Laser therapy for benign prostatic hyperplasia

Several laser methods for treating an enlarged prostate gland (benign prostatic hyperplasia, or BPH) are now being used. Laser therapy (also called photoselective vaporization of the prostate, or PVP) 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:

• Visual laser ablation and contact laser ablation improve symptoms the same amount as TURP.¹
• Laser vaporization treatment is as effective as TURP.¹
• Compared to TURP, laser methods have a shorter hospital stay and fewer complications from surgery. But men who have laser surgeries need to have another surgery more often.²

Other considerations include the following:

• Some men may choose laser therapy because of the shorter hospital stay and lower risk of complications.
• Laser prostatectomy causes less bleeding than other types of surgery. But discomfort during urination lasts longer after laser surgery, and a catheter may be needed for a longer time.

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

Citations

1. Webber R (2006). Benign prostatic hyperplasia, search date May 2005. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
2. Hoffman RM, et al. (2003). Laser prostatectomy versus transurethral resection for treating benign prostatic obstruction: A systematic review. Journal of Urology, 169(1): 210–215.