Laser treatment and enlarged prostates: is it effective?

This study compared the safety and effectiveness of two types of laser treatments used to remove prostate tissue in patients with large prostates. It concluded that both treatments were safe, improved urinary function and decreased prostate size.

Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. An enlarged prostate can affect bladder function and have a negative impact on quality of life. Treatments for BPH may include medication or surgery to remove excess prostate tissue. Medications for BPH often result in many side effects while surgery can lead to complications. Complications often include sexual and urinary dysfunction.

Lasers can also be used to breakdown excess prostate tissue. Thulium (ThuVEP) and holmium (HoVEP) are two different kinds of lasers which can be used to break down the tissue. This surgical technique can be less invasive than traditional prostate tissue removal. This type of treatment has also shown improvement in BPH patients in other studies. 

94 male BPH patients were selected.  These patients were 18 years old or older and had very large prostates. Patients were randomly assigned to either the TuVEP or HoLEP laser groups. Erectile function, urine flow and quality of life were examined before, at 1 and at 6 months after surgery.

At the beginning of the study, there was no difference between the two groups. 15.2% of patients in the HoVEP group retained urine at 1 month after surgery, compared to 2.1% of those in the ThuVEP group. Stress incontinence occurred in approximately 19% of the ThuVEP group compared to 17.5% of the HoVEP group. Urge incontinence occurred in approximately 2% of the ThuVEP group and 9% of the HoVEP group 1 month after surgery. Approximately 2% of the patients in each group suffered urge incontinence (inability to hold on to urine) at 6 months after surgery. No patient had stress incontinence (urinating when coughing or straining) at the 6 month mark. Urinary tract infections occurred in a small percentage of patients in both groups. Quality of life and urine flow improved in both groups at both the 1 and 6 month marks. Prostate size also reduced in both groups at 6 months after surgery.

This study concluded that in BPH patients with larger prostates, both ThuVEP and HoVEP lasers were safe and could improve urinary function.

The authors note that 4 weeks after surgery, a higher number of the HoLEP group than the ThuVEP group had to have a catheter fitted. They also note that future studies like this one should use a bigger number of patients.

If you are interested in learning more about Thulium or Holmium laser treatment for BPH, contact your doctor.