Prostate Laser Surgery

Prostate laser surgery, also known as laser prostatectomy or laser ablation of the prostate, is a minimally invasive surgical procedure used to treat benign prostatic hyperplasia (BPH). BPH is a common condition in older men where the prostate gland enlarges and causes urinary symptoms due to obstruction of the urethra.

Here’s an in-depth look at prostate laser surgery:

  1. Types of Laser Surgery:
  • Laser Vaporization (Laser Vaporization of the Prostate – PVP): This technique involves using a laser to vaporize and remove excess prostate tissue that is causing obstruction. The laser energy is delivered through a fiber-optic device inserted into the urethra, and the vaporized tissue is then flushed out through the urinary tract.
  • Laser Enucleation (Laser Enucleation of the Prostate – LEP or Holmium Laser Enucleation of the Prostate – HoLEP): In this method, a laser is used to precisely remove and dissect the enlarged prostate tissue from its capsule, similar to traditional surgical enucleation but with the use of laser energy for cutting and coagulation.
  1. Procedure Overview:
  • Prostate laser surgery is typically performed under general or spinal anesthesia.
  • A cystoscope, a thin tube with a camera and light source, is inserted into the urethra to visualize the prostate.
  • The laser fiber is then inserted through the cystoscope, allowing the surgeon to deliver laser energy to the prostate tissue.
  • The surgeon carefully removes or vaporizes excess prostate tissue to alleviate urinary obstruction.
  • The procedure may take 1 to 2 hours, depending on the size of the prostate and the technique used.
  1. Advantages:
  • Minimally Invasive: Prostate laser surgery is minimally invasive compared to traditional surgical methods like transurethral resection of the prostate (TURP). It typically results in less bleeding, shorter hospital stays, and quicker recovery times.
  • Reduced Risk of Complications: Laser surgery reduces the risk of certain complications associated with traditional surgery, such as bleeding and fluid absorption.
  • Preservation of Sexual Function: Laser surgery is associated with a lower risk of sexual side effects compared to some other BPH treatments.
  1. Postoperative Care:
  • Patients may need to stay in the hospital for observation for a day or two after the procedure.
  • Catheterization may be required temporarily to drain urine from the bladder and allow the urethra to heal.
  • Patients are usually prescribed medications to manage pain and prevent infection.
  • Most patients can resume normal activities within a few days to weeks after the procedure.
  1. Efficacy and Outcomes:
  • Prostate laser surgery has been shown to effectively relieve urinary symptoms and improve urinary flow in men with BPH.
  • Long-term studies have demonstrated durable improvements in urinary symptoms and flow rates, with low rates of recurrence or retreatment.
  1. Patient Selection:
  • Prostate laser surgery is suitable for men with moderate to severe urinary symptoms due to BPH who have not responded adequately to medication or who prefer a minimally invasive treatment option.
  • Patients with very large prostates or certain anatomical factors may not be good candidates for laser surgery and may require alternative treatments.
  1. Risks and Complications:
  • While prostate laser surgery is generally safe, like any surgical procedure, it carries some risks, including urinary tract infection, urinary retention, bleeding, and injury to surrounding structures.