TUR-P v. GreenLight/PVP v. HOLAP

[CIRQL8]

Any surgical urology nurses/techs out there with experience in all 3? I do TUR-P and PVP (greenlight laser), but I have never seen a HOLAP (holmium laser). My product rep is bugging me to educate the urologists about the HOLAP, and I would like an unbiased opinion.

Thank-You,

Dave

[Kabin]

I'm doing a urology clinical rotation and the topic interests me. Sounds like more surgeon training and equipment costs for possible improved results. I found a few tidbits from this UK link:

http://www.nice.org.uk/pdf/ip/ipg017guidance.pdf

... relatively high morbidity associated

with TURP has led to the development of a

range of minimally invasive techniques, some

of which use thermal energy. One such

minimally invasive technique is the use of a

holmium:yttrium-aluminium-garnet (YAG)

laser.

The studies reviewed showed that holmium

laser prostatectomy is at least as effective as

TURP at improving bladder neck obstruction,

symptom scores and quality of life. Duration of

catheterisation and hospital stay were reported

to be shorter than for TURP. However, the

studies were characterised by short follow-up

periods and small sample sizes. For more details

refer to the sources of evidence below.

[NurseRoRo]

we do tons of PVPs but have only had the holmium on standby for use in cysto/stone extractions. good luck.

[mcmike55]

I've done the "old fashion" TUP-P's for years using electrocautery.

A few, maybe 5 years ago, we started using the GreenLight Laser, the name of the company escapes me at the moment. LaserScope I think.

I love this laser!! Clean, quick cuts, excellent hemostasis, easy to use, and as lasers go, safe for the staff.

Our OR times for GreenLights are less than the traditional ESU TUR-P's.

We bring in the laser, used to be called a Niagra here, on a case, by case basis. The company we use (Fortec Medical) told me recently that a newer Holmium laser is coming out for TUR's.

It's similar to the low watt Holmium that we use for stones, this one is higher output, I believe. According to the rep, the Holmium has some of the same properties of the green light, but less draw backs, kind of a hybred, I think.

I expect to get more info soon, I try to let you know.

Mike