Urological Science 27 (2016) 35
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Editorial comment
Comments on diode laser þ bTURP vs. uTURP
Taiwan has published most of the important clinical articles in diode laser treatment of BPH [1e5]. Diode laser at 980 nm is an attractive wave length with good absorption of laser energy in both water and hemoglobin. Initial report using diode vaporization was not good [1,2] and the same group improved surgical outcomes through modifying its original version to diode laser vaporization plus bipolar TURP [3], which is the surgical technique applied in this article. The other approaches for better outcomes were diode laser enucleation of prostate at lower energy of 80 W [4] and diode laser-assisted bipolar transurethral resection of the prostate with the oyster procedure [5]. We, urologists, embraced laser technology for better care of BPH. We do have some difficulty in applying pure laser prostatectomy, and many of us use bipolar TURP without hesitate. This article is another example to reflect current situation in managing big prostate. However, the additional use of bipolar TURP raises the question that do we really need diode vaporization before TURP? In the future, the authors are encouraged to prove that combination therapy is better than bipolar TURP, instead of monoploar TURP. Non-inferiority of laser prostatecomy is actually not good enough to replace TURP [6]. Until we prove that some type of laser prostatectomy is superior to monopolar or bipolar TURP, that kind of laser will be the champion of next generation of prostatectomy. Conflicts of interest The authors declare that they have no financial or non-financial conflicts of interest related to the subject matter or materials discussed in the manuscript. Sources of funding
References 1. Chiang PH, Chen CH, Kang CH, Chuang YC. GreenLight HPS laser 120-W versus diode laser 200-W vaporization of the prostate: comparative clinical experience. Lasers Surg Med 2010;42:624e9. 2. Chiang PH, Chen CH. Prostate vaporization in the treatment of benign prostatic hyperplasia by using a 200-w high-intensity diode laser. Curr Urol Rep 2010;11: 249e53. 3. Chen CH, Chiang PH, Lee WC, Chuang YC, Kang CH, Hsu CC, et al. High-intensity diode laser in combination with bipolar transurethral resection of the prostate: a new strategy for the treatment of large prostates (>80 ml). Lasers Surg Med 2012;44:699e704. 4. Yang SS, Hsieh CH, Lee YS, Chang SJ. Diode laser (980 nm) enucleation of the prostate: a promising alternative to transurethral resection of the prostate. Lasers Med Sci 2013;28:353e60. 5. Shih HJ, Chen JT, Chen YL, Chiang HC. Laser-assisted bipolar transurethral resection of the prostate with the oyster procedure for patients with prostate glands larger than 80 mL. Urology 2013;81:1315e9. 6. Thomas JA, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, et al. Green lightXPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: two-yr outcomes of the GOLIATH study. Eur Urol 2016;69:94e102.
Stephen Shei-Dei Yang* Division of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan Medical College of Buddhist Tzu Chi University, Hualien, Taiwan Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan *
16F, #289, Chienkuo Road, Division of Urology, Taipei Tzu Chi Hospital, Xindian, New Taipei 231, Taiwan. E-mail address:
[email protected]. 29 January 2016
No funding was received for the work described in this article.
http://dx.doi.org/10.1016/j.urols.2016.02.005 1879-5226/Copyright © 2016, Taiwan Urological Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
