Prostate Laser Surgery

Enlargement of the prostate gland due to age factor is known as benign prostatic hyperplasia (BPH). The prostate gland is present around urethra beneath the urinary bladder. When this gland enlarges, it narrows down the urethra and reduces urine flow.

To treat this condition, prostate laser surgery is done as endoscopic surgery through the urethra. During prostate laser surgery, the doctor passes a laser beam through the endoscope to deliver energy to shrink or remover extra tissues that prevent urination flow.

Through the endoscopic equipment, an irrigation solution is passed to evaporate the excess tissue that causes enlarged prostate glands. This surgical procedure lasts for around one to two hours. The treatment is performed in the influence of either general or spinal anaesthesia.

The major benefits of prostate laser surgery are minimal need for pain killers and less bleeding compared to the traditional transurethral resection of the prostate (TURP) procedure. This means patients suffering from enlarged prostate gland can return home conveniently the same day. So, there is no need to be hospitalised for days or weeks.

Prostate Laser Surgery Type

Various types of treatment are performed with the laser with varying wavelengths. Until recent years, this technique was rarely used. But with the advance of technology, laser prostatectomy has become common now.

Here is a small list of common prostate laser surgeries:

  • Green Light Laser “Photoselective Vaporization of the Prostate (PVP): In this procedure, the excess prostate tissue evaporates and the urination channel broadens due to the laser beam.
  • Holmium Laser Ablation of the Prostate (HoLAP): This laser surgery is similar to PVP but makes use of a different laser type.
  • Holmium Laser Enucleation of the Prostate (HoLEP): In this procedure, the laser removes excessive tissue that blocks the urethra. Further, the prostate tissue is cut into tiny pieces for easy removal. This is an ideal option for men with the severely enlarged prostate gland.

The laser surgery type varies from patient to patient, depending on the following:

  • The patient’s overall health
  • The size of the prostate
  • The type of equipment

Thebest candidates for prostate laser surgery: Men with enlarged prostate gland who want to avoid invasive surgery.

Benefits of Prostate Laser Surgery

Minimal bleeding

Only 30% of patients need a post-op catheter

Discharge on the same day

Resume normal activities in 2 to 3 days with caution

Return to vigorous activity level in 4 to 6 weeks

Complications occur infrequently and are mild if they do

Post-operative importance has not been associated with PVP

Retrograde ejaculation is less likely with PVP

Erectile Dysfunction is not typical in PVP patients

Long-term success in improved urine flow

Why is a Prostate Laser Surgery Done?

Prostate laser surgery is done to decrease various urinary symptoms caused by BPH. The common urinary symptoms due to BPH are:

  • Prolonged (slow) urination
  • Difficulty to start urination
  • Frequent need to urinate
  • Urinary tract infections
  • Nocturia – Frequent urination at night
  • A feeling that you cannot empty your bladder completely
  • Stopping and again starting while urination

Laser surgery can also be done to treat or prevent the following issues due to blocked urination flow:

  • Bladder or kidney damage
  • Recurring urinary tract infections
  • Bladder stones
  • Blood in urine
  • Inability to urinate (urinary retention) or inability to control urination (urinary incontinence)

While there are various treatment methods to cure enlarged prostates, laser surgery has several benefits over other procedures like open prostatectomy and TURP. Some of these advantages are:

  • Lesser risk of bleeding, as a laser process is not invasive at all.
  • A shorter stay at the hospital due to same-day treatment.
  • Quicker recovery, as laser surgery takes little time to recover compared to open surgery or TURP.
  • Least need to use a catheter for treating enlarged prostate. For laser surgery, a catheter is required for less than 24 hours.
  • Laser surgery has more-immediate results and better chances of improvement that are noticeable instantly. On the other hand, it takes several weeks or months to notice visible improvement with medications or drugs prescribed by the doctor.

Risk Factor

The common risk factors associated with prostate laser surgery are as follows:

  • Temporary problem while urinating: The patient might feel trouble while urinating for some days after the laser treatment. Unless a patient can urinate on his own, he requires a catheter to be inserted into their penis for letting urine out of their urinary bladder.
  • Narrowing of the urethra: After the prostate laser surgery, scars can block urine flow and may require additional treatment for curing the problem.
  • Urinary tract infection: This type of infection is possible after any prostate treatment. The urinary infection is likely to increase or occur the longer the catheter is placed inside the penis. The patients need antibiotics or other medications for treating the infection.
  • Erectile dysfunction: After laser prostate surgery, the risk of erectile dysfunction is lower than other traditional prostate treatments. However, the risk is still present and may need further treatment.
  • Dry orgasm: Another long-term and common risk factor associated with prostate laser surgery is the release of semen after ejaculation into the urinary bladder, instead of outside the penis. This condition is also known as retrograde ejaculation or dry orgasm. It is not a harmful problem, as it does not affect sexual pleasure. However, it can certainly interfere with the patient’s ability to be potent or father of a child.
  • Need for retreatment: After laser prostate surgery, some men may need follow-up treatment because all the prostate tissues are removed and may take some time to grow back. Men who had undergone HoLEP typically don’t need the re-treatment, as the entire portion of the prostate that could block urine flow has been removed.

Additional risks may include:

  • Overactive bladder
  • Impotence
  • Infertility
  • Full or partial incontinence for sometime
  • Leaking of urine at the time when one feels the urge to urinate urgently

How you Prepare

When preparing yourself for the treatment, do follow all the instructions given by the doctor. Here are some problems to discuss with the doctor:

  • Activity restrictions: You might be advised by your doctor not to do any strenuous activity around two weeks before and after the surgery. However, the activity restrictions depend on the type of laser treatment you have undergone and how much more or less recovery time you need as per the procedure. So, do ask your doctor about how much time you may require for doing certain activities like exercises, swimming, playing sports, etc. after the laser treatment.
  • Medications: Tell the doctor about the over-the-counter or prescribed medications or supplements that you take. It is important, specifically if you take any blood-thinning medication, such as clopidogrel (Plavix), warfarin (Coumadin) or any non-prescription pain killers like aspirin, naproxen sodium (Aleve or others) or ibuprofen (Motrin IB, Advil or others). The doctor will recommend you stop taking any of these medications (that may enhance the risk of bleeding) several days before your surgery.
  • Arrangements before the treatment: Do ask your doctor what arrangements you need to do before the treatment and how long you’re expected to be in the hospital. If you have a catheter in the urinary bladder, you’d be able to drive back home the same day after the laser procedure.

What YouCan Expect

The prostate laser surgery to reduce enlarged prostate may take around 30 minutes to a few hours, depending on the anatomy and size of the prostate that needs treatment.

Before the surgery, you’ll be given general anaesthesia or spinal anaesthesia.

Usually, the laser surgery for enlarged prostate is done by putting viewing instruments through the penis’ tip into the urethra. It makes the surgery possible without any need for incisions on the patient’s body.

What to expect during and after the procedure usually depends on the type of laser and procedure used.

During the procedure

A thin fibre-optic instrument or scope is inserted via the tip of a penis into the urethra. This enables the doctor to access the prostate through the penis without making any cuts on the body. Furthermore, the doctor utilizes a laser beam to vaporize, destroy or cut the prostate tissue that blocks the urine flow. Depending on the technique, the doctor can also use equipment to cut pieces of prostate tissue from a urinary bladder.

After the procedure

A catheter is placed inside the penis, as urine flow is blocked for a while due to swelling. If you are not able to urinate even when the tube is taken out, the doctor may replace the catheter for a while to let you heal on your own until the swelling reduces and you start urinating normally again.

You may even notice:

Irritating urination: You may feel an urgent need to urinate more frequently than usual.

Blood in your urine: You may notice some blood in the urine for a few days or weeks after the laser treatment.

Difficulty holding urine: It may occur due to the bladder being used for pushing urine via urethra that’s narrowed down by enlarged prostate tissues. This issue gets better with time.

Do follow the doctor’s instructions carefully to recover quickly. Some of the instructions may include:

  • Not doing any strenuous activity like heavy workouts, heavy lifting, etc. until the doctor says so.
  • Hold sex for a while: Avoid having sex until the doctor says it’s OK. For many men, this instruction is for up to a week or two after the treatment. This is because having an ejaculation or orgasm soon after the treatment may cause bleeding or pain.
  • Watch for blood in the urine for a few days after the treatment. If the bleeding seems to be worsening or if you notice a blood clot blocking the urine flow, do consult the doctor immediately.
  • Take the prescribed medication for the full course as the doctor says.

Result

Prostate laser surgery helps in improving the urine flow in men suffering from an enlarged prostate. Generally, the results of prostate laser treatment are long-lasting and beneficial for many patients suffering from this condition.

However, in many cases, particularly ablation techniques, prostate laser surgery cannot remove all the tissues in the prostate or the tissues may start growing back to block the urine flow in men. Hence, further treatment is required.

If you observe any worsening urinary symptoms, do call the doctor for an appointment to discuss another treatment procedure.

Hospital for Prostate LaserSurgery in Delhi NCR

SCI Hospital is one of the biggest and advanced medical practices in Delhi and across the world. Our experienced medical team is skilled in many specialities, including prostate laser surgery. This advanced laser surgery is done with the latest instruments to ensure successful treatment.

Our experienced specialists from various areas work together as a team for diagnosing and treating different types of prostate issues. Our urologists and urologic surgeons have been working closely with specialists in radiology, physician and nutrition to assure patients the most comprehensive care.

All thanks to the advanced technology, we can effectively diagnose the medical condition on-time and begin the treatment immediately. Our experts use the latest catheter (tube) for easing the urine flow and advanced scope for accessing the prostate for better treatment.

Prostate Laser Surgery Experts

Dr. Gautam Banga

MBBS, MS, M.Ch (Urology)
Reconstructive Urologist & Andrologist

Dr. Vishal DuttGour

MBBS, MS, M.Ch (Urology)
Urologist and Andrologist

Dr. Himanshu Shekhar

General Medicine
MBBS, MD (Medicine) Medical Director

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