From the Research
Laser ablation for urinary retention is a highly effective treatment option, particularly for patients with benign prostatic hyperplasia (BPH), as it provides significant improvement in urinary flow and reduction in symptoms, with minimal complications, as evident from the most recent study in 2021 1.
Key Points to Consider
- Laser ablation, also known as laser prostatectomy, is a minimally invasive surgical procedure that uses concentrated light energy to remove excess prostate tissue blocking urine flow.
- The procedure is primarily used to treat BPH when it causes urinary retention, and common laser technologies used include holmium laser enucleation of the prostate (HoLEP), photoselective vaporization of the prostate (PVP), and thulium laser enucleation (ThuLEP).
- The most recent and highest quality study, a multicentre randomised controlled trial comparing transperineal percutaneous laser ablation with transurethral resection of the prostate for treating BPH, found that laser ablation has non-inferior efficacy to TURP in improving International Prostate Symptom Score (IPSS) at 3 months, with lower incidence of post-surgery complications 1.
Benefits and Considerations
- Laser ablation is beneficial for patients on blood thinners or with larger prostates who might not be good candidates for other procedures.
- The procedure typically takes 1-2 hours under general or spinal anesthesia, with most patients requiring catheterization for 1-2 days afterward.
- Recovery is relatively quick, with most patients experiencing improved urinary flow within days.
- However, it is essential to consider the potential risks and complications, such as urinary tract infections, and to carefully select patients who are suitable for this treatment option.
Evidence-Based Recommendation
- Based on the most recent and highest quality evidence, laser ablation is a recommended treatment option for patients with urinary retention due to BPH, particularly those who are at high risk for complications or have larger prostates 1.