Laser removal of prostate adenoma is a modern method that does not require incisions or general anesthesia, and is therefore much safer. There are several techniques that differ in the technique used and the technologies used, but they are all quite similar. Before the procedure, small preparatory measures are required 2 weeks before the scheduled date of the operation. The rehabilitation period compared to classic prostate removal is reduced from two months to two weeks.
Types of operations
Laser removal of prostate adenoma is performed in one of 4 ways:
- Enucleation.
- Vaporization.
- Ablation.
- Resection.
Enucleation
Laser treatment of prostate adenoma using the enucleation method involves gradual exfoliation of tumor tissue and separation of it from normal tissue. The operation is performed with a holmium laser under the control of an endoscope with a camera and a light source, which allows tissue to be removed in a targeted manner.
Surgical intervention is performed as follows:
- the patient is placed in a reclining position in a chair;
- anesthesia is performed;
- the endoscope is inserted through the urinary tract;
- the affected tissue is removed, then it is crushed and removed through the bladder;
- a catheter is installed for 2 days.
The duration of the operation is from 15 to 30 minutes.
Vaporization
Vaporization differs from enucleation in that the tumor tissue evaporates and therefore does not require subsequent removal. Evaporation occurs in layers of 1 mm, so normally functioning tissue is not affected.
This operation to remove the prostate with a laser is done as follows:
- the patient is placed in a reclining position in a chair;
- anesthesia is performed;
- the endoscope is inserted through the urinary tract;
- the affected tissue is evaporated.
The operation lasts from 30 to 60 minutes, depending on how much tissue is to be removed. The disadvantage is the impossibility of further studying the removed tissue for the presence of oncological processes.
Resection
Treatment of prostate adenoma with laser resection has no fundamental differences from classic TUR, except that the removal is performed with a laser. The operation lasts from 40 minutes to 2 hours, depending on the complexity. The rehabilitation period lasts 2 months.
Ablation
Treatment of BPH with a laser using the ablation method involves the use of a weaker laser beam, plasma, or exposure to radio waves. This promotes deep penetration into the tissues and their subsequent death, after which they are naturally excreted through urination. The disadvantage is the possibility of intoxication when dead tissue particles enter the bloodstream.
Advantages of laser resection
Laser removal of BPH has a number of advantages over classical transurethral resection:
- During laser surgery, nearby vessels are coagulated (cauterized), so there is no bleeding.
- The surgery can be performed under local anesthesia, so there are no complications from general anesthesia.
- Minimum chance of infection.
- All manipulations are performed through the urinary tract; no incisions are required.
- Short rehabilitation period.
- A high-quality operation using a laser guarantees the absence of relapses for 10-14 years.
Contraindications
The list of contraindications for this procedure includes:
- previous heart attack or stroke;
- use of a pacemaker;
- severe diseases of the cardiovascular system;
- acute liver or kidney failure;
- bleeding disorders;
- infectious diseases of the genitourinary system.
Preparing for laser removal
The essence of preparatory measures does not differ from those for other operations. If the surgical intervention is performed as planned, it is necessary to undergo a consultation with a surgeon several weeks in advance, where possible complications will be discussed and an anamnesis will be collected. Next, you will need to undergo urine and blood tests, a coagulogram, an ECG or ultrasound of the heart, and tests for allergens to anesthetics and anesthesia. It is worth notifying the doctor about the medications you are taking, especially anticoagulants. You need to stop taking them 1-2 weeks before surgery, start taking antibiotics 3 days before, and stop eating 8 hours before.
Rehabilitation
The postoperative period in the clinic takes 2 days; if no complications are observed, the catheter is removed and the patient is discharged. Complete rehabilitation takes 2 weeks.
At this time, medications are prescribed, primarily antibiotics. Other types of medications may be prescribed depending on the individual situation.
One of the important areas for restoring the body is proper nutrition. It is necessary to exclude fatty, smoked, salty, spicy and fried foods. The diet should consist mainly of plant components. You need to eat 5-6 times a day.
In addition, you need to follow a drinking regime, this will help restore normal urination faster. It is recommended to drink 2.5-3 liters of still water per day. Strong tea, coffee and alcohol should be excluded.
You should refrain from visiting baths, saunas, as well as hypothermia. Physical activity and sexual intercourse are also prohibited.
Possible consequences
Laser removal of the prostate may cause side effects in the first few days. The most common occurrence is a temperature elevated to 37 °C. This is a normal reaction of the body to surgery; the symptom goes away on its own. If the temperature rises above 38 °C, you should consult a doctor, because this indicator may indicate an infection and the onset of an inflammatory process.
Urination may also be impaired: incontinence may occur, a slight burning sensation may be felt, and there may be blood or cloudiness in the urine. This is also a normal phenomenon; over time, the process will normalize and the symptoms will disappear on their own.
All symptoms that appear should be reported to the doctor, and if complications are suspected, an examination will be performed.
