FM8 656
Advertising Feature
Supported by Boston Scientific
The GreenLight XPS™ Laser Therapy System redefines the standard
of care for safe and effective treatment of BPO
In recent years, the use of novel laser treatments for patients
with benign prostatic obstruction (BPO) has consistently
been on the rise, meeting the increasing demand for mini-
mally invasive surgical procedures (after failure of medical
therapy) which offer shorter hospitalization times as well as
faster mobilization and recovery. Dr. med. Claus Brunken,
Head of the Urology Department at the Asklepios Westklini-
kum in Hamburg, Germany, discusses the different minimal-
ly invasive transurethral BPO treatment options currently
available and shares his expertise with the GreenLight XPS™
Laser Therapy System and its impact in clinical practice.
Dr. Brunken, how long have you been using the
GreenLight XPS™ Laser System?
I have conducted approximately 1,000 GreenLight laser pro-
cedures within the last ten years. Along with the holmium
laser for transurethral enucleation, GreenLight has become
a specialty at our clinic, where we currently perform approxi-
mately 100 to 120 laser procedures per year. However, since
the prevalence of BPO increases with age, the number of
BPO treatments is set to rise as a result of aging societies.
Today, symptomatic BPO is the most common reason for
lower urinary tract symptoms (LUTS) and has a global preva-
lence of 50% to 60% among men in their 60s.
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In your experience, what is the tangible impact of BPO
on patients’ lives?
Studies have shown that the perceived burden of disease for
men with BPO is high – sometimes it is even comparable to
the burden associated with malignant diseases. In addition
to sleepless nights resulting from nocturia, everyday outings
such as shopping or going to the cinema become difficult
due to common symptoms like urge incontinence and other
lower urinary tract symptoms. This indicates a significantly
reduced quality of life not only for patients but also for their
partners.
These everyday restrictions are particularly frustrating for
patients considering their increasingly high expectations
regarding quality of life. In contrast to 20 years ago, it is now
the norm for men in their 70s to expect to lead the same
active lifestyle as men in their 60s. Patients want to leave
hospital as soon as possible and often the first question they
ask post-surgery is how quickly they can take up sport again.
The consequences for BPO treatment are significant; ideally,
procedures should be as minimally invasive as possible with
short catheterization time, allowing patients to quickly return
to the active lifestyle they strive for.
Today, urologists can select from a broad range of differ-
ent laser techniques which complement TURP (transure-
thral prostate resection) as the current standard of care
in BPO treatment.What are the benefits of novel laser
systems in clinical practice?
Having a variety of different laser systems enables us to select
the most appropriate treatment for each patient’s needs,
adapting treatment to the individual profile and thus poten-
tially improving patient outcomes. This is particularly impor
tant considering pre-existing conditions, current medication
(especially anticoagulants) and prostate size. At our clinic,
we offer both transurethral enucleation with the Holmium
(HoLEP) and transurethral vaporization with the GreenLight
laser to cater for different prostate sizes. We use the
GreenLight laser vaporization under consideration of the
patient’s general condition for small to larger prostate glands.
Normally, patients with relevant comorbidities are directly
referred to us for treatment with the GreenLight laser, since
this is often considered the most suitable option for these
patients. However, all laser systems enable a minimally inva-
sive procedure with comparable clinical results to the current
standard of care.
Which patients are particularly eligible for GreenLight
laser treatment?
Patients who need a surgical BPO therapy approach and
who have a high bleeding risk, e.g. due to receiving anticoag-
ulation therapy, are generally indicated for GreenLight laser
treatment due to the excellent hemostatic effect achieved
during the procedure. Moreover, the lower volumes of irriga-
tion fluid necessary and the low fluid intake with GreenLight
also make the procedure less strenuous. This also makes
GreenLight a suitable and established option for elderly or
frail patients with comorbidities, cardiac or other pre-existing
conditions, simply because the procedure has a favorable
risk profile and is less demanding for such patients than the
standard TURP procedure. Due to the rising life expectancy
and improved medical therapy options, we see an increasing
number of this patient type in clinical practice.
Dr. med. Claus Brunken, Head of the Urology Department at the Asklepios
Westklinikum in Hamburg, Germany