Photoselective Vaporization of the Prostate: An Effective Procedure for the Treatment of Benign Prostatic Hyperplasia

[摘要] The diagnostic and therapeutic algorithms for benign prostatic hyperplasia (BPH) have undergone and continue to undergo change. Guided by new research, the approval of novel pharmaceutical and minimally invasive therapies, and the economics of health care financing, physicians have altered their approach to patient care in distinct ways. This evolution in thinking continues today. An example is the application of laser therapies for BPH. For decades, the gold standard for treatment of BPH was electrocautery-based transurethral resection of the prostate (TURP). However, because of perceived morbidity associated with the procedure, there has been a concerted quest to develop safer and more effective treatment alternatives. The attraction to laser therapy is that in theory it promises several advantages over standard TURP, including technical simplicity and the absence or minimization of complications, such as intraoperative fluid absorption, bleeding, retrograde ejaculation, impotence, and incontinence. From an economic perspective, laser therapy is associated with a shorter hospital stay and faster recovery. A further advantage of laser therapy is its minimal bleeding and irrigant absorption. This allows laser prostatectomy on larger glands with less physiologic stress and suggests a role for laser therapy in patients with a high burden of coexisting disease. Recent estimates suggest that an increasing number of practicing urologists are in fact already performing laser prostatectomies on patients with symptomatic BPH, and this number is certain to keep increasing.

[学科分类] 基础医学