Prostate Laser Surgery Procedure

ByJanis Updated

Overview

Urologists commonly use prostate laser surgery to help men with enlarged prostates, known as benign prostatic hyperplasia (BPH). This condition occurs when the prostate gland, which surrounds the urethra, becomes larger and makes it hard for urine to flow. By using focused laser energy, doctors remove or shrink the extra prostate tissue that causes the blockage.

How Prostate Laser Surgery Works

  • The doctor places a thin, flexible scope through the tip of the penis into the urethra.
  • The laser passes through this scope and targets the prostate tissue.
  • Concentrated light from the laser creates heat, which either vaporizes or cuts away the tissue blocking urine flow.

Types of Prostate Laser Surgery

Type of Procedure Description Typical Use Case
Photoselective Vaporization of the Prostate (PVP) Melts and removes extra tissue to clear the urinary passage Mild to moderate prostate enlargement
Holmium Laser Ablation of the Prostate (HoLAP) Similar to PVP, but uses a different kind of laser Mild to moderate enlargement
Holmium Laser Enucleation of the Prostate (HoLEP) Cuts and removes large sections of tissue blocking the urethra Severe prostate enlargement

Doctors choose the most suitable treatment based on several important factors:

  • The size and shape of the prostate gland.
  • The patient’s overall health.
  • Doctor’s training and experience with laser techniques.

Each of these treatment options helps men urinate more easily, improving their quality of life. Urologists guide patients and answer questions about which procedure may be best for their specific needs.

Reasons for the Procedure

Doctors use laser surgery to treat problems caused by benign prostatic hyperplasia (BPH), also known as an enlarged prostate. BPH can cause bothersome lower urinary tract symptoms, which may affect daily life. Common symptoms that lead to treatment include:

  • Needing to urinate urgently and often
  • Difficulty starting to urinate
  • Weak or slow urine flow
  • Waking up at night to urinate
  • Stopping and starting while urinating
  • Feeling as though the bladder is not fully empty
  • Repeated urinary tract infections (UTIs)

Doctors may also recommend treatment to manage or prevent more serious problems related to blocked urine flow. These can include:

Possible Complications Description
Repeated UTIs Ongoing bladder or kidney infections
Organ damage Harm to kidneys or bladder over time
Urinary retention Inability to urinate or loss of bladder control
Bladder stones Hard deposits in the bladder
Blood in urine Presence of blood detected in urination

Laser surgery for BPH offers key advantages compared to older surgical methods like transurethral resection of the prostate (TURP) or open prostate surgery. Many patients experience faster relief from symptoms, and the recovery time is usually shorter.

Benefits of Laser Surgery

  • Lower risk of bleeding, especially helpful for those on blood thinners.
  • Shorter or no hospital stay, often as an outpatient procedure.
  • Quicker return to normal activities.
  • Less time with a urinary catheter.

Immediate improvement in urinary symptoms can occur after the procedure, which can make a big difference in quality of life for people affected by benign prostatic obstruction.

Possible Complications

Prostate laser surgery can bring several side effects and risks that patients should know about. Some of the most common issues include:

  • Short-Term Trouble Urinating: After surgery, some people may find it hard to pass urine for a few days. They may need a catheter for a short period until they can urinate by themselves.
  • Urinary Tract Infection (UTI): Using a catheter can increase the risk of a UTI. Doctors usually prescribe antibiotics if this happens.
  • Scarring and Urethral Narrowing: Scar tissue can sometimes cause the urethra, the tube carrying urine out of the body, to narrow. This may block urine flow and require more treatment.

Other possible effects include:

  • Urinary Incontinence: Some people may have trouble controlling their bladder after surgery, but this happens less often compared to other methods.
  • Retrograde Ejaculation (Dry Orgasm): Semen may travel into the bladder instead of out of the penis during ejaculation. This is not dangerous, but it can affect fertility.
  • Erectile Dysfunction: The risk of problems with getting or keeping an erection is low, and laser surgery is less likely to cause this than traditional methods.
  • Blood in Urine (Hematuria): Some bleeding is normal for a short while after the procedure.
  • Bladder Neck Contracture: Rarely, scar tissue forms at the bladder neck causing tightness.

The table below summarizes some risks:

Risk How Common Can It Be Treated?
Urinary retention Common Yes, with catheter
UTI Common Yes, with antibiotics
Urethral stricture Less common Yes, further treatment
Retrograde ejaculation Common No treatment needed
Erectile dysfunction Rare Sometimes

Doctors see most serious complications, like long-lasting incontinence or severe erectile problems, much less often with laser surgery compared to other types of prostate surgery.

Getting Ready for Surgery

Eating, Drinking, and Medicines

Doctors often tell patients to stop taking anything that could cause more bleeding. This may include blood thinners and common pain relievers such as aspirin, ibuprofen, or naproxen sodium.

Patients should ask a doctor before stopping any medication, especially if they use them for anticoagulation therapy. Doctors may also give an antibiotic to lower the chance of a urinary tract infection.

Extra Steps to Take

Patients should plan for someone else to drive them home on the day of surgery. Many patients leave the hospital with a catheter in their bladder. Being prepared with comfortable clothing and following medical instructions helps the process go smoothly.

What You Can Expect

What Happens During the Procedure

The healthcare team gives the patient either general anesthesia, which puts them into a deep sleep, or spinal anesthesia, which numbs the lower body but keeps them awake. They choose the anesthesia based on the procedure and the patient’s needs.

Doctors place a thin fiber-optic scope through the tip of the penis and into the urethra. They use this scope to view the prostate and guide the instruments. A tiny laser device goes through the scope to the prostate. The surgeon directs the laser energy at the tissue blocking urine flow.

The laser either cuts out or vaporizes the extra prostate tissue. Sometimes, doctors use other instruments to help remove the tissue pieces from the bladder. Common laser techniques include:

  • Photoselective vaporization of the prostate (PVP)
  • Holmium laser enucleation of the prostate (HoLEP)
  • Laser ablation or vaporization
  • Water vapor therapy
  • Aquablation
  • Robotic prostatectomy

These methods typically do not require cutting through the skin, making them minimally invasive. Depending on the method and the size of the prostate, surgery can take from 1 to 3 hours.

What to Expect After Surgery

After the procedure, doctors usually fit patients with a urinary catheter. The catheter drains urine because the urethra can be swollen after surgery, blocking normal flow. Catheterization time might range from a few hours to a few days.

In some cases, if urination remains difficult, doctors may reinsert the catheter, or patients may use self-catheterization for a short period. Possible effects after surgery include:

Symptom Details
Blood in urine Pink or red urine may appear for days to weeks.
Urinary discomfort Burning, urgency, or frequent urination is common.
Difficulty holding urine Temporary leakage or incontinence can occur.

Extra care is needed at home. Doctors often advise patients to:

  • Limit physical activity. Avoid heavy lifting.
  • Refrain from sexual activity. Wait at least 1-2 weeks or as recommended.
  • Take all medication as instructed. Complete any antibiotics if prescribed.

Some types of laser prostate surgery are outpatient procedures, so patients may go home the same day. Others, like HoLEP or robotic prostatectomy, might require a short hospital stay. Most urinary symptoms improve as swelling goes down and tissues heal.

It may take days to weeks for full recovery, depending on the type of procedure and how the individual heals. Regular follow-ups with the healthcare team help ensure healing is going well and allow doctors to check for any complications.

Findings

Laser surgery for the prostate often improves urine flow and reduces urinary symptoms, like frequent urination. Most patients experience a higher quality of life after the procedure. Over many years, clinical outcomes stay strong, though some patients may need follow-up care if prostate tissue grows back or symptoms worsen.

Factor Typical Result
Urine Flow Improved
Urinary Symptoms Reduced
Quality of Life Better
Prostate Size Decreased
Frequent Urination Less Common
Long-Term Outcomes Mostly Stable

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Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.