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 Reviewer E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer J. Curtis Nickel, MD, FRCSC – Urology

Current as ofMarch 14, 2017