Category Archives: Laser Prostate Surgery

Enlarged Prostate Treatment Delhi NCR

Enlarged prostate Treatment Delhi NCR

The prostate is a gland that produces the fluid which carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through which urine passes out of the body. An enlarged prostate means the gland has grown bigger. Prostate enlargement is common in older men. An enlarged prostate is often called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.

The actual cause of prostate enlargement is unknown. Factors linked to ageing and changes in the cells of the testicles may have a role in the growth of the gland, as well as testosterone levels. Men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH.

Also, if the testicles are removed after a man develops BPH, the prostate begins to shrink in size.

Some facts about Enlarged prostate Treatment Delhi NCR

  • The likelihood of developing enlarged prostate increases with age.
  • BPH is so common that it has been said all Men will have an enlarged prostate if they live long enough.
  • A small amount of prostate enlargement is present in many Men over age 40. More than 90% of men over age 80 have the condition.
  • No risk factors have been identified, other than having normally functioning testicles.
  • For most men, these nightly bathroom runs may be the first sign of an enlarged prostate. Other symptoms may include trouble starting a stream of urine, leaking, or dribbling. And, like grey hair, an enlarged prostate is a natural by-product of getting older, doctors say. Trouble is, the nightly bathroom runs become more frequent — eventually edging their way into the daytime routine.

Symptoms and Causes Enlarged Prostate Treatment Delhi NCR

In men, urine flows from the bladder through the urethra. BPH is a benign (noncancerous) enlargement of the prostate that blocks the flow of urine through the urethra. The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra through which urine and semen exit the body.

As the urethra narrows, the bladder has to contract more forcefully to push urine through the body.

Over time, the bladder muscle may gradually become stronger, thicker, and overly sensitive; it begins to contract even when it contains small amounts of urine, causing a need to urinate frequently. Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra so urine remains in the bladder and it is not completely emptied.

Symptoms of an enlarged prostate treatment delhi can include:

  • A weak or slow urinary stream
  • A feeling of incomplete bladder emptying
  • Difficulty starting urination
  • Frequent urination
  • Urgency to urinate
  • Getting up frequently at night to urinate
  • A urinary stream that starts and stops
  • Straining to urinate
  • Continued dribbling of urine
  • Returning to urinate again minutes after finishing

When the bladder does not empty completely, you become at risk for developing urinary tract infections. Other serious problems can also develop over time, including bladder stones, blood in the urine, incontinence, and acute urinary retention (an inability to urinate). A sudden and complete inability to urinate is a medical emergency; you should see your doctor immediately. In rare cases, bladder and/or kidney damage can develop from BPH.

Deciding Enlarged Prostate Treatment Delhi NCR

A range of treatments can relieve enlarged prostate symptoms — medications, minimally-invasive office procedures, and surgery. The best one for you depends on your symptoms, how severe they are, and whether you have other medical conditions.

Medications for an Enlarged Prostate Treatment Delhi NCR

Minimally Invasive Enlarged Prostate Treatment Delhi NCR

When medications don’t help your enlarged prostate, several procedures can relieve symptoms — without surgery. They are performed in a doctor’s office. “These procedures use various types of heat energy to shrink a portion of the prostate,” explains Westney. “They are very effective.”

Types of Surgery

TURP (transurethral resection of the prostate): This is the most common surgery for an enlarged prostate, and considered to bring the greatest reduction in symptoms. Only the tissue growth that is pressing against the urethra is removed to allow urine to flow easily. The procedure involves an electrical loop that cuts tissue and seals blood vessels. Most doctors suggest using TURP whenever surgery is required, as it is less traumatic than open surgery and requires shorter recovery time.

Transurethral resection of the prostate (TURP). Your doctor removes portions of the prostate that are affecting your urinary flow. This is the most common surgical procedure for BPH and remains the gold standard of interventional treatment options.

There is no cutting and no external scars are seen since a scope is inserted through the urethra to remove the excess tissue.

With TURP, some men might get what’s called “retrograde ejaculation,” (ejaculation of semen into the bladder instead of through the urethra).

Laser Surgery: This procedure uses a high energy vaporizing laser to destroy prostate tissue. It is done under general anesthesia and may require an overnight stay at the hospital. It provides immediate relief of symptoms, yet men may suffer from painful urination for a few weeks. In general, this procedure causes less blood loss, and side effects can include retrograde ejaculation.

For many years, transurethral resection of the prostate (TURP) has been accepted as the gold standard to surgically alleviate obstructive voiding dysfunction in men with benign prostatic hyperplasia (BPH). This historical standard has been challenged repeatedly over the last decade by consistent data demonstrating the superiority of Holmium enucleation of the prostate (HoLEP). This review summarizes the literature comparing HoLEP and traditional therapies for BPH that are widely used and have long-term efficacy data, primarily TURP, open prostatectomy (OP), and alternative laser therapies (PVP, ThuLEP, etc).

Results: Patients undergoing HoLEP have greater improvements in post-operative Qmax, greater reduction in post-operative subjective symptom scores, and lower rates of repeat endoscopic procedures for recurrent symptoms at 5-10 year follow up compared with TURP, OP, and other laser therapies. Furthermore, patients undergoing HoLEP benefit from significantly shortened catheterization times, decreased the length of hospital stay (LOS), and fewer serious post-operative complications. In particular, randomized controlled trials (RCT) have demonstrated that HoLEP can be used to resect adenomas greater than 100 grams with equivalent efficacy to open prostatectomy, but with radically decreased morbidity.

Conclusion: Numerous large, RCTs demonstrate HoLEP to be objectively superior to other surgical therapies for BPH. The urologic community should embrace HoLEP as the new gold standard for surgical BPH therapy, especially in men with large prostates who would otherwise be considered for an OP or staged TURP. The only obstacle to widespread implementation of HoLEP remains its difficult learning curve when compared with traditional transurethral resection. Further allocation of resources towards appropriate mentoring and teaching of HoLEP is warranted, particularly in residency training programs.

Keywords: HoLEP, holmium, laser, enucleation, benign prostatic hyperplasia, transurethral resection of prostate, open prostatectomy

HoLEP

HoLEP is poised to replace TURP as the standard, based on years of data that consistently demonstrate equivalent or superior outcomes with fewer post-operative complications and longer durability based on re-operation rates. There is an abundance of level 1 data directly comparing outcomes and complications for HoLEP and TURP. it was the only endoscopic procedure to do so. Regarding durability, HoLEP was the only procedure that did not require re-operation for adenoma regrowth within 5 years.

An argument against HoLEP is that operative times are significantly longer than with TURP. Post-operative complications tend to be lower for HoLEP compared to TURP, and post-HoLEP TUR syndrome has never been reported-even for adenomas hundreds of grams in size

HoLEP and OP

Since the origin of HoLEP in the early 1990s, it has revolutionized the surgical treatment of men with large prostates. Men with adenomas deemed too large to resect endoscopically are often advised to undergo open prostatectomy-a surgery associated with high transfusion rates, lengthy catheterization times, and hospital stays averaging as many as 5.4-10 days

Contrary to TURP, HoLEP is a size-independent procedure. The consequence of this is that HoLEP will eventually make OP all but a historical operation for even the largest of prostates. HoLEP has been used to successfully enucleate adenomas as large as 800 g [5]. Numerous well-designed studies have demonstrated that HoLEP outcomes, catheterization time, and hospital length of stay are independent of pre-operative TRUS volume.

Conclusion

Based on all available evidence, HoLEP offers patients a safer, more efficient, and at least equally efficacious, if not more efficacious, treatment for BPH related LUTS when compared to other surgical therapies. When compared with TURP, currently the reference gold standard, patients undergoing HoLEP benefit from a shorter catheterization time, shorter hospital LOS, and fewer complications.

For Further Information on Enlarged Prostate Treatment Delhi NCR, you may reach out to :

info@scihospital.com

Laser Prostate Surgery by Best Andrologist

What is Enlarged prostate and Laser Prostate Surgery?

Laser Prostate Surgery is the latest methodolgy to treat Prostate. Its latest with best results with minimum risks.

The prostate is a walnut-size gland located between the bladder and the penis. The prostate is just in front of the rectum. The Urethra runs through the centre of the prostate, from the bladder to the penis, letting urine flow of the body.

The prostate secretes fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra and it’s expelled with sperm as semen.

For men above 50 years old the most common prostate problem is Prostate enlargement. This condition is also called Benign Prostatic Hyperplasia (BPH). Older men are at risk for prostate cancer as well but this disease is much less common than BPH.

Laser Prostate Surgery

 

Symptoms of Enlarged Prostate:
  • A frequent and urgent need to urinate.
  • Trouble starting a urine stream. Even though you feel you have to rush to go to the bathroom, you find it hard to stat urinating.
  • A weak stream of urine.
  • Incomplete emptying of your bladder.
  • Pain while urinating or bloody urine.
  • Leaking or dribbling urine.
  • Strong and sudden urge to urinate.
  • The feeling that you still have to go, even when you have just finished urinating.

What are the others procedures available of Enlarged Prostate to operate it?

If the problem is symptomatic then Urologists advice to get it operated. A series of tests are required to diagnose BPH. The following tests are required :

  • Urine flow rate
  • Urinalysis to check for blood or infection.
  • Prostate Specific Antigen (PSA) to screen for Prostate cancer.
  • Cystoscopy.
  • Ultrasound to check the Prostate size and residual urine.

The factors which are considered for a prostate to be operated are:

  • how much the symptoms are interfering the patient’s routine life
  • the size of the prostate
  • Patient’s age
  • overall health
  • any other medical conditions

There are specialized surgical treatment options available at SCI International Hospital for enlarged prostate.

  • HOLEP(Holmium Laser Enucleation of the prostate)
  • THULVP (Vaporisation of prostate using Thulium Laser)
  • Bipolar TURP
  • Monopolar TURP
  • TRUS Guided Prostate Biopsy-Saturated & Supersaturated using Siemens USG Machine.

What is Laser prostate surgery?

Laser prostate surgery is a minimal invasive procedure  to treat prostate. The laser prostate surgery is ideal treatment with than other ways of prostate.

  • No incision is required
  • Minimal blood loss
  • Outpatient procedure, requires only a short or no hospital stay
  • Faster recovery period (7 days to 2 weeks)
  • Needs urinary catheter to be present less than 24 hours
  • Immediate and more speedy improvement compared to other procedures

Laser surgery for BPH involves inserting a scope through the penis tip into the urethra. A laser fibre passed through the scope removes prostate tissue by ablation (vaporization) or enucleation (cutting).

SCI International Hospital, Delhi has an advanced centre for Urology and Andrology

Equipped with latest high end Lasers and Modular Operation Theatres. SCI Hospital has the best equipments as Holmium and Thulium Lasers.

Thulium laser has excellent results in case of enlarged prostate. The small and medium sized gland and patient with cardiac and high risk, Thulium Laser is the safest mode of treatment.

What you can expect during the laser prostate surgery?

    1. Duration of the surgery depends upon the prostate size.
    2. Process is under spinal anaesthesisa so patient can actually see the procedure on monitor.
    3. It is a safe procedure and smooth post operative recovery.

What patient should expect after the procedure?

  1. After Laser Surgery, catheter is  there for 24-48 hours. Patient might have to pass urine frequently post-surgery for 3-4 days. So, flow of urine improves significantly post surgery and remains stable.

What are the dos and don’ts of laser prostate surgery?

  1. Catheter care is something very important. The patient should strictly follow the instructions.
  2. Prevent constipation
  3. Avoid lifting heavy weights
  4. Avoid sexual activity for 10-14 days.

What are the advantages of laser prostate surgery?

  • Does not involve any incisions
  • Minimal blood loss
  • Outpatient procedure, requires only a short or no hospital stay
  • Faster recovery period (7 days to 2 weeks)
  • Needs urinary catheter to be present less than 24 hours
  • Immediate and more speedy improvement compared to other procedures

Risks in laser prostate surgery?

Laser prostate surgery is a safe procedure with minimal complications. Expertise and experience by the operating doctor matters.

Major risk factors (1-2%) are:-

  1. Post surgery stress incontinence
  2. Infection with burning sensation while passing urine
  3. Narrowing of urethra (stricture)
  4. Bladder neck narrowing

Do I need to stay in the hospital after surgery?

One to two days Hospital stay may be necessary  after the prostate surgery. Length of stay entirely depends upon the condition of the patient.  Once the patient is stable, he gets discharge and requires to come for follow up after a week.

What is the recovery time for laser prostate surgery?

Recovery in laser prostate surgery is smooth and fast. Catheter is taken out after 24 hours. The patient can resume his routine work after a week.

Which specialist will do Laser prostate surgery?

A skilled Urologist who carries a good experience in operating such cases is the right doctor. One who is with enlarged prostate or even if you feel something symptomatic.

Urologist decides the line of treatment after examining the patient, whether the case is treatable by medical/ conservative management or by surgery.

Does health Insurance cover it?

Enlarged prostate or Benign Prostatic Hyperplasia is part of all the Health insurance companies.

 

Dr. Gautam Banga explains  the details on Laser Prostate Surgery. Why its the most prefferable treatment for Enlarged Prostate.

If you have any question on Laser Prostate Surgery . Share it with us. We look forwad to hear from you. Let us know what do you feel about this article.

Dr. Gautam Banga MBBS, MS, M.Ch (Urology) Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon Fellowship in Reconstructive Urology, Belgrade (Serbia)

Email:gautambanga@gmail.com

Contact No. :   +91-9999446622, 011-41041131
W: www.urethraandpenilesurgery.com

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