Benign prostat hiperplazisinin cerrahi tedavisinde fotoselektif prostat vaporizasyonu (GREEN LIGHTTM)

  • Ümit Yıldırım
  • R. Taner Divrik

Bull Urooncol 2010;9(4):75-79

Benign Prostate Hyperplasia (BPH) affects > %50 of men older than 60 years. The gold standard treatment of BPH has been the transurethral resection of prostate (TURP). However this procedure is associated with a number of complications, and several minimally invasive procedures are available for treating of BPH. During the past 10 years, the use of lasers has developed from coagulation to cutting and vaporization. Photo-selective vaporization of prostate is one of minimal invasive procedure. This technique uses a KTP crystal to double the frequency of a Nd: YAG laser to produce a wavelength of 532 nm (in the green part of the electromagnetic spectrum) which is then preferentially absorbed by oxyhemoglobin, but not the irrigation fluid. Furthermore, due to its wavelength it has a small penetration depth of 1 to 2mm while the fiber does not need to be held in close contact to the prostate. When combined with a pulsing technology that uses a frequency of pulses so fast that it is almost continuous (quasi-continuous) to prevent cumulative heating (which can lead to a large amount of coagulative necrosis), the laser produces a very thin layer of coagulation and minimal blood loss. The TURP-like technique of photo-selective vaporization of the prostate (PVP) with the Green-Light laser is easy to learn and has gained wide acceptance amongst urologists. In numerous clinical trials, PVP proved safe and effective, with immediate tissue debulking properties leading to prompt improvement of LUTS.