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PVP Vs. Holmium Laser Treatment For Prostate
There are exciting new laser techniques for treating prostate conditions, that promise shorter recovery times, minimal side effects, and can be used with patients on Coumadin/Warfarin or other blood thinning medications. Prospective patients should know there are two competing laser technologies. This article describes and outlines the two procedures.
There are new laser treatments available for sufferers of BHP (Benign Hypertrophic Prostate) and other prostate conditions. They are replacing the “gold standard” TURP and TUNA procedures, and are characterized by much shorter recovery periods and are ideal for patients who might also be on blood thinner medication (Coumadin/Warfarin).
There are two competing laser technologies for prostate treatments - you should understand the differences: the Holmium (YAG) laser, and PVP (KPT) laser (otherwise known as “Green Light”.) The differences between the two are in the wavelength of the lasers used, and the nature of the energy transmitted to the tissues.
PVP LASER (Green Light)
The PVP (KPT) laser has a somewhat long wavelength that penetrates the tissue more deeply - in fact, the energy penetrates more deeply than it ablates (removes). The consequence is that unablated remaining tissue has been affected by the laser. The result can be a phenomenon known as necrosis of the affected tissue: the remaining tissue dies and may require further treatment of other means to remove, down the line.
This is a potential detrimental side effect. Because of the higher possibility of necrosis, PVP is not recommended for larger prostate conditions. It is considered viable for smaller prostates.
HOLMIUM LASER
The Holmium (YAG) laser has a shorter wavelength and penetrates less deeply than the PVP. Energy from the laser is imparted only to the the tissue that is ablated (removed). As a result, there is no necrosis concern.
In a panel discussion of noted urologists comparing the two technologies for HoLAP procedures[1], the experiences of all came down positively for the Holmium vs. the PVP laser.
HoLEP - ENUCLEATION OF THE PROSTATE
With the Holmium laser, it is now possible to completely remove the prostate with minimal side effects. This is called enucleation. The procedure entails making a pair of incisions in the bladder, going in with the flexible laser instruments, and detaching the prostate completely from the surrounding tissues. It is then sectioned, and the sections are brought into the bladder through the incisions, where they are broken up into passable bits (the bits are passed through the catheter.)
This is becoming the new “gold standared” treatment, replacing the TURP procedure in many advanced urological centers. Side effects are minimal, and, according to one study[2], sexual function (ability to gain and maintain an erection) may actually increase, depending on the nature of prior dysfunction, if any.
WHERE TO GO?
One consideration is going overseas for treatment. HoLEP is available in at least one group of urolotical hospitals located in India, using exactly the same procedures and equipment as in major US facilities. Costs overseas can be significantly less than that in the US.
[1]Urological Times [2]Journal of Andrology