Fotovaporización prostática (FVP) mediante láser verde: Ventajas quirúrgicas en pacientes de riesgo

Abstract

It is more and more common to have patients in our clinics with the diagnosis of BPH and indication for surgery who present limitations due to their medications, age, associated morbidity or psychosocial conditions. Transurethral resection of the prostate, though it is the surgical standard of reference, is not free from complications such as reabsorption syndrome, bleeding, or even blood transfusion in a percentage of cases. Laser PVP may be a valid alternative in this subgroup of patients. We review our experience with this procedure, as well as the published articles on this topic, and describe technical recommendations we consider useful to avoid complications when possible during surgery or the immediate postoperative period.

Greenlight Photoselective Vaporisation of the Prostate in 133 High Surgical Risk Patients: A 5-Year Outcome Study

“…The risk of blood transfusion in risk-free TURP patients is about 2.5%. This percentage increases to 9% -33% in high-risk patients according to the European Guidelines [2,5,[8][9][10][11], with a 10% -27% likelihood of readmission. Different publications have analysed the incidence of TURP complications and found frank intraoperative haematuria in up to 10.8% of cases [4], complications in 15% -20%, reabsorption syndrome in 5%, reoperation required within the first 10 years in 10% -15% [12], erectile dysfunction in about 13% in a multicentre study conducted by the AUA [13], mortality in up to 0.8%, morbidity ranging from 7% to 14% depending on the series [7], retrograde ejaculation in 75% [13], post-TURP syndrome in about 5%, perforation in 10%, reoperations in 12% [14].…”