A Review of Laser Prostate Procedures

by Garrick Berger

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.

There are two competing laser technologies for prostate treatments - you should understand the differences: 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). The consequence is that unablated remaining tissue 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. Because of the higher possibility of necrosis, PVP is not recommended for larger prostate conditions. It is considered viable for smaller prostates.

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 discussion comparing the two technologies (for HoLAP application)[1], a panel of noted urlogists universally concluded the Holmium laser to be preferable to. 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 prostate is completely detached with fine (2-3mm) laser instruments, and passed through a pair of incisions in the bladder. 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. Costs overseas can be significantly less than that in the US.

[1]Urological Times [2]Journal of Andrology

About the Author

Garrick Berger is the managing director of Overseas Medical Connection (http://www.overseasmc.com), a company dedicated to assisting prospective patients evaluate their overseas treatment/medical tourism options. The company also maintains a forum (http://forum.overseasmc.com ) for those wishing to exchange research and experiences on medical treatment overseas.