Current state of the art photoselective vaporization prostatectomy: laser therapy for benign prostatic hyperplasia

摘要

Since the beginning of this millennium, laser technology for prostatectomy, specifically the 532nm green light wavelength has steadily gained clinical utility, potentially replacing trans urethral resection of the prostate (TURP). Multiple clinical studies demonstrate that its unique features of minimal invasiveness with minimal morbidity are combined in a desirable, safe and efficacious procedure to treat benign prostatic hyperplasia (BPH). Early outcomes studies based on the 80W KTP laser system are comparable to those of TURP, and favor the 532nm laser technology especially in the light of decreased morbidity with the laser. This review will focus on the rationale for treatment and survey the data surrounding the current state of photoselective laser vaporization of the prostate, including multicenter studies, series comparing to TURP, treatment of large prostates and its use in high surgical risk and anticoagulated patients who are not ideal candidates for TURP or open prostatectomy. Finally, the new higher power 532nm laser technology will be presented, highlighting the technological advances that will segueway the future for this technology.