Review ArticlesPhotoselective Vaporization of the Prostate: An Effective Procedure for the Treatment of Benign Prostatic HyperplasiaIntroductionSteven A Kaplan
Review ArticlesExpanding the Role of Photoselective Vaporization of the ProstatePhotoselective Vaporization of the ProstateSteven A KaplanThe use of the potassium-titanyl-phosphate (KTP) laser for the ablative treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) has gained wide acceptance in the urologic community. The efficacy and safety of photoselective vaporization of the prostate using 60-W or 80-W KTP have been demonstrated in multiple trials, with significant impact on special high-risk surgical populations (ie, patients with large prostates and anticoagulated patients with multiple comorbidities) with symptomatic BPH. The high-power KTP laser technique has also shown encouraging results in the management of urethral strictures. With catheter removal, improvement in voiding may not immediately occur; however, with the efficient vaporization and limited coagulation necrosis that are routinely noted with high-power KTP applications, improvement may occur in as early as a few days to 1 week. Because of the superior surgical hemostasis associated with laser prostatectomy, no restrictions on physical activity are required after the procedure, even in the immediate postoperative period. [Rev Urol. 2006;8(suppl 3):S3-S8]BPHUrethral stricturesProstatectomyKTP laserVaporization
Review ArticlesEconomic Impact of Surgical Intervention in the Treatment of Benign Prostatic HyperplasiaPhotoselective Vaporization of the ProstateJohn M HollingsworthJohn T WeiThe economic burden of benign prostatic hyperplasia (BPH) on our health care system is significant and likely to continue to grow given the burgeoning elderly population. Coincident with the rising number of annual physician office visits and expenditures for BPH has been a dramatic shift in the disease’s management, from surgical to medical care. However, long-term cost data call into question the appropriateness of medical therapy as the initial treatment approach for all men with BPH, particularly those with moderate to severe symptoms. Although there has been a paradigm shift away from traditional BPH surgery, there has been renewed interest in the treatment of BPH with novel surgical techniques and minimally invasive surgeries. The economics of surgical interventions for BPH are discussed. [Rev Urol. 2006;8(suppl 3):S9-S15]Benign prostatic hyperplasiaEconomicsSurgical procedures, minimally invasiveTransurethral resection of prostate
Review ArticlesSafety and Efficacy of the Potassium-Titanyl-Phosphate Laser and Photoselective Vaporization of the Prostate for Benign Prostatic HyperplasiaPhotoselective Vaporization of the ProstateClaus G RoehrbornThe currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate in men with lower urinary tract symptoms and benign prostatic hyperplasia (BPH) is a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Efficacy data from multicenter prospective studies, comparative studies against other interventions, and single-center long-term outcomes suggest the efficacy to be at least equivalent to that of transurethral resection of the prostate, with a very good safety profile. New technological developments promise to further enhance the utility of this laser for application in BPH and urology. [Rev Urol. 2006;8(suppl 3):S16-S23]Benign prostatic hyperplasiaLower urinary tract symptomsPotassium-titanyl-phosphate laserLaser prostatec-tomyPhotoselective vaporization of the prostate
Review ArticlesThe Next Generation In Laser Treatments and the Role of the GreenLight High-Performance System LaserPhotoselective Vaporization of the ProstateAlexis E TeLasers have evolved over the past decade, with technical refinements that have resulted in a procedure that can achieve transurethral-like results in a safe and efficacious manner. The physics and characteristics of the laser light, such as wavelength and power densities, influence efficiency of treatment and safety profiles of various laser techniques and systems. The currently commercially available 80-W potassium-titanyl-phosphate laser used for photoselective vaporization of the prostate gland in men with lower urinary tract symptoms and benign prostatic hyperplasia has been shown to be a safe and effective therapeutic alternative for a wide spectrum of prostate sizes and configurations. Refinements based on clinical experience as well as progress in available technologies have produced an advanced system with improvements in beam quality and an increase in power to provide an increase in vaporization efficiency and flexibility in technique. The refinements require adjustments to current technique. The advanced technological developments enhance the utility of this laser for application in benign prostatic hyperplasia and urology. [Rev Urol. 2006;8(suppl 3):S24-S30]Benign prostatic hyperplasiaLower urinary tract symptomsLaser prostatectomyPotassium-titanyl-phosphate laserTransurethral resection of the prostate