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Dr. David
Dr. David, Board Certified MD
Category: Medical
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Experience:  Board Certified Physician
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I am confused by the variety of treatments for benign prostate

Resolved Question:

I am confused by the variety of treatments for benign prostate enlargement -- BPH -- causing BPO..
I understand TURP.
But how many different laser treatments are there?
Is TURis [transurethral plasma vaporization of prostate] different to bipolar plasma vaporization of prostate [TUVP]?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

there are many different types of lasers which are used to vaporize prostate tissue.

Dr. David :

none of them have been shown to be any better than others

Dr. David :

or any better than traditional TURP

Customer:

but most lasers have a better record in regard to recovery process and recovery time, i have read. would you support that? TURP seems crude in comparison.

Dr. David :

TURP is an older technique and has been around longer and so there are longer follow up data for it.

Dr. David :

laser ablative techniques are newer technology so the follow up data is not as long.

Dr. David :

but both can be used to help open up a wider channel for urine to flow out of bladder through the prostate gland.

Customer:

yes, but, the laser treatment seems less 'heavy' in side effects, or the things which accompany the surgery...

Customer:

can you tell me the different kinds of laser treatments, and if the NHS offers them?

Dr. David :

http://www.nhs.uk/Conditions/resectionoftheprostate/Pages/Introduction.aspx

Dr. David :

yes, the NHS does offer them.

Dr. David :

this is from the NHS website

Dr. David :

There are a number of alternatives to a TURP. Some are not suitable for all men with prostate enlargement and may not be as effective in the long term. They include the following. Holmium laser enucleation of the prostate (HOLEP) - a laser is used to separate excess tissue from the prostate into the bladder and the tissue is then removed. HOLEP causes less blood loss, involves a shorter stay in hospital and is suitable for moderate to large prostates. Access to this type of treatment is currently limited in England. Potassium-titanyl-phosphate (KTP) laser vaporisation of the prostate - this involves placing a small fibre optic cable into the urethra (the opening through which you pass urine) and up towards the prostate. Lasers can then be directed out of the fibre optic cable and used to burn away excess prostate tissue. Both HOLEP and KTP laser vaporisation of the prostate may be more suitable for very large prostates, older men who are not fit, or for those using blood thinning medication such as warfarin. Read more about the alternatives to TURP.

Dr. David :

your prostate size of 80 is definitely considered a large prostate

Dr. David :

bordering on very large.

Dr. David :

you are right that healing time will be faster with less blood loss with laser ablation of the prostate gland.

Customer:

good, getting clearer.

Dr. David :

that is good.

Customer:

Is TURis [bipolar plasma vaporisation of pros.] -- seemingly called BPVP or sometimes TUVP [to be confusing] -- same as HOLEP or KTP?,

Dr. David :

yes.

Dr. David :

these are just the two types of lasers used by the NHS.

Dr. David :

Holmium laser and Potassium-titanyl-phosphate laser

Dr. David :

let me know if you have other questions.

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