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Enlarged Prostate: Laser Therapies

Topic Overview

Several laser methods for treating an enlarged prostate gland (benign prostatic hyperplasia, or BPH) are now being used. Laser therapy uses a laser beam to remove the part of the prostate that is blocking the urethra. The procedure is done under either a general or spinal anesthetic. Most men who have laser treatment of BPH are able to leave the hospital the same or the next day.

While several laser methods are used, in general they all either sear (laser ablation) or vaporize (laser vaporization) the prostate tissue.

  • As the seared tissue heals, it shrinks, dead tissue falls off, and the blockage is reduced. This may require several days.
  • With vaporization, a channel is immediately opened, allowing the free flow of urine.

Studies comparing laser methods with transurethral resection of the prostate (TURP) have found that:

  • Laser therapies improve symptoms about the same as TURP.footnote 1, footnote 2
  • Laser therapies improve quality of life about as well as TURP.footnote 3
  • Compared to men who have TURP, men who have a laser therapy have a shorter hospital stay.footnote 4
  • Men who have a laser therapy need to have another treatment more often than men who have TURP.footnote 3

Other things to think about include the following:

  • Some men may choose laser therapy because of the shorter hospital stay, shorter time with a urinary catheter, and lower risk of complications. But discomfort during urination lasts longer after laser surgery.
  • Laser therapies are newer than other treatments for BPH, so there isn't as much evidence on long-term results. Men who have laser therapy for BPH may be more likely to need another treatment than men who have an older treatment, like transurethral resection of the prostate (TURP).

Prostate surgery using a laser may not be available in all hospitals.

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References

Citations

  1. Lourenco T, et al. (2008). Minimally invasive treatments for benign prostatic enlargement: Systematic review of randomised controlled trials. BMJ, 337(7676): a1662-a1669.
  2. Lourenco T, et al. (2008). Alternative approaches to endoscopic ablation for benign enlargement of the prostate: Systematic review of randomised controlled trials. BMJ, 337(301): a449-a457.
  3. Wilt TJ, N'Dow J (2008). Benign prostatic hyperplasia. Part 2-Management. BMJ, 336(7637): 206-210.
  4. AUA Practice Guidelines Committee (2010). AUA guideline on management of benign prostatic hyperplasia. Chapter 1: Guideline on the management of benign prostatic hyperplasia (BPH). Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.

Credits

ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerJ. Curtis Nickel, MD, FRCSC - Urology

Current as ofDecember 3, 2017


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