Laser endoscopic procedures on the prostate: it is the small details that count.

This review aims to highlight the pros and cons of each laser device and to consider additional possible milestones for the development of laser technologies in the surgical treatment of benign prostate hyperplasia.

Over the last three decades, lasers' role in endourology has gone from strength to strength. Specifically, the primary techniques where laser surgery for BPO relief is concerned are vaporization and enucleation. The idea behind vaporization is that lasers are able to vaporize substantial amounts of tissue due to deep ablation depth and increased power. The most efficient devices for vaporization are those affecting hemoglobin as primary chromophore and/or using a continuous firing mode (KTP/LBO:YAG, diode lasers, Tm:YAG). As for enucleation, multiple devices have been suggested for the adequate anatomical enucleation of the prostate (EEP). As it is a skill-dependent technique, the EEP is effective irrespective of which device the surgeon uses. However, some devices have shown significant advances where enucleation is concerned.

The choice of device should be based primarily on the technique the surgeon prefers. Although the most suitable lasers for vaporization are hemoglobin-targeting and/or continuous wave devices, the EEP may be done with any enough powered laser, yet some provides specific effects which you should be aware before the surgery.

Current opinion in urology. 2021 Jul 06 [Epub ahead of print]

Mark Taratkin, Camilla Azilgareeva, Daria Taratkina, Evgenia Goryacheva, Leonid Rapoport, Dmitry Enikeev

Institute for Urology and Reproductive Health International School "Medicine of the Future", Sechenov University Moscow State University of Medicine and Dentistry Department of Internal Diseases, Sechenov University, Moscow, Russia.

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