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Laser Therapy

Laser Therapy is used in several procedures that treat prostate enlargement1

How does Laser Therapy treat an enlarged prostate?
Both our Photoselective vaporization of the prostate and Holmium Laser Therapies are endoscopic procedures and treat an enlarged prostate by using light.

When the laser beam is absorbed by the tissue, it gets hot and makes the cells burst, turning the targeted tissue into vapour. This heat can make the blood vessels near the treated area clot, which helps keep the surgical area clear. If there is any bleeding, the machine has a feature to stop it with pulses of energy.1–5

How does a Photovaporisation of the prostate work?

The energy from the Photoselective vaporization of the prostate laser is absorbed by a substance called haemoglobin, found in red blood cells in the body.6 The absorption of energy by haemoglobin causes the affected red blood cells to collapse, leading to the removal of excess tissue.6

Due to the absorption nature of Photovaporisation of the prostate Laser Therapy, it is a potential treatment option for patients taking anticoagulants.5

How does a Holmium laser work?
A Holmium Laser Therapy is another treatment option, and its energy is absorbed by water and water-containing tissues, such as the prostate.6 Holmium lasers provide precise incisions penetrating to a tissue depth of 0.4 mm, precision that quickly coagulating tissue without causing deep thermal injury.1,6,7

Furthermore, the Holmium Laser Therapy laser is a procedure that can achieve the desired results in prostates of different sizes.9

Both types of Laser Therapy are backed by clinical evidence

How effective is Laser Therapy?

Laser Therapy has been shown to effectively relieve symptoms associated with an enlarged prostate over a five-year follow-up period.8 Improvements in symptom relief were maintained after 10 years9 and up to 92% of patients were satisfied with the results of both the photoselective vaporization and enucleation of the prostate using laser therapies.10,11,12

Are there any side effects of Photovaporisation of the prostate Laser Therapy?

As with any clinical procedure, Photovaporisation of the prostate laser therapy carries potential risks. These may include:

  • Irritative symptoms13
  • Bleeding13
  • Retrograde ejaculation13
  • Urinary tract infection (UTI)13

It is crucial to discuss the benefits and risks associated with all therapy options with your doctor before initiating treatment.

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Download our Holmium Laser Enucleation Therapy brochure
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Download our Laser Photoselective Vaporisation of the prostate brochure

Frequently asked questions

While surgical treatments are often necessary to relieve bothersome urinary symptoms, these procedures are associated with an increased risk of sexual dysfunction. Nevertheless, both techniques can be performed in an “Ejaculation” sparing approach.*14,15

*Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health.

Studies have shown Laser Therapy symptom improvement can last at least five years after treatment.10, 16-18

Most patients are able to discontinue prostate medication within a few weeks after the procedure. However, it is recommended to consult with your doctor before making any changes to dosage of any current medication.19

References

1.Gravas S, Cornu JN, Gacci M, et al. EAU guidelines on management of non-neurogenic male LUTS. March 2023. Available at: https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts. [Accessed September 2023].

2.Lai S, et al. Comparison of photoselective green light laser vaporisation versus traditional transurethral resection for benign prostate hyperplasia: an updated systematic review and meta-analysis of randomised controlled trials and prospective studies. BMJ Open. 2019;9(8):e028855.

3.Zhong J, et al. A Systematic review and meta-analysis of efficacy and safety following holmium laser enucleation of prostate and transurethral resection of prostate for benign prostatic hyperplasia. Urology. 2019;131:14–20.

4.Cornu JN, et al. A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol. 2015;67(6):1066–1096.

5.EAU Guidelines. Edn. presented at the EAU Annual Congress Milan March 2023. ISBN 978-94-92671-19-6

6.Dołowy Ł, Krajewski W, Dembowski J, Zdrojowy R, Kołodziej A. The role of lasers in modern urology. Cent European J Urol. 2015;68(2):175-82. doi: 10.5173/ceju.2015.53 Epub 2015 Jun 18. PMID: 26251737; PMCID: PMC4526611.

7.Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA

8.Law KW, Tholomier C, Nguyen DD, et al. Global Greenlight Group: largest international Greenlight experience for benign prostatic hyperplasia to assess efficacy and safety. World J Urol. 2021 Mar;39:4398‐95.

9.Elmansy HM, Kotb A, Elhilali MM. Holmium laser enucleation of the prostate: long term durability of clinical outcomes and complication rates during 10 years of followup. J Urol. 2011;186(5):1972–1976..

10.Calves J, Thoulouzan M, Perrouin Verbe MA, et al. Long-term patient reported clinical outcomes and reoperation rate after photovaporization with the XPS 180W greenlight laser. Eur Urol Focus. 2019;5(4):676–680.

11.Bachmann A, et al. A European multicenter randomized noninferiority trial comparing 180 W GreenLight XPS laser vaporization and transurethral resection of the prostate for the treatment of benign prostatic obstruction: 12-month results of the GOLIATH study. J Urol. 2015;193(2):570–578.

12.Gilling PJ, Aho TF, Frampton CM, et al. Holmium laser enucleation of the prostate: results at 6 years. Eur Urol. 2008;53(4):744–749.

13.Lukacs B, Loeffler J, Bruyère F, et al. Photoselective vaporization of the prostate with GreenLight 120 W laser compared with monopolar transurethral resection of the prostate: a multicenter randomized controlled trial. Eur Urol. 2012;61(6):1165–1173.

14. Kim, M., Sh, S., Jh, K., Kim, H. J., & Paick, J. S. (2014). Pilot study of the clinical efficacy of ejaculatory hood sparing technique for ejaculation preservation in holmium laser enucleation of the prostate. International Journal of Impotence Research, 27(1), 20-24. https://doi.org/10.1038/ijir.2014.22.

15. Kini M, Te AE, Kashanian JA, et al. Ejaculatory hood-sparing photoselective vaporization of the prostate vs bipolar button plasma vaporization of the prostate in the surgical management of benign prostatic hyperplasia. J Endourol. 2020 Mar;34(3):322-9.

16. Law KW, Tholomier C, Nguyen DD, et al. Global Greenlight Group: largest international Greenlight experience for benign prostatic hyperplasia to assess efficacy and safety. World J Urol. 2021 Mar;39:4398‐95.

17, Sun I, Yoo S, Park J, et al. Quality of life after photo-selective vaporization and holmium-laser enucleation of the prostate: 5-year outcomes. Sci Rep. 2019;9(1):8261​

18. Woolin T, Denstedt J. The holmium laser in urology. J Clin Laser Med Surg. 2009;16(1):13–20 ​

19. M. Rieken, C. de Nunzio, J.-N. Cornu et al., Medical Treatment Incidence and Persistence After Surgical Relief of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction: A Critical Analysis of the Literature, Eur Urol Focus (2023), https://doi.org/10.1016/j.euf.2023.08.013​ 

The GreenLight™ laser system is intended for incision/excision, vaporization, ablation, hemostasis, and coagulation of soft tissue, including photoselective vaporization of the prostate for benign prostatic hyperplasia (BPH). The laser system is contraindicated for patients who: are contraindicated for surgery, contraindicated where appropriate anesthesia is contraindicated by patient history, have calcified tissue, require hemostasis in >2mm vessels, have uncontrolled bleeding disorders, have prostate cancer, have acute urinary tract infection (UTI), or severe urethral stricture. Possible risks and complications include, but are not limited to, irritative symptoms (dysuria, urgency, frequency), retrograde ejaculation, urinary incontinence, erectile dysfunction, hematuria - gross, UTI, bladder neck contracture/outlet obstruct, urinary retention, perforation - prostate, urethral stricture.

The Lumenis Pulse 120H System  is intended to relieve symptoms and obstructions and reduce prostate tissue associated with BPH  It is contraindicated for patients who are unable to receive endoscopic treatments or are intolerant to prolonged anesthesia, as well as for resection or excision of large vascularized organs.  Holmium lasers are intended solely for use by physicians trained in the use of the Ho:YAG (2.1 μm) wavelength.  Incorrect treatment settings can cause serious tissue damage.  The laser should be used only on tissues that are fully observable.  Possible risks and complications include, but are not limited to, irritative symptoms (dysuria, urgency, frequency), retrograde ejaculation, urinary incontinence, erectile dysfunction, hematuria - gross, UTI, bladder neck contracture/outlet obstruct, urinary retention, perforation - prostate, urethral stricture. You should talk with your doctor about benefits and risks before moving forward with any treatment option.

Boston Scientific acquired the global surgical business of Lumenis Ltd. Some registered names of products manufactured and sold by Boston Scientific may contain the term “Lumenis”. Lumenis is a registered trademark of Lumenis Be.

MyProstateInfo.co.uk is a website sponsored by Boston Scientific.

This material is for informational purposes only and not meant for medical diagnosis. This information does not constitute medical or legal advice, and Boston Scientific makes no representation regarding the medical benefits included in this information. Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health.

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