Patients with benign prostatic hyperplasia (BPH) who are at high risk of bleeding can be safely and efficiently treated with a laser surgery called two-micrometer (2-μm) continuous laser vaporization, according to results of a new study.
The study, “The Efficacy And Safety Of 2-Μm Continuous Laser In The Treatment Of High-Risk Patients With Benign Prostatic Hyperplasia,” was published in the journal Lasers in Medical Science.
Current surgical techniques used in the treatment of BPH include transurethral resection of the prostate (TURP) and open prostatectomy. However, the rate of complications occurring during and after surgery increases with both methods. Also, patients who had heart conditions and receive anticoagulant medication cannot undergo standard TURP or open surgery due to risk of bleeding.
Another possibility for patients with BPH is the 2-μm continuous laser vaporization, a technique using a laser to perform resection of the prostatic lobes in a way similar to peeling a tangerine. Previous studies have shown that this surgical treatment is both safe and efficient in treating BPH. However, whether this extends to BPH patients with high risk of bleeding remains elusive.
The study included 248 BPH patients with high-risk of bleeding, with moderate to severe lower urinary tract symptoms (LUTS), who underwent a 2-μm continuous laser vaporization of the prostate. They were followed for the next two years to evaluate the safety and effectiveness of the procedure.
All patients had other medical conditions and 94 patients were on oral anticoagulant medication.
The procedure successfully treated BPH in all patients, with no adverse side effects during or after the surgery, although 20 patients needed bladder irrigation afterward. Patients had an average catheterization time (and, thus, hospital time) of approximately two days (range one-five days).
Results indicated that the maximum urinary flow rates (Qmax) increased from 6.9 ± 1.7 ml/s at three months of follow-up, to 19.5 ± 4.1 ml/s at two years after the surgery. Also, the Mean International Prostate Symptom Scores (IPSS) decreased from 27.6 ± 5.1 before the surgery, to 6.25 ± 1.30 at two years after the surgery.
“Two-micrometer continuous laser vaporization is a safe and effective surgical endoscopic technique associated with low complication rate in BPH patients at high risk and those on anticoagulation therapy who have severe LUTS caused by BPH,” the authors concluded.