Interessa gli uomini di età superiore ai 50 anni ed è dovuta ad un aumento delle dimensioni e del volume della ghiandola prostatica.

Sintomatologia
– Stranguria (bruciore alla minzione)
– Pollachiuria (stimolo frequente alla minzione)
– Senso di pesantezza sovrapubica e perineale
– Nicturia (il paziente si alza la notte ad urinare)
– Difficoltà alla minzione

Diagnosi
– PSA
– Ecografia addome inferiore
– Flussimetria
– Valutazione del residuo post-minzionale.

Terapia medica
– Farmaci alfa bloccanti
– Inibitori della 5 alfa reduttasi

Terapia chirurgica
– TURP e TURP bipolare: resezione per via endoscopica del tessuto prostatico mediante un’ansa che taglia e coagula tramite la corrente elettrica che la attraversa.
– Adenectomia prostatica trans-vescicale.
– Laser Holmium: permette incisione ed asportazione dei lobi prostatici. I risultati sono simili alla TURP con il vantaggio però di ottenere scarso sanguinamento e breve cateterismo (massimo 48 ore). Lo svantaggio è rappresentato dalla comparsa di sindrome irritativa dato che tale tecnica agisce in profondità, trasmettendo calore alla capsula prostatica (svantaggio che però può essere eliminato dalla capacità e dall’esperienza dell’operatore).
– Laser KTP (Potassio Tytanil Fosfato): permette fotovaporizzazione selettiva (PVP) della prostata. I vantaggi sono rappresentati da un più ridotto sanguinamento,da un cateterismo di durata inferiore a 30 ore, dal mantenimento di eiaculazione anterograda e dalla ripresa dell’attività lavorativa entro 7-10 giorni. La sindrome irritativa compare più facilmente se il trattamento interessa ghiandole prostatiche di notevoli dimensioni che necessitano di maggiore energia.
– Laser Tullio: ha il notevole vantaggio di potere svolgere entrambe le azioni dei precedenti laser con minori effetti collaterali. Tale laser ci permette di aggredire prostate di qualsiasi dimensione cambiando solo la tecnica chirurgica.
Superiore a tutti gli altri tipi di laser, la nuova frontiera negli interventi considerati mini invasivi in urologia è ormai segnata dal Thulium Laser 120W che rappresenta un ulteriore passo avanti rispetto predecessore Laser Tullio 70 watt, al laser KTP, ed al laser olmio.

Abstract

Thulium (Tm:YAG) laser vaporesection of prostate and bipolar transurethral resection of prostate in patients with benign prostate hyperplasia: a systematic review and meta-analysis.
Transurethral thulium laser enucleation versus resection of the prostate for treating benign prostatic hyperplasia: a retrospective study.
Photoselective vaporization of the prostate with the 180-W XPS-Greenlight laser: Five-year experience of safety, efficiency, and functional outcomes.
A Randomized Trial Comparing The Learning Curve of 3 Endoscopic Enucleation Techniques (HoLEP, ThuFLEP, and MEP) for BPH Using Mentoring Approach-Initial Results.
Monocenter Experience with 532 Nm-Laser Photoselective-Vaporization of the Prostate by GreenLight XPS™ Laser: Is It Really an Endourological Joker Card?
Comparison of Vela and holmium laser enucleation of the prostate: a
retrospective clinical trial with a 12-month follow-up.

Thulium laser resection versus plasmakinetic resection of prostates larger than 80 ml.
Efficacy and safety of 120-W thulium:yttrium-aluminum-garnet vapoenucleation of prostates compared with holmium laser enucleation of prostates for benign prostatic hyperplasia.
Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis.
Thulium Laser Enucleation Versus Plasmakinetic Enucleation of the Prostate: A Randomized Trial of a Single Center.
A Review of Laser Treatment for Symptomatic BPH (Benign Prostatic Hyperplasia).
Safety and Efficacy of Thulium Laser Prostatectomy Versus Transurethral Resection of Prostate for Treatment of Benign Prostate Hyperplasia: A Meta-Analysis.
Comparison of thulium laser enucleation and plasmakinetic resection of the prostate in a randomized prospective trial with 5-year follow-up.
Comparative study between thulium laser (Tm: YAG) 150W and greenlight laser (LBO:ND-YAG) 120W for the treatment of benign prostatic hyperpplasia: Short-term efficacy and security.
Thulium laser enucleation (ThuLEP) versus transurethral resection of the prostate in saline (TURis): A randomized prospective trial to compare intra and early postoperative outcomes.
Laser enucleation of the prostate (HOLEP and THULEP): a comparative effectiveness analysis in treating recurrent prostatic hyperplasia
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.

Congressi

CONGRESSO 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

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

THREE YEARS REVIEW OF 170 PATIENTS TREATED FOR BPH WITH REVOLIX 2 MICRON CONTINUOUS WAVE LASER
S. Mattioli, Istituto Clinico S. Ambrogio, Milano

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

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

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

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

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

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

Congresso 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

EAU 2015 MADRID

THULIUM LASER FOR Treatment OF BENIGN PROSTATIC HYPERPLASIA IN LARGE
PROSTATE: NEW TECHNIQUE
Dr. S. Mattioli, Dr. A. Picinotti, Dr.ssa A. Burgio
CENTRO UROLOGIALASER.IT

WCE 2013 NEW ORLEANS

THULIUM LASER IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA ON
ANTICOAGULANT AND ANTIPLATELET DRUGS
Dr. S. Mattioli , Dr. A. Picinotti, Dr.ssa A. Burgio
CENTRO UROLOGIALASER.IT

Via Petrarca, 22/A - 52100 Arezzo (AR)

Phone

Phone

+39 0575 401642

Email

Email

info@urologialaser.it