Benign prostatic hyperplasia


It concerns over 50-year-old men and it is due to the increase in extent and volume of the prostatic gland


Symptomatology:
1 Strangury
2 Pollakiuria (frequent stymulus to urination)
3 Aching pubis and perineum (sense of overpubic and perineal heaviness)
4 Nycturia (the patient often gets up at night to urinate)
5 Trouble urinating

Diagnosis:
1 PSA
2 Lower abdomen ultrasound scanning
3 Uroflowmeter
4 Evaluation of the post-urinating residue.

Medical therapy:
1 Alpha blocking medicines
2 Inhibitory 5 alpha reductase

Surgery Therapy:
1 TURP resection by endoscopy of the prostatic tissue, by a loop which cuts and coagulates by means of the power that runs through it
2 Transvesical prostatic adenomectomy
3 Holmium laser: it grants incision and removal of the prostatic lobes. Results are similar to the ones obtained by TURP, but here there is the advantage of poor bleeding and short catheterism (48 hours at most). The disadvantage is represented by the appearance of irritative syndrome, since this tecnique goes deep, conveying heat to the prostatic capsule (this disadvantage, anyway, can be eliminated by the skill of the surgeon)
4 KTP laser (Potassium, Tytanil, Phosphate): it grants a selective photoselective vaporization of the prostate (PVP). The advantages consist in a decreased bleeding, a catheterism during less than 30 hours, a preservation of ejaculatiion and resumption of work within 7-10 days. The irritative syndrome is more likely to appear if the treatment concerns prostatic glands of remarkable extent which need greater power.
5 Thulium laser: it grants the remarkable advantage of being able to carry out both of the actions of the previous lasers with fewer side effects. This laser allows us to attack even prostate of greater extent (80-100 gr).

The Laser Urology Centre Arezzo Italy was born thanks to the experience of Doctor Stefano Mattioli, who was the italian urologist who first introduced the use of laser in urologic surgery rooms ever since 1984. Doctor Alessandro Picinotti is another promoter of the centre and the one who means to continue such procedures through divulgation and spreading of information about the use of laser in urology.

The Italian technology meets the urological surgery with laser Tullio 120 watts. In January 2009, the Laser Urology Centre Arezzo directed by Dr. Stefano Mattioli and Dott.Alessandro Picinotti, after using a thulium laser 120W made ??in Germany, began to use also one of Italian manufacture.


Abstract:
Thulium:YAG laser enucleation (VapoEnucleation) of the prostate: safety and durability during intermediate-term follow-up.
Thulium: YAG 2 mum cw laser prostatectomy: where do we stand?
Thulium:YAG vapoenucleation in large volume prostates.
Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years.
Risk of erectile dysfunction and retrograde ejaculation associated with thulium laser vaporesection of the prostatefor bladder outflow obstruction: a retrospective study.
Comparison of 120-200 W 2 ?m thulium:yttrium-aluminum-garnet vapoenucleation of the prostate.
Thulium:YAG VapoEnucleation of the prostate in large glands: a prospective comparison using 70- and 120-W 2-µm lasers.
Systematic review of surgical treatments for benign prostatic hyperplasia and presentation of an approach to investigate therapeutic equivalence (non-inferiority).
Thulium laser versus holmium laser transurethral enucleation of the prostate: 18-month follow-up data of a single center.
Thulium laser (Revolix) vapoenucleation of the prostate is a safe procedure in patients with an increased risk of hemorrhage.
National trends in surgical therapy for benign prostatic hyperplasia in the United States (2000-2008).
Holmium laser ablation of the prostate (HoLAP): intermediate-term results of 144 patients.
Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 ml: preliminary results of a prospective, randomized clinical trial.
120-W 2-µm thulium:yttrium-aluminium-garnet vapoenucleation of the prostate: 12-month follow-up.
Photoselective vaporisation of the prostate using 80-W and 120-W laser versus transurethral resection of theprostate for benign prostatic hyperplasia: a systematic review with meta-analysis from 2002 to 2012.
120W GreenLight High Performance System laser for benign prostate hyperplasia: 68 patients with 3-year follow-up and analysis of predictors of response. 
A comparative study of thulium laser resection of the prostate and bipolar transurethral plasmakinetic prostatectomy for treating benign prostatic hyperplasia. 
Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients. 
Thulium laser vaporesection versus transurethral electrovaporization of the prostate in high-risk patients with benign prostatic hyperplasia. 
A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laserenucleation of the prostate based on a 2-year followup. 
Photoselective potassium-titanyl-phosphate laser vaporization of the benign obstructive prostate: observations on long-term outcomes. 
Thulium laser resection of prostate-tangerine technique in treatment of benign prostate hyperplasia. 
Photoselective laser vaporization prostatectomy in men receiving anticoagulants. 
Photoselective vaporization of the enlarged prostate with KTP laser: long-term results in 240 patients. 
Current role of lasers in the treatment of benign prostatic hyperplasia (BPH). 
Impact of prostate-specific antigen level and prostate volume as predictors of efficacy in photoselective vaporization prostatectomy: analysis and results of an ongoing prospective multicentre study at 3 years. 
Safety and efficacy of the potassium-titanyl-phosphate laser and photoselective vaporization of the prostate for benign prostatic hyperplasia. 
New laser treatment approaches for benign prostatic hyperplasia. 
Safety and Effectiveness of Photoselective Vaporization of the Prostate (PVP) in Patients on Ongoing Oral Anticoagulation. 
RevoLix vaporesection of the prostate: initial results after 54 patients with an one-year follow-up. 
Thulium Laser versus Standard Transurethral Resection of the Prostate: A Randomized Prospective Trial. 
KTP laser photovaporization of the prostate. 
Predictability of irritative voiding symptoms following photoselective laser vaporization of the prostate. 
Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Xia SJ, Zhuo J, Sun XW, Han BM, Shao Y, Zhang YN. 
Systematic Evaluation of a Recently Introduced 2-Micron Continuous Wave Thulium Laser for Vaporesection of the Prostate. Wendt-Nordahl G, Huckele S, Honeck P, Alken P, Knoll T, Michel MS, Häcker A. 



Conferences:

CONFERENCE AURO, TAORMINA 2008
3 ANNI DI IMPIEGO DEL LASER TULLIO NEL TRATTAMENTO DELL'IPERTROFIA PROSTATICA BENIGNA
Dr A. PICINOTTI, Dr S. MATTIOLI, Dr.ssa M. SBRAGI
Centro Urologialaser.it

TRATAMIENTO DEL LA HIPERTROFIA BENIGNA DE PROSTATA CON EL LASER REVOLIX
Dr S. MATTIOLI, Dr R. MUNOZ, Dr C. RECASENS, Dr J. CORTADA, Dr J.M. URMENETA y H. TEICHMAN
Arch. Esp. Urol., 61, 9 (1.037-1.043), 2008

SIU Centennial Celebration September 2-6, 2007, Paris
THREE YEARS REVIEW OF 170 PATIENTS TREATED FOR BPH WITH REVOLIX 2 MICRON CONTINUOUS WAVE LASER
S. Mattioli, Istituto Clinico S. Ambrogio, Milano

22ND European Congress EAU 21-24 Marzo 2007, Berlino
TWO YEARS REVIEW OF 120 PATIENTS TREATED FOR BPH USING THE REVOLIX 2 MICRON CONTINUOUS WAVE LASER
Mattioli S. Istituto Clinico S. Ambrogio. Milan, Italy

First International Workshop, 29-30 Aprile 2006, Mombay, India
JASLOK HOSPITAL AND RESEARCH CENTRE CONDUCTS THE FIRST INTERNATIONAL WORKSHOP WITH THE REVOLUTIONARY NEW CONTINUOUS WAVE SURGICAL LASER, REVOLIX

20 ND EAU Congress, Marzo 2005, Istanbul, Turchia
VAPORIZATION OF THE PROSTATE: INITIAL EXPERIENCE WITH A THULIUM LASER FOR TREATMENT OF BENIGNIN PROSTATIC HYPERPLASIA
Dott. S. Mattioli, Istituto Clinico S. Ambrogio, Milano

Shanghai Chapter Of Chinese Society Of Urology, Dicembre 2004
PRELIMINARY EXPERIENCE OF REVOLIX 2 MICRON LASER SYSTEM IN MINIMAL INVASIVE UROLOGICAL SURGERY
Dott. S. Mattioli, Istituto Clinico S. Ambrogio, Milano

Conference SIU, Giugno 2004, Milano (IT)
VAPORIZZAZIONE FOTOSELETTIVA DELLA PROSTATA CON LASER KTP 80 W: PRIMO ANNO DI ESPERIENZA IN ITALIA
Dott. S. Mattioli*, Dott. A. Picinotti, Dott. sa S. Civinini, Dott. S. Tenti, Prof. P.P. Paoletti.
"Istituto Clinico S.Ambrogio" Milano. "Casa di Cura Poggio del Sole" Arezzo

Conference Auro, Ottobre 2003, Roma
TRATTAMENTO CHIRURGICO DELL'IPB CON LASER KTP 80 W, PRIMI 6 MESI DI ESPERIENZA
Dott. A. Picinotti, Dott. S. Tenti, Prof. P.P. Paoletti, Casa di Cura Poggio del Sole, Arezzo

Wce Settembre 2003, Montreal, Canada
PHOTOSELECTIVE LASER VAPORIZATION OF PROSTATE (PVP) FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA (BPH)
Dott. S. Mattioli, Istituto Clinico S. Ambrogio, Milano

18 Nd Eau Congress, Marzo 2003, Madrid, Spagna
HIGH POWER KTP/532 LASER FOR PHOTOSELECTIVE VAPORIZATION OF PROSTATE (PVP)
Dott. S. Mattioli, Istituto Clinico S. Ambrogio, Milano


Photographic references: