Láseres en el tratamiento de la HBP

In 1996 the FDA (the North American agency responsible for the regulation of medical procedures) approved lasers for the treatment of obstructive BPH. Since then, many kinds of lasers have been developed.This technique destroys prostate tissue by producing thermal energy that is conducted through a fiber inserted through the urethra, which is used to cut, coagulate and vaporize the tissue and convert it into CO2 and water vapor.

What kinds of lasers are used?

The most frequently used lasers are Ho:YAG (holmium laser), KTP (potassium titanil phosphate or green laser), LBO (lithium triborato), and SCD (semiconductor diode laser).

Holmium laser

This laser uses a fiber that allows the tissue to be simultaneously cut and vaporized, allowing it to be used on large prostates. BPH tissue is cut into 2 or 3 pieces that, by use of a shredder, are separated into small pieces, which are later removed.The advantage of this technique is that patients who have received anticoagulant treatment and who have large prostates can be treated as in open surgery, but with much less bleeding and with a shorter time of hospitilization, between 1 and 2 days. This laser technique does not provide advantages in the treatment of smaller prostates over TUPR (transurethral prostate resection).This laser uses a fiber that allows the tissue to be simultaneously cut and vaporized, allowing it to be used on large prostates.BPH tissue is cut into 2 or 3 pieces that, by use of a shredder, are separated into small pieces, which are later removed.The advantage of this technique is that patients who have received anticoagulant treatment and who have large prostates can be treated as in open surgery, but with much less bleeding and with a shorter time of hospitilization, between 1 and 2 days. This laser technique does not provide advantages in the treatment of smaller prostates over TUPR (transurethral prostate resection).

KTB and LBO laser

KTB is popularly known as “green laser” and works with a maximium energy of 80 W, while LBO needs 120 W. Both techniques allow for adequate tissue destruction by vaporization.KTB is popularly known as “green laser” and works with a maximium energy of 80 W, while LBO needs 120 W. Both techniques allow for adequate tissue destruction by vaporization.

 

The procedure can be monitored by endorectal prostate ultrasound, a technique which we pioneered and have practiced since 2007, which allows us an appropriate view of the photovaporization process. (youtube video). The rate of vaporization is approximately 6 grams in 10 minutes. The procedure can be used on prostates up to 80 grams in weight and in patients that are on anticoagulants. Twenty-four hours after the procedure the urethral probe is removed and the patient is discharged.

Diode laser

Also known as “red laser,” this laser requires a maximum energy of 120 W. Its primary advantage is that it has the highest rate of vaporization, approaching the destruction of 7 grams in 10 minutes, as well as stronger coagulation than other laser models. (Put video). This laser can treat prostates up to 80 grams in weight and the procedure can be monitored by ultrasound. Twenty-four hours after the operation the probe is removed and the patient is discharged.

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Hospital Quirón Teknon
Dr. Jose Mª Gil-Vernet

Consultorios Vilana (despacho 195, 3ª planta)
C/ Vilana, 12
08022 Barcelona

T. +34 93 393 31 95
F. +34 93 393 30 95