New advances in benign prostatic hyperplasia: laser therapy

Throughout the past decade, numerous techniques for the treatment of benign prostatic hyperplasia have emerged. Laser therapy, in particular, has gained widespread popularity among urologists. Since its inception in 1996, holmium laser enucleation of the prostate (HoLEP) has been evaluated rigorously in the treatment of glands of all sizes. HoLEP has produced superior relief of bladder outlet obstruction as compared to transurethral resection of the prostate based on urodynamics, and has proved equally as effective as open prostatectomy, for the management of very large glands (>100 cc), with lower morbidity. In addition to HoLEP, several newer but less well-studied laser techniques currently are available. These include photoselective laser vaporization utilizing the potassium-titanyl-phosphate (KTP or "green light") laser, thulium laser enucleation, and high-power diode laser vaporization. This report reviews the most current literature on laser therapies utilized in the treatment of benign prostatic hyperplasia with regards to safety, outcome, efficiency, and long-term durability.