Prostate Laser Surgery

To relieve moderate to severe urinary symptoms caused by an enlarged prostate - benign prostatic hyperplasia (BPH) is the use of prostate laser surgery.

Your doctor inserts a scope through the tip of your penis into the urethra – which is surrounded by the prostate.

A laser is passed through the scope that will deliver energy to remove or shrink the excess tissue that is blocking the urine flow.

Laser surgery removes excess prostate tissue by:

• Enucleation – cutting the excess tissue by the laser.
• Ablative – melting the excess tissue by laser.

The types of prostate laser surgery include:

• Holmium laser ablation of the prostate (HoLAP) – the laser will vaporize the excess prostate tissue.
• Holmium laser enucleation of the prostate (HoLEP) – by cutting the excess tissue by the use of a laser.
• Photoselective vaporization of the prostate (PVP) – similar to HoLAP by melting away the excess tissue. 

Here are the most common reasons to undergo a prostate laser surgery.

The use of prostate laser surgery is to help reduce urinary symptoms caused by BPH, the symptoms include:

• difficulty starting urination
• frequent urination
• increased frequency of urination at night
• slow urination
• urinary tract infections (UTI)
• you feel that your bladder is not completely empty
• stopping and starting again while urinating

This surgery might also be done to prevent complications which include:

• bladder or kidney damage
• recurring urinary tract infections
• bladder stones
• recurring blood in the urine
• incontinence or urinary retention

The advantages of prostate laser surgery include:

• no, or shorter hospital stay
• lower risk of bleeding
• sometimes you do not need to use a catheter
• quick recovery
• immediate results as soon as the surgery is done

The risks of complications in prostate laser surgery include:

• urinary tract infection (UTI) – the longer you have a catheter, the higher the risk of having this infection
• temporary difficulty urinating – you may feel this for a few days after the procedure
• retrograde ejaculation or dry orgasm – this means that when you ejaculate, it will enter the bladder rather than exit your penis and this is a long-term side effect that is not harmful but can affect your ability to father a child
• narrowing of the urethra – these are scars that can block urine flow and needs further treatment
• need for retreatment – some patients need follow-up treatment
• erectile dysfunction – this means that you are unable to maintain an erection

To prepare for the prostate laser surgery:

• you should tell your doctor about what kind of medications, vitamins, and supplements you are taking especially if it a blood thinning medicine, your doctor may ask you to stop using them a week before the procedure
• you are not allowed to eat and drink the night before the surgery
• ask your doctor if how long are you going to stay at the hospital so you can ask someone to drive you home
• you cannot go back to your normal activities after two weeks of the surgery

Here you can find out what to expect from your prostate laser surgery.

Depending on the size and anatomy of the prostate being treated, the surgery can take from 30 minutes to a couple of hours. Your doctor will give you anesthesia before the procedure.

By inserting viewing scopes and instruments through the tip of the penis into the urethra is how laser surgery is done. Your doctor will not make any incisions.

A narrow fiber-optic scope is inserted through the tip of your penis into the urethra. Your doctor can now have access in your prostate through your penis.

He will use the laser to vaporize or destroy the prostate tissue blocking urine flow. He might also use instruments to remove cut pieces of prostate tissue from the bladder depending on the procedure.

You might have a catheter placed to help you urinate.

You will experience:

• blood in urine for a few days up to a few weeks but if worsens call your doctor immediately
• difficulty holding urine but this may improve with time; irritating urinary symptoms such as burning sensation at the tip of the penis that may last up to several weeks or months

Your doctor will give you specific restrictions after the surgery such as:

• hold off on sex two weeks or until your doctor says it is okay because ejaculation may cause pain and bleeding
• do not do any strenuous activities for up to two weeks or until your doctor says it is okay
• take medications as prescribed by your doctor
• check if there’s blood in your urine

If you do not understand your prostate laser surgery results, consult with your doctor.

Most of the patients who went through this surgery have improvement in their urinary flow.

The tissue grows back or does not remove all of the prostate tissue blocking urine flow in some cases. If this happens, further treatment is required.