestive of bladder outlet obstruction. Urology 56:604–609

    Article  PubMed  CAS  Google Scholar 

  21. Fong BC, Elhilali MM (2002) Video article. Ho:YAG laser enucleation of the prostate: technical details. BJU Int 90:870

    Google Scholar 

  22. Fraundorfer MR, Gilling PJ, Kennett KM, Dunton NG (2001) Holmium laser resection of the prostate is more cost effective than transurethral resection of the prostate: results of a randomized prospective study. Urology 57:454–458

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  24. Gilling PJ, Cass CB, Cresswell MD, Fraundorfer MR (1996) Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology 47:48–51

    Article  PubMed  CAS  Google Scholar 

  25. Gilling PJ, Kennett K, Das AK, Thompson D, Fraundorfer MR (1998) Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol 12:457–459

    PubMed  CAS  Google Scholar 

  26. Gilling PJ, Kennett KM, Fraundorfer MR (2000) Holmium laser enucleation of the prostate for glands larger than 100 g: an endourologic alternative to open prostatectomy. J Endourol 14:529–531

    PubMed  CAS  Google Scholar 

  27. Gilling PJ, Kennett KM, Fraundorfer MR (2000) Holmium laser resection v transurethral resection of the prostate: results of a randomized trial with 2 years of follow-up. J Endourol 14:757–760

    PubMed  CAS  Google Scholar 

  28. Gilling PJ, Mackey M, Cresswell M, Kennett K, Kabalin JN, Fraundorfer MR (1999) Holmium laser versus transurethral resection of the prostate: a randomized prospective trial with 1-year followup. J Urol 162:1640–1644

    Article  PubMed  CAS  Google Scholar 

  29. Gilling PJ, Cass CB, Cresswell MD, Malcolm AR, Fraundorfer MR (1996) The use of the holmium laser in the treatment of benign prostatic hyperplasia. J Endourol 10:459

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  31. Hai MA, Malek RS (2003) Photoselective vaporization of the prostate: initial experience with a new 80 W KTP laser for the treatment of benign prostatic hyperplasia. J Endourol 17:93–96

    Article  PubMed  Google Scholar 

  32. Hettiarachchi JA, Samadi AA, Konno S, Das AK (2002) Holmium laser enucleation for large (greater than 100 mL) prostate glands. Int J Urol 9:233–236

    Article  PubMed  Google Scholar 

  33. Hofsteter A (1991) Interstitielle Thermokoagulation(ITK) von Prsoststatumoren. Laser Med 7:179

    Google Scholar 

  34. Hurle R, Vavassori I, Piccinelli A, Manzetti A, Valenti S, Vismara A (2002) Holmium laser enucleation of the prostate combined with mechanical morcellation in 155 patients with benign prostatic hyperplasia. Urology 60:449–453

    Article  PubMed  Google Scholar 

  35. Jacobsen SJ, Girman CJ, Lieber MM (2001) Natural history of benign prostatic hyperplasia. Urology 58(Suppl 1):5–16

    Article  PubMed  CAS  Google Scholar 

  36. Jung P, Mattelaer P, Wolff JM, Mersdorf A, Jakse G (1996) Visual laser ablation of the prostate: efficacy evaluated by urodynamics and compared to TURP. Eur Urol 30:418–423

    PubMed  CAS  Google Scholar 

  37. Kabalin JN (1996) Holmium:YAG laser prostatectomy canine feasibility study. Laser Surg Med 18:221–224

    Article  CAS  Google Scholar 

  38. Keoghane SR, Cranston DW, Lawrence KC, Doll HA, Fellows GJ, Smith JC (1996) The Oxford laser prostate trial: a double-blind randomized controlled trial of contact vaporization of the prostate against transurethral resection; preliminary results. Br J Urol 77:382–385

    PubMed  CAS  Google Scholar 

  39. Keoghane SR, Lawrence KC, Gray AM, Doll HA, Hancock AM, Turner K, Sullivan ME, Dyar O, Cranston D (2000) 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 85:74–78

    Article  PubMed  CAS  Google Scholar 

  40. Keoghane SR, Sullivan ME, Doll HA, Kourambas J, Cranston DW (2000) Five-year data from the Oxford laser prostatectomy trial. BJU Int 86:227–228

    Article  PubMed  CAS  Google Scholar 

  41. Kuntz RM, Ahyai S, Lehrich K, Fayad A (2004) Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol 172:1012–1016

    Article  PubMed  Google Scholar 

  42. Kuntz RM, Lehrich K, Ahyai S (2004) Does perioperative outcome of transurethral holmium laser enucleation of the prostate depend on prostate size? J Endourol 18:183–188

    Article  PubMed  Google Scholar 

  43. Kuntz RM, Lehrich K, Ahyai S (2004) Transurethral holmium laser enucleation of the prostate compared with transvesical open prostatectomy: 18-month follow-up of a randomized trial. J Endourol 18:189–191

    Article  PubMed  Google Scholar 

  44. Kuntz RM, Lehrich K (2002) Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm.: a randomized prospective trial of 120 patients. J Urol 168(4 Pt 1):1465–1469

    Article  PubMed  Google Scholar 

  45. Kuntzman RS, Malek RS, Barrett DM, Bostwick DG (1997) High-power (60-watt) potassium-titanyl-phosphate laser vaporization prostatectomy in living canines and in human and canine cadavers. Urology 49:703–708

    Article  PubMed  CAS  Google Scholar 

  46. Kuo RL, Kim SC, Lingeman JE, Paterson RF, Watkins SL, Simmons GR, Steele RE (2003) Holmium laser enucleation of prostate (HoLEP): the Methodist Hospital experience with greater than 75 gram enucleations. J Urol 170:149–152

    Article  PubMed  Google Scholar 

  47. Kuo RL, Paterson RF, Siqueira TM Jr, Watkins SL, Simmons GR, Steele RE, Lingeman JE (2003) Holmium laser enucleation of the prostate: morbidity in a series of 206 patients. Urology 62:59–63

    Article  PubMed  Google Scholar 

  48. Kuo RL, Paterson RF, Kim SC, Siqueira TM Jr, Elhilali MM, Lingeman JE (2003) Holmium laser enucleation of the prostate (HoLEP): a technical update. World J Surg Oncol 1:6

    Article  PubMed  Google Scholar 

  49. Kursh ED, Concepcion R, Chan S, Hudson P, Ratner M, Eyre R (2003) Interstitial laser coagulation versus transurethral prostate resection for treating benign prostatic obstruction: a randomized trial with 2-year follow-up. Urology 61:573–578

    Article  PubMed  Google Scholar 

  50. Laguna MP, Alivizatos G, De La Rosette JJ (2003) Interstitial laser coagulation treatment of benign prostatic hyperplasia: is it to be recommended? J Endourol 17:595–600

    Article  PubMed  Google Scholar 

  51. Larner TR, Agarwal D, Costello AJ (2003) Day-case holmium laser enucleation of the prostate for gland volumes of <60 mL: early experience. BJU Int 91:61–64

    Article  PubMed  CAS  Google Scholar 

  52. Le Duc A, Gilling PJ (1999) Holmium laser resection of the prostate. Eur Urol 35:155–160

    Article  PubMed  CAS  Google Scholar 

  53. Mackey MJ, Chilton CP, Gilling PJ, Fraundorfer M, Cresswell MD (1998) The results of holmium laser resection of the prostate. Br J Urol 81(4):518–519

    PubMed  CAS  Google Scholar 

  54. 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 46:547–554

    Article  PubMed  Google Scholar 

  55. Madersbacher S, Marszalek M, Ponholzer A, Brossner C (2004) Holmium laser-enucleation of the prostate enables early catheter removal. BJU Int 94:931–933

    Article  PubMed  Google Scholar 

  56. Malek R, Kuntsman RS (2003) Photoselective vaporization of the prostate: 5 year experience with high power KTP laser. J Urol 169(suppl 4):390. Abstract 1457

    Google Scholar 

  57. Malek R, Nahen K (1994) AUA update series, vol 23, lesson 20, pp 154–159

  58. Malek RS, Barrett DM, Kuntzman RS (1998) High-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 hours later. Urology 51(2):254–256

    Article  PubMed  CAS  Google Scholar 

  59. Malek RS, Kuntzman RS, Barrett DM (2000) High power potassium-titanyl-phosphate laser vaporization prostatectomy. J Urol 163:1730–1733

    Article  PubMed  CAS  Google Scholar 

  60. Martenson AC, De La Rosette JJ (1999) Interstitial laser coagulation in the treatment of benign prostatic hyperplasia using a diode laser system: results of an evolving technology. Prostate Cancer Prostatic Dis 2:148–154

    Article  PubMed  Google Scholar 

  61. McAllister WJ, Absalom MJ, Mir K, Shivde S, Anson K, Kirby RS, Lawrence WT, Paterson PJ, Watson GM, Fowler CG (2000) Does endoscopic laser ablation of the prostate stand the test of time? Five-year results from a multicentre randomized controlled trial of endoscopic laser ablation against transurethral resection of the prostate. BJU Int 85:437–439

    Article  PubMed  CAS  Google Scholar 

  62. McNicholas TA, Steger AC, Bown SG (1993) Interstitial laser coagulation of the prostate. An experimental study. Br J Urol 71:439–444

    Article  PubMed  CAS  Google Scholar 

  63. Mebust WK, Holtgrewe HL, Cockett AT, Peters PC, writing committee (1989) Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol 141:243

    PubMed  CAS  Google Scholar 

  64. Montorsi F, Naspro R, Salonia A, Suardi N, Briganti A, Zanoni M, Valenti S, Vavassori I, Rigatti P (2004) 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 172(5 Pt 1):1926–1929

    Article  PubMed  Google Scholar 

  65. Moody JA, Lingeman JE (2000) Holmium laser enucleation of the prostate with tissue morcellation: initial United States experience. J Endourol 14:219

    PubMed  CAS  Google Scholar 

  66. Mottet N, Anidjar M, Bourdon O, Louis JF, Teillac P, Costa P, Le Duc A (1999 ) Randomized comparison of transurethral electroresection and holmium: YAG laser vaporization for symptomatic benign prostatic hyperplasia. J Endourol 13:127–130

    Article  PubMed  CAS  Google Scholar 

  67. Muschter R, Hofstetter A (1995) Interstitial laser therapy outcomes in benign prostatic hyperplasia. J Endourol 9:129–135

    PubMed  CAS  Google Scholar 

  68. Naspro R, Freschi M, Salonia A, Guazzoni G, Girolamo V, Colombo R, Scattoni V, Rigatti P, Montorsi F (2004) Holmium laser enucleation versus transurethral resection of the prostate. Are histological findings comparable? J Urol 171:1203–1206

    Article  PubMed  Google Scholar 

  69. Norris JP, Norris DM, Lee RD, Rubenstein MA (1993) Visual laser ablation of the prostate: clinical experience in 108 patients. J Urol 150(5 Pt 2):1612–1614

    PubMed  CAS  Google Scholar 

  70. Pedraza R, Samadi A, Eshghi M (2004) Holmium laser enucleation of the prostate in critically ill patients with technique modification. J Endourol 18:795–798

    Article  PubMed  Google Scholar 

  71. Razvi HA, Denstedt JD, Chun SS, Sales JL (1996) Intracorporeal lithotripsy with the Holmium: YAG laser. J Urol 156:912–914

    Article  PubMed  CAS  Google Scholar 

  72. Roos NP, Wennberg JE, Malenka DJ, Fisher ES, McPherson K, Andersen TF, Cohen MM, Ramsey E (1989) Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. N Engl J Med 320:1120–1124

    Article  PubMed  CAS  Google Scholar 

  73. Singal RK, Denstedt JD, Razvi HA, Chun SS (1997) Holmium: YAG laser endoureterotomy for treatment of ureteral stricture. Urology 50:875–880

    Article  PubMed  CAS  Google Scholar 

  74. Tan AH, Gilling PJ (2002) Holmium laser prostatectomy: current techniques. Urology 60:152–156

    Article  PubMed  Google Scholar 

  75. Tan AH, Gilling PJ, Kennett KM, Fletcher H, Fraundorfer MR (2003) Long-term results of high-power holmium laser vaporization (ablation) of the prostate. BJU Int 92:707–709

    Article  PubMed  CAS  Google Scholar 

  76. Tan AH, Gilling PJ, Kennett KM, Frampton C, Westenberg AM, Fraundorfer MR (2003) A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40 to 200 grams). J Urol 170[4 Pt 1]:1270–1274

    Article  PubMed  CAS  Google Scholar 

  77. Te AE, Malloy TR, Stein BS, Ulchaker JC, Nseyo UO, Hai MA, Malek RS (2004) Photoselective vaporization of the prostate (PVP) for the treatment of benign proatate (BPH): 12 months results from the first U.S. multicenter prospective trial. J Urol 172(4 Pt 1):1404–1408

    Article  PubMed  Google Scholar 

  78. Te AE (2004) The development of laser prostatectomy. BJU Int 93:262

    Article  PubMed  CAS  Google Scholar 

  79. Tinmouth WW, Habib E, Kim SC, Kuo RL, Paterson RF, Terry CL, Elhilali M, Lingeman JE (2005) Change in serum prostate specific antigen concentration after holmium laser enucleation of the prostate: a marker for completeness of adenoma resection? J Endourol 19:550–554

    Article  PubMed  Google Scholar 

  80. Tooher R, Sutherland P, Costello A, Gilling P, Rees G, Maddern G (2004) A systematic review of holmium laser prostatectomy for benign prostatic hyperplasia. J Urol 171:1773–1781

    Article  PubMed  Google Scholar 

  81. van Melick HH, van Venrooij GE, Boon TA (2003) Laser prostatectomy in patients on anticoagulant therapy or with bleeding disorders. J Urol 170(5):1851–1855

    Article  PubMed  Google Scholar 

  82. Vavassori I, Hurle R, Vismara A, Manzetti A, Valenti S (2004) Holmium laser enucleation of the prostate combined with mechanical morcellation: two years of experience with 196 patients. J Endourol 18:109–112

    Article  PubMed  Google Scholar 

  83. Westenberg A, Gilling P, Kennett K, Frampton C, Fraundorfer M (2004) Holmium laser resection of the prostate versus transurethral resection of the prostate: results of a randomized trial with 4-year minimum long-term followup. J Urol 172:616–619

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urology, McGill University School of Medicine, Royal Victoria Hospital, MUHC, 687 Pine Avenue West, Room S6.95, H3A 1A1, Montreal, QC, Canada

    Ehab A. Elzayat & Mostafa M. Elhilali

Authors
  1. Ehab A. Elzayat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mostafa M. Elhilali
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mostafa M. Elhilali.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Elzayat, E.A., Elhilali, M.M. Laser treatment of symptomatic benign prostatic hyperplasia. World J Urol 24, 410–417 (2006). https://doi.org/10.1007/s00345-006-0063-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-006-0063-5

Keywords

Search

Navigation