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Holmium-Laser-Enukleation der Prostata (HoLEP)

  • Chapter
Endoskopische Urologie

Zusammenfassung

Für kleine und mittelgroße Prostatadrüsen gilt die TUR-Prostata (TURP) nach wie vor als Therapie der Wahl [1, 2]. Allerdings liegt trotz Senkung der Mortalität auf nahezu Null die Morbidität der TURP nach wie vor bei etwa 15%, wofür unter anderem ein relativ hoher Blutverlust mit einer mittleren Transfusionsrate von 8% (5–11%) verantwortlich ist [1]. Deshalb wurde in den letzten Jahren nach Alternativverfahren mit ähnlicher Effektivität, jedoch geringerer Morbidität gesucht. Auch verschiedene Laser mit unterschiedlicher Wirkungsweise und Effizienz fanden dabei klinische Anwendung [3, 4], dies sind im Wesentlichen:

  • der Neodym: YAG-Laser zur transurethralen berührungsfreien seitlichen Laserbestrahlung der Prostata (visuelle Laserablation der Prostata in Side-fire-Technik = VLAP) oder zur interstitiellen Laserkoagulation (ILK), bei der die Laserenergie über intraprostatisch eingestochene Nadeln appliziert wird,

  • der KTP-Laser (Frequenzverdopplung der Neodym: YAG-Strahlung) sowie Diodenlaser zur Vaporisation von Prostatagewebe,

  • der Thulium-Laser mit sehr ähnlicher Wellenlänge (und ähnlichen physikalischen Eigenschaften) wie der Holmium-Laser, aber im quasi-Dauerstrichmodus appliziert und

  • der Holmium: YAG-Laser zur Holmium-Laser-Resektion bzw.-enukleation der Prostata.

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Authors and Affiliations

  1. Auguste Viktoria-Krankenhaus, Rubenstraße 125, 12157, Berlin

    Prof. Dr. med. R. M. Kuntz (Chefarzt der Urologischen Klinik)

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  1. Prof. Dr. med. R. M. Kuntz
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Editors and Affiliations

  1. Philipps-Universität Marburg, Baldingerstraße, 35033, Marburg

    Rainer Hofmann (Direktor der Klinik für Urologie und Kinderurologie) (Direktor der Klinik für Urologie und Kinderurologie)

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Kuntz, R.M. (2009). Holmium-Laser-Enukleation der Prostata (HoLEP). In: Hofmann, R. (eds) Endoskopische Urologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01167-2_9

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  • DOI: https://doi.org/10.1007/978-3-642-01167-2_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-01166-5

  • Online ISBN: 978-3-642-01167-2

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