Lasers for benign prostatic hyperplasia (hybrid, blue diode, TFL, Moses). Which one to choose?

ABSTRACT

PURPOSE OF REVIEW To present the evidence of latest developments of lasers for the surgical treatment of benign prostatic hyperplasia (BPH). We focused on recent advancements in HoYAG laser such as Moses technology, the Thulium Fiber Laser (TFL), the blue diode laser, and hybrid laser. RECENT FINDINGS: Laser enucleation of prostate techniques using either HoYAG laser with the Moses technology and Moses 2.0, or TFL seem efficient and safe compared with the standard enucleation using HoYAG laser. Only in vitro studies evaluated the blue diode laser and hybrid laser (combination of a continuous wave TFL and blue diode laser). Blue diode laser showed intermediate incision depth and minimal coagulation depth compared with HoYAG laser and Super Pulse TFL. Hybrid laser showed deep incision depth and small coagulation area compared with HoYAG laser and continuous wave TFL. SUMMARY: Surgical treatment of BPH using Moses technology, Moses 2.0, and TFL shows encouraging results comparable to the standard enucleation using HoYAG laser. Only in vitro data are currently available for blue diode laser and hybrid laser. Future well-designed studies comparing these technologies and evaluating them on specific risk groups of patients as well as the long-term durability of outcomes are needed.