الفهرس 
ANATOMY OF THE PROSTATEOnly 14 pages are availabe for public view
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Abstract
Benign prostatic hyperplasia (BPH), is one of the most common problems of aging men, it can be associated with bothersome lower urinary tract symptoms (LUTS) that affect quality of life.
The range of therapeutic options for the management of BPH continues to widen as technology continues to evolve and improve. But when surgical treatment is considered, transurethral resection of the prostate (TURP) is still the gold standard.
Laser prostatectomy
Laser technology was applied to treat BPH for more than 15 years ago. Technique consists of coagulation, vaporization, resection, and dissection, depending on the wavelength, power, and type of laser emission (Kuntz, 2007).
Holmium laser resection of the prostate (HoLRP)
The Holmium laser (2140 nm) is a pulsed, solid-state laser that has been used in urology for a variety of endourological applications in soft tissues and for the disintegration of urinary calculi. Prostatectomy using this energy source is a relatively new technique with the first patient reports appearing in 1995 (Le Duc et al., 1999).
The peak power achieved results in intense tissue vaporization and in precise and efficient cutting ability in the prostatic tissue (Gilling et al., 1998).
Diode Laser:
Diode laser vaporization of the prostate has the wave lengths 940,980 and 1470mm.
A new type of fibers, commercially named “Twister fiber”, has been recently introduced which is an end-fiber with a 30 degree angulated tip. It has several advantages over the standard side-firing fiber, mainly which it works in a non-contact mode. And if it gets in contact with the tissue it heats up and the reflective tip gets damaged (Hassan Shaker et al., 2010).
The Twister fiber seems to behave equally good to the sidefiring fibre with regard to the ablative power but degrades faster. The coagulation zone appears to be lower for the sidefiring fiber at lower power as compared with the Twister fibre. The coagulation zone, although similar in both fibres, become significantly deeper at higher power seeting (Hassan Shaker et al., 2010).
Despite its favourable intra-operative safety, long-term follow-up and large scale trials are necessary to finally evaluate the technique (Ruszat et al., 2009).
Thulium laser enucleation of the prostate (ThuLEP):
Treatment technique of BPH using widely blunt dissection of the adenoma from the surgical capsule in combination of Thulium laser use (Thulium laser enucleation of the prostate, ThuLEP). This technique offers the advantages of complete removal of prostatic adenoma similar to open prostatectomy but with transurethral minimal invasive approach. This minimally invasive treatment therefore offers maximum efficacy. Short- and long-term clinical data have to prove this assumption.
KTP Laser Vaporization of the Prostate
The new generation of high-powered KTP lasers is currently gaining popularity at a fast speed because of its ability to create a prostate cavity almost bloodlessly along with the added benefit of a small learning curve and the prospect of a day-case, catheter-free procedure.
On the other hand, the procedure can be lengthy at times, while the laser and installation costs can be difficult to justify since KTP lasers have limited urological applications thus far (Ruszat et al., 2010).