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LASER

Laser Vaporization of the Prostate

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Laser vaporization is a common treatment option for BPE. The laser uses intensive light to vaporize the prostate tissue. At the same time, the heat from the laser is used to close blood vessels. This is why only a small amount of blood is lost during this type of surgery. Laser vaporization can be done with different laser systems. The choice of the laser depends on the expertise of your doctor and what is available in your hospital.

When should I consider laser vaporization of the Prostate ?

Vaporization may be an option if your prostate is smaller than 80 millilitres. Because vaporization causes very little blood loss, it is recommended to men who need to take blood- thinning medication for other conditions.

How is laser vaporization performed ?

For laser vaporization you will receive general or spinal anaesthesia. Once you are under anaesthesia, the doctor uses a laser resectoscope to enter your bladder through the urethra without making an incision in your lower abdomen. The resectoscope has a laser for vaporization and a small camera. The camera allows the doctor to see a high-quality image of the prostate on a video monitor.

During the procedure, the laser heats up a small part of the prostate. When the prostate tissue reaches boiling point it starts to vaporize. In this way, the whole prostate can be treated. After the operation a urinary catheter will be placed in your bladder to drain urine. It is also used to continuously flush your bladder and urethra with sterile solution to prevent blood clots. You will need the catheter for some days until the urethra is healed and you can urinate on your own.

How do I prepare for the procedure ?

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Your doctor will advise you in detail about how to prepare for the procedure. You must not eat, drink, or smoke for 6 hours before surgery to prepare for the anaesthesia. If you are taking any prescribed medication, discuss it with your doctor. You may need to stop taking it before surgery.

How long will it take me to get back to my daily activities ?

Usually you can leave the hospital 1 or 2 days after surgery. The length of hospital stay can vary in different countries. There may be some blood in your urine and you may feel pain when you urinate. This can last up to several weeks.
For 4-6 weeks after the surgery:

  • Drink 1-2 litres every day, especially water.
  • Do not lift anything heavier than 5 kilograms.
  • Do not do any heavy exercise and avoid bike riding.
  • Do not take thermal baths or go to the sauna.
  • Prevent constipation by adapting your diet.
  • Discuss any prescribed medication with your doctor.
  • Avoid having sex for 2-3 weeks. After laser vaporization, you may suffer from retrograde ejaculation. This is a chronic condition where semen can no longer leave through the urethra during orgasm. Instead it goes into the bladder and later leaves your body during urination.

You need go to your doctor or go back to the hospital right away if you:

  • Develop a fever.
  • Are unable to urinate on your own.
  • Have heavy blood loss or pain.

Advantages of laser vaporization

  • Immediate improvement of the urine flow.
  • Short hospital stay.
  • Shorter period of using a catheter.
  • Low risk of complications.
  • No need to stop blood-thinning medication.

Disadvantages of vaporization.

  • Less effective for very large prostates.
  • Painful urination for some time after the surgery.
  • May need another surgery after several years because the prostate continues.
  • No possibility to analyse the prostate tissue after the surgery.
  • Risk of retrograde ejaculation.
  • Risk of urinary retention, urinary tract infection, and urgency.
  • Very low risk of urinary incontinence.

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