A Review of Laser Prostate Procedures
Posted on Friday 28th September 2007 by Garrick Berger. Hits: 116
There is good news for sufferers of BHP (Benign Hypertrophy of the Prostate) and other prostate conditions - new laser treatments are available that have significantly less side effects than the previous treatments (TURP/TUNA), and much shorter recovery durations. In addition, the new laser techniques are ideal for patient who are on blood thinning medications - a not uncommon coincidence, as both conditions tend to crop up in men over fifty.
You should, however, know that there are two laser technologies currently in use for prostate reduction or enucleation: the Holmium (YAG) laser, and PVP (KPT) laser (otherwise known as "Green Light".) The differences between the two are in the wavelength of the lasers used, and the nature of the energy transmitted to the tissues.
PVP LASER (Green Light)
The PVP (KPT) laser has a somewhat long wavelength that penetrates the tissue more deeply - in fact, the energy penetrates more deeply than it ablates (removes). What this means is that tissue that is left behind has been affected by the laser. The result can be a phenomenon known as necrosis of the affected tissue: the remaining tissue dies and may require further treatment of other means to remove, down the line.
This can be a serious side effect. PVP laser treatment is considered viable for smaller prostate conditions, but not for larger, as the possibility of necrosis is higher.
HOLMIUM LASER
The Holmium (YAG) laser has a shorter wavelength and penetrates less deeply than the PVP. Energy from the laser is imparted only to the the tissue that is ablated (removed). As a result, there is no necrosis concern.
In a panel discussion of noted urologists comparing the two technologies for HoLAP procedures[1], the experiences of all came down positively for the Holmium vs. the PVP laser.
HoLEP - ENUCLEATION OF THE PROSTATE
With the Holmium laser, it is now possible to completely remove the prostate with minimal side effects. This is called enucleation. The procedure entails making a pair of incisions in the bladder, going in with the flexible laser instruments, and detaching the prostate completely from the surrounding tissues. It is then sectioned, and the sections are brought into the bladder through the incisions, where they are broken up into passable bits (the bits are passed through the catheter.)
This is becoming the new "gold standared" treatment, replacing the TURP procedure in many advanced urological centers. Side effects are minimal, and, according to one study[2], sexual function (ability to gain and maintain an erection) may actually increase, depending on the nature of prior dysfunction, if any.
WHERE TO GO?
One consideration is going overseas for treatment. HoLEP is available in at least one group of urolotical hospitals located in India, using exactly the same procedures and equipment as in major US facilities. The procedure can be done for as little as a fifth to a tenth of that in the US.
[1]Urological Times [2]Journal of Andrology
Garrick Berger is the managing director of Overseas Medical Connection a company dedicated to assisting prospective patients evaluate their overseas treatment/medical tourism options. The company also maintains a forum for those wishing to exchange research and experiences on medical treatment overseas.
You should, however, know that there are two laser technologies currently in use for prostate reduction or enucleation: the Holmium (YAG) laser, and PVP (KPT) laser (otherwise known as "Green Light".) The differences between the two are in the wavelength of the lasers used, and the nature of the energy transmitted to the tissues.
PVP LASER (Green Light)
The PVP (KPT) laser has a somewhat long wavelength that penetrates the tissue more deeply - in fact, the energy penetrates more deeply than it ablates (removes). What this means is that tissue that is left behind has been affected by the laser. The result can be a phenomenon known as necrosis of the affected tissue: the remaining tissue dies and may require further treatment of other means to remove, down the line.
This can be a serious side effect. PVP laser treatment is considered viable for smaller prostate conditions, but not for larger, as the possibility of necrosis is higher.
HOLMIUM LASER
The Holmium (YAG) laser has a shorter wavelength and penetrates less deeply than the PVP. Energy from the laser is imparted only to the the tissue that is ablated (removed). As a result, there is no necrosis concern.
In a panel discussion of noted urologists comparing the two technologies for HoLAP procedures[1], the experiences of all came down positively for the Holmium vs. the PVP laser.
HoLEP - ENUCLEATION OF THE PROSTATE
With the Holmium laser, it is now possible to completely remove the prostate with minimal side effects. This is called enucleation. The procedure entails making a pair of incisions in the bladder, going in with the flexible laser instruments, and detaching the prostate completely from the surrounding tissues. It is then sectioned, and the sections are brought into the bladder through the incisions, where they are broken up into passable bits (the bits are passed through the catheter.)
This is becoming the new "gold standared" treatment, replacing the TURP procedure in many advanced urological centers. Side effects are minimal, and, according to one study[2], sexual function (ability to gain and maintain an erection) may actually increase, depending on the nature of prior dysfunction, if any.
WHERE TO GO?
One consideration is going overseas for treatment. HoLEP is available in at least one group of urolotical hospitals located in India, using exactly the same procedures and equipment as in major US facilities. The procedure can be done for as little as a fifth to a tenth of that in the US.
[1]Urological Times [2]Journal of Andrology
Garrick Berger is the managing director of Overseas Medical Connection a company dedicated to assisting prospective patients evaluate their overseas treatment/medical tourism options. The company also maintains a forum for those wishing to exchange research and experiences on medical treatment overseas.
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