KTP Green Laser Prostate Vaporization

Introduction

The prostate is an external secretory gland and, together with the seminal vesicles, constitutes the most important secondary sexual organ in man. Its main role is the secretion of a large proportion of seminal fluid, which plays an important role in fertilization: it serves as a vehicle and nutrition to increase the chances of survival of sperm. The secretions of these glands make up most of the volume and chemical composition of part of the semen.

Prostatism

Over the years, the prostate grows in all men due to the “hyperplasia” that it experiences. The main symptomatology of prostate hyperplasia is caused by the obstruction produced by the enlarged prostate when urine exits the bladder. At an early stage in the process, the patient usually has very few symptoms since the bladder is still able to compensate for the increased resistance to urinary flow. However, as the obstruction progresses, a constellation of symptoms known generically by the name of "prostatism", caused by obstructive symptoms, develops. These symptoms are well known to many elderly men and are the ones that often make the patient come to the consultation: difficulty and delay in the onset of urination, decreased caliber and strength of the voiding stream, intermittent or prolonged urination, postvoid drip, incomplete emptying sensation, urinary retention, overflow incontinence. Most of these effects are due to a narrowing of the urethra, so you have to use more force to urinate.

The obstruction is associated with a decrease in bladder compliance. All of these changes combine to cause the irritative symptoms that often worry patients the most: decreased functional capacity of the bladder and the resulting onset of frequency, urgency, nocturia, and urge incontinence. The irritative symptoms are usually the reflection of involuntary contractions of the bladder.

Medical and surgical treatment of benign prostatic hyperplasia

There are several treatments that depend fundamentally on the symptoms suffered by the patient, age, evolution time, concomitant diseases, etc ... In principle there are two basic treatment options: drug treatment and surgery.

Surgical treatment of BPH is always a second option when drug treatment has not sufficiently alleviated the symptoms or when the patient's symptoms prevent him from leading an almost normal life.

Types of prostate surgery

Two basic modalities of surgical treatment of the prostate can be distinguished. One is transurethral resection of the prostate and another is open prostate surgery.

Surgery is by far the best treatment for benign prostatic hyperplasia. Its main mission is to eliminate the increase in tissue that has occurred over the years and therefore eliminate that obstruction to the exit of urine from the bladder.

Fundamentally, the criterion of choice depends on the size of the prostate. In large prostates, open surgery is better because it allows better removal of the same. Other decisive factors are the general condition of the patient: in patients with heart problems, transurethral resection is better, the age of the patient, etc.

Both traditional techniques require a hospital stay of between 3 and 10 days.

KTP «Green Light» laser

This Benign Prostate Hyperplasia (BPH) treatment system has been developed by the Laserscope company in the United States and represents the most important advance that has been made in the last 25 years for the treatment of this pathology, which affects millions of patients. males all over the world, mainly over 55-60 years.

• The system called “VFP Green Light” is unique, because it uses a latest generation, high-energy KTP (Potassium-Titanium-Phosphorus) laser in conjunction with an optical fiber specially designed for this application. The union of both, (laser + fiber) allows us to vaporize soft tissues, completely eliminating the enlarged prostate tissue. The concept of vaporization consists in the complete elimination of the tissue as well as the simultaneous photocoagulation of the blood vessels, practically avoiding the possibility of bleeding, which is always the great concern of urologists in prostate surgery.

KTP laser action mechanism

The mechanism of action focuses on the introduction through the urethra of a dual current cystoscope with the laser fiber, which works with a beam of light with a wavelength of 532 nanometers and with a high affinity for the pigment of hemoglobin. It works at great power by vaporizing the prostate, turning it into water vapor, and eliminating it through a continuous irrigation system. At the same time, it «seals the blood vessels due to its affinity with hemoglobin, a fact that practically eliminates the possibility of bleeding and allows the patient to leave the operation with a probe that is removed in a maximum period of 24-48 hours because the patient he begins to urinate spontaneously.

Another benefit is if the surgical time needs to be extended, but without risks. “This method uses a continuous irrigation system with sterile water and not glycine, as is the case in TUR. By photosealing the blood vessels and using sterile water, there is no possibility of reabsorption of fluids, such as glycine, which is one of the great inconveniences that TUR can cause to the patient.

Advantages of “green light” KTP laser vaporization

According to clinical data obtained in various studies, the KTP laser offers certain advantages:

• It can be administered on an outpatient basis or with minimum hospital admission, between 12 and 24 hours.
• Virtually no blood loss. Ideal for high-risk patients on anticoagulant treatment.
• Quick relief of symptoms.
• Rapid recovery of normal patient activity.
• Bladder catheterization generally less than 24-48 hours.
• Vapor up to 2g per minute.
• In the five years of follow-up at the Mayo Clinic, no patient has required re-treatment.

Remember that MAPFRE Salud incorporates this technique into its policies at no cost to the insured.