532-nm High-Power Transurethral Laser Prostatectomy

Currently, the gold standard for treatment of BPH lies with electrocautery-based transurethral resection of the prostate (TURP). TURP, however, is associated with complications and side effects, including fluid absorption, electrolyte imbalance, intraoperative and postoperative bleeding, and inadequate resection. This has led to the development of safer and more effective alternative treatments. The high-power 532-nm wavelength laser is selectively absorbed by hemoglobin, achieving rapid, hemostatic vaporization of prostate tissue. The 532-nm laser therapy has several advantages over standard TURP, including technical simplicity, the absence or minimization of complications such as intraoperative fluid absorption, bleeding, retrograde ejaculation, impotence, and incontinence. Laser therapy also requires a shorter hospital stay and allows faster recovery. This chapter is a comprehensive review of laser theory, technique, current studies of the 532-nm laser, and the future of this technology.