Laser Prostatectomy is a surgery that is performed in males who show symptom of trouble with passing urine due to the enlargement of the prostate gland.
Normally the prostate is a small gland in males that produces seminal fluid essential to protect and nourish the sperm. It is situated below the bladder and at the beginning of the urethra.
Prostate enlargement may cause one or more of the following symptoms:
- Increased frequency of micturition
- Urgent voiding of urine
- Increased urination at night
- Incomplete emptying during each voiding
Laser Prostatectomy Explained:
- An anaesthetic gel is used for lubrication and an instrument called a resectoscope is introduced through the urethra
- The resectoscope has fluid that irrigates as well as keeps the camera clear and flushes away blood and debris.
- The laser fibre within the resectoscope and the laser beam is used as knife to cut the prostate tissue.
- The fragments of prostate tissue that are cut away are pushed into the bladder.
- These pieces are then either flushed out through the resectoscope if they are small or an instrument called the morcellator is used to shred the tissue into smaller pieces
- The morcellator is an instrument which passes through the resectoscope that sucks in the pieces of prostate tissue and its sharp blades cut down the prostate tissue into tiny pieces making it easier to suck the pieces out
- Such tissues removed during surgery are collected and sent to the laboratory where it is looked at under the microscope for routine analysis
- After making sure that all the tissue fragments are removed, a catheter is placed to drain your urine.
- Photoselective Vaporization of the Prostate (PVP).
- Holmium Laser Ablation of the Prostate (HoLAP).
- Holmium Laser Enucleation of the Prostate (HoLEP).
How to prepare for the surgery?
- Your urologist will conduct a preliminary examination and necessary assessments to make sure the procedure is right for you.
- You may be prescribed blood-thinning medications and other pain relievers to be taken prior to the surgery
- Antibiotics may be prescribed to reduce the risk of urinary tract infection.
What can you expect?
- Prior to the surgery, you will be administered general anaesthesia or spinal anaesthesia.
- If general anaesthesia is administered, you’ll be fully unconscious during the procedure.
- With spinal anaesthesia, you will be conscious, but with no pain in the surgical area
- The type of anaesthesia varies based on the type of laser and technique used.
After the Procedure
- You will have a urinary catheter because of swelling that blocks urine flow
- If you do not resume urination after the catheter is removed, a new one may have to be inserted
- You may see blood for a few days to weeks after the procedure.
- You may feel an urgency to urinate or may have to get up during the night to urinate.
- A lot of men experience a burning sensation at the tip of the penis towards the end of voiding.
- Incontinence may be present for a while but this improves with time
- Avoid strenuous activities such as heavy lifting for about two weeks
- You may need to wait about two weeks after to resume intimacy
What are the Advantages of a Laser Prostatectomy?
- Lower risk of bleeding.
- Shorter or no hospital stay.
- Quicker recovery.
- Less need for a catheter.
Are there any Risks associated with the Procedure?
- Temporary difficulty urinating for a few days after the procedure. Until you can urinate on your own, you will need to have a catheter inserted into your penis to carry urine out of your bladder.
- Urinary tract infection is a common and possible complication after any prostate procedure. Your doctor will prescribe antibiotics to treat the infection.
- Narrowing (stricture) of the urethra. Scars that form during healing after prostate surgery can block urine flow and may cause the need for treatment
- Dry orgasm is a common effect of any type of prostate surgery and refers to the release of semen into the bladder rather than out of the penis.
- Erectile dysfunction. The risk of erectile dysfunction after prostate treatments is small and generally lower with laser surgery and is a major advantage
How to recover well following the surgery?
- Eat better and move more– Try to take a balanced diet and encompass moderate exercise into your routine. Keep your body active and maintain a healthy weight. A reasonable weight loss will help to ease the symptoms of an enlarged prostate
- Follow post-operative instructions – If your doctor has instructed you to stay away from heavy work, follow them diligently
- Keep follow-up appointments: You may require timely appointments to make sure that you have healed well. Your doctor will monitor how you are healing and avoid complications.
FAQs
Lower Risk of Bleeding
Laser Prostatectomy offers a lower risk of bleeding compared to traditional prostate surgeries. The precise and controlled nature of laser energy enables surgeons to cauterize blood vessels during the procedure effectively. This results in significantly reduced intraoperative bleeding, making it a safe option for individuals, especially those with coagulation or bleeding disorders.
Shorter or No Hospital Stay
Laser Prostatectomy is often associated with a shorter hospital stay or, in some cases, no hospitalization at all. This is because the minimally invasive nature of the procedure allows for faster recovery. Patients may undergo the surgery as an outpatient procedure, returning home on the same day or the day after, depending on their specific case. Reduced hospitalisation time contributes to overall cost savings and convenience for patients.
Quicker Recovery
One of the most significant advantages of Laser Prostatectomy is the relatively rapid recovery period. Patients typically experience less post-operative pain and discomfort compared to traditional open surgeries, allowing them to resume their daily activities more quickly. While recovery times may vary, many patients can return to their normal routines within a few days to a couple of weeks, depending on their overall health and the extent of the procedure.
Less Need for a Catheter
Laser Prostatectomy results in a reduced need for long-term catheterization. In many cases, a urinary catheter is only required temporarily after the procedure to facilitate the initial healing process. Once the swelling subsides and the urethra can function properly, the catheter is removed, and patients can urinate naturally. This contrasts with older surgical methods that often necessitate the use of catheters for an extended period, leading to potential discomfort and inconvenience.
Laser Prostatectomy is a surgical procedure used to treat urinary problems caused by an enlarged prostate gland. It’s typically performed when symptoms like increased urination frequency, urgent voiding, night time urination, or incomplete emptying occur due to prostate enlargement.
During Laser Prostatectomy, a resectoscope is inserted through the urethra, and a laser fiber within the resectoscope is used to cut the prostate tissue. The removed tissue is either flushed out if it’s small or shredded into smaller pieces using an instrument called the morcellator.
There are several types of Laser Prostatectomy procedures, including Photoselective Vaporization of the Prostate (PVP), Holmium Laser Ablation of the Prostate (HoLAP), and Holmium Laser Enucleation of the Prostate (HoLEP). The specific type chosen may depend on the individual case and surgeon’s preference.
Preparing for Laser Prostatectomy involves preliminary examinations and assessments by a urologist. You may be prescribed medications, such as blood-thinners and antibiotics, and your urologist will guide you through the necessary preparations.
After the procedure, you will most likely have a urinary catheter temporarily due to the swelling post surgery. You may experience some blood in your urine, an urge to urinate frequently, and temporary incontinence. It’s important to avoid strenuous activities, and your doctor will advise you on the appropriate time to resume normal activities and intimacy. However, these side effects typically improve with time.