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A Personal Reflection of Greenlight 532?nm Laser for BPH Treatment

DOI: 10.1155/2014/207901

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Abstract:

Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia are a bothersome symptom set that affect approximately one in every four males above the age of 50. First line treatment is typically medication, but when medications fail surgical therapy is the next option. Technological advances have made surgical therapy safer and more effective. One area that our group has particular interest and focus in is the application of the 532?nm laser in surgical therapy. The high power 532?nm laser is used to remove obstructive prostatic tissue and the laser energy is selectively absorbed by hemoglobin in the prostate tissue, resulting in effective tissue vaporization and removal. We review our experience with Greenlight laser system and its evolution from the original 60-watt laser to the most recent 180-watt Greenlight system with MoXy fiber. 1. Introduction Our group’s focus has been on men’s health, specifically benign prostatic diseases. We continually look for novel treatments and approaches to dealing with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Initial therapy typically involves medical therapy with alpha blockers, 5 alpha reductase inhibitors, and overactive bladder medications. For many patients, however, these do not provide adequate symptom relief, and surgical intervention is necessary to debulk the prostate to relieve bladder outlet obstruction secondary to a progressive growing prostate responsible for the obstruction and consequent symptoms. The classic, traditional, and minimally invasive procedures involve a prostatectomy that removes/resects the prostate with a wire loop to open the prostatic urethra for better flow. This is commonly known as transurethral resection of the prostate or TURP. This procedure had well known side effects and adverse events including fluid absorption, electrolyte imbalance, intraoperative and postoperative bleeding, and inadequate resection. This prompted the development of novel tools to remove tissue with fewer risks and the development of the original 532?nm laser. Based on a potassium-titanyl-phosphate (KTP) crystal, it provides the technology to attain this improved method of prostatectomy, achieving the desired results with fewer risks. Over the last decade, our group has been involved in its development to improve this technology and we have sought to characterize its safety, efficacy, and durability with our clinical experience of this technology. The 532?nm wavelength is preferentially absorbed by hemoglobin which acts as an intracellular

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