Laser Prostatectomy

What is laser prostatectomy?

In laser prostatectomy, laser energy is passed through a thin tube called a cystoscope to vaporise and remove excess prostate tissue in conditions such as benign prostatic hyperplasia (BPH).

This helps to alleviate constriction in the urethra and restore the normal flow of urine from the bladder.

Bipolar transurethral resection of the prostate (TURP) vs laser surgery

Although TURP and laser surgery are mostly similar, laser surgery:

  • Does not yield any tissue samples for further examination
  • Does not require the stoppage of blood thinners

Why do you need laser prostatectomy?

Laser prostatectomy is commonly used to treat the symptoms of benign prostatic hyperplasia (BPH), also known as enlargement of the prostate.

BPH is a non-cancerous condition where the prostate grows larger. As it enlarges, the gland presses against the urethra (urinary tube), restricting the flow of urine.

BPH symptoms include:

  • Slow (prolonged) urination
  • Difficulty starting urination
  • Frequent, urgent need to urinate
  • Increased frequency of urination at night
  • Stopping and starting again while urinating
  • The feeling of being unable to completely empty the bladder
  • Urinary tract infections
  • Bladder stones

Laser prostatectomy eases many of these urinary symptoms almost immediately and offers faster recovery outcomes compared to traditional surgery. It can be done as an outpatient procedure or may require a short overnight stay.

Laser prostatectomy can also be used to prevent or treat complications due to blocked urine flow, such as:

  • Kidney or bladder damage
  • Recurring urinary tract infections
  • Inability to control urination or an inability to urinate at all
  • Blood in the urine
  • Bladder stones

What are the risks and complications of laser prostatectomy?

Laser prostatectomy is generally safe. Serious long-term complications are less likely with prostate laser surgery than with traditional surgery.

However, there are still some risks and complications to be aware of:

  • Temporary difficulty urinating for a few days after the procedure. This means you may need a catheter to carry urine out of the bladder.
  • Dry orgasm (retrograde ejaculation) is a common and long-term effect of any type of prostate surgery. This is the ejaculation of semen into the bladder rather than out of the penis. The condition is not harmful and generally does not affect sexual pleasure, but it can affect fertility.
  • Urinary tract infection is a possible complication after any prostate procedure. This is more likely the longer the catheter is in place.
  • Urinary incontinence is a rare but important complication that affects the ability to control the release of urine from the bladder.
  • Narrowing (stricture) of the urethra is a rare complication that may occur due to scarring. Scars after prostate surgery can block urine flow and require additional treatment.
  • Erectile dysfunction is a rare complication. Compared to traditional surgery, there is a lower risk of erectile dysfunction occurring due to laser surgery.
  • Re-treatment may be needed if not all of the tissue is removed or if it grows back over time. Re-treatment may also be more commonly required for similar procedures such as transurethral resection of the prostate (TURP) and prostatic enucleation.
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