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133 - Interstitial laser thermal therapy for benign prostatic hyperplasia

Published online by Cambridge University Press:  12 January 2010

Muta M. Issa
Affiliation:
Emory University, School of Medicine, Atlanta, GA
Rafael Bouet-Blasini
Affiliation:
Emory University, School of Medicine, Atlanta, GA
Michael F. Lubin
Affiliation:
Emory University, Atlanta
Robert B. Smith
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Nathan O. Spell
Affiliation:
Emory University, Atlanta
H. Kenneth Walker
Affiliation:
Emory University, Atlanta
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Summary

Although TURP is a very efficacious treatment for BPH, its risks, morbidity profile, inconveniences, and recovery time concerns patients and urologists. The wide gap that existed for years between simple medical therapy and TURP coupled with the need for simpler, less morbid alternatives to TURP, led to the development of minimally invasive thermal therapies such as interstitial laser thermal therapy (ILTT), which achieves its therapeutic effect through thermal ablation of the prostatic tissue (110°C). Various other nomenclatures have been used in the literature for this procedure, including interstitial laser coagulation (ILC), interstitial thermal therapy (ITT), interstitial laser therapy (ILT), laser-induced thermal therapy (LITT), and laser delivered interstitial therapy (LDIT).

These are numerous advantages over conventional surgical therapy offered by ILTT, including the fact that it can be performed on an outpatient basis rather than in the operating room; it requires local anesthesia rather than spinal or general anesthesia; it is safe and has negligible morbidity profile with regard to bleeding, impotence, retrograde ejaculation, and urinary incontinence when compared to TURP; it is efficacious in the treatment of BPH; patients can often resume work and normal daily activities within a few days after the procedure; and it can be performed safely on high surgical risk patients, the elderly, and those on anticoagulation therapy.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
, pp. 791 - 792
Publisher: Cambridge University Press
Print publication year: 2006

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References

Issa, M. M., Ritenour, C., Greenberger, M., Hollabaugh, R. & Steiner, M.The prostate block for outpatient prostate surgery. World J. Urol. 1998; 16(6): 378–383.CrossRefGoogle ScholarPubMed
Issa, M. M., Townsend, M., Jiminez, V. K., Miller, L. E. & Anastasia, K.A new technique of intra-prostatic fiber placement to minimize thermal injury to prostatic urothelium during indigo interstitial laser thermal therapy. Urology 1998; 51: 105–110.CrossRefGoogle Scholar
Kiursh, E. D., Conception, R., Chan, S.et al. Interstitial laser coagulation versus transurethral resection for treating benign prostatic obstruction: a randomized trial with 2-year follow-up. Urology 2003; 61(3): 573–578.CrossRefGoogle Scholar
Muschter, R. Interstitial laser therapy of benign prostatic hyperplasia. In Graham, S. D. Jr. & Glenn, J. F., eds. Glenn's Urological Surgery. 5th edn. Philadelphia, PA: Lippincott-Raven, 1998: 1111–1117.Google Scholar

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