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From coagulation to enucleation: the use of lasers in surgery for benign prostatic hyperplasia

Nature Clinical Practice Urology volume 2, pages 443–448 (2005)Cite this article

Abstract

The application of lasers for the treatment of benign prostatic hyperplasia has evolved over the past 15 years. Early-generation neodymium: yttrium aluminum garnet lasers were used to coagulate and ablate prostatic tissue, but significant postoperative irritative symptoms and high reoperation rates meant that this approach did not seriously challenge the status quo for long. Ablative techniques have recently become popular again with the marketing of the newer-generation, higher-power potassium titanyl phosphate and holmium lasers. Although short-term data are encouraging, there are no comparative trials of significant duration, so it is not yet possible to draw conclusions with regard to efficacy and durability. The holmium laser can also be used as an incisional and dissecting tool that allows resection or enucleation of whole lobes of the prostate, mimicking the action of the index finger in open prostatectomy. The safety, efficacy, durability and cost-effectiveness of the holmium laser have been shown in well-designed randomized controlled trials.

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Authors and Affiliations

  1. Pediatric Urology Fellow at Great Ormond St Hospital for Children, London, UK

    Liam C Wilson

  2. Consultant Urologist at the Tauranga Hospital, Tauranga, New Zealand

    Peter J Gilling

Authors
  1. Liam C Wilson
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  2. Peter J Gilling
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Correspondence to Peter J Gilling.

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The authors declare no competing financial interests.

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Wilson, L., Gilling, P. From coagulation to enucleation: the use of lasers in surgery for benign prostatic hyperplasia. Nat Rev Urol 2, 443–448 (2005). https://doi.org/10.1038/ncpuro0276

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  • DOI: https://doi.org/10.1038/ncpuro0276

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