Laser removal methods for prostate adenoma
An effective treatment is laser prostate therapy.
Due to the use of radiation, a stable bactericidal effect and high-quality destruction of cancer cells are produced.
The procedure helps to get rid of adenoma, normalize metabolism in the prostate, improve tissue regeneration, remove infectious foci.
Laser surgery to remove prostate adenoma
Laser treatment of the prostate should be carried out only in the subacute period.
Laser surgery of prostate adenoma is divided into several types:
- Laser enucleation of the prostate, or endoscopic method
Laser treatment of prostate adenoma consists in the evaporation using the rays of the enlarged prostate tissue.
Transurethral enucleation of prostate adenoma allows to reduce the recovery period of the patient and to exclude injuries during surgery.
The operation on the prostate with a laser takes place without burns to the organ and allows you to use the smallest and finest manipulations at the exact location of the organ lesion.
During the operation, radiation is used to quickly and efficiently evaporate pathologically overgrown tissues in a transurethral manner.
The operation is gentle and is indicated even for those patients who do not have the opportunity to conduct another type of surgical operation for health reasons. This category of patients includes patients with diabetes mellitus and with problems of the cardiovascular system.
The procedure allows not only to destroy pathological processes, but also guarantees the full restoration of the genitourinary system.
Laser enucleation of prostate adenoma is carried out if a man has a significant tumor size. A holmium laser is used for surgery on the prostate gland, with the help of which it is possible to qualitatively remove a large formation with minimal risk to the health and life of the patient.
On the prostate, the surgeon performs a laser operation through the urethral canal, removing all necessary glandular lesions damaged by the disease. In this case, nearby tissues are not damaged and the integrity of the capsule itself is not violated, since the surgeon can control and see all the necessary manipulations with the help of the screen.
When working with a laser, tissue is heated, so during the operation, a sore spot is irrigated to cool it to the required temperature.
Removal by this method of adenoma is carried out in two stages:
- At the first stage, diseased tissues are removed, and then the diseased lobes are divided into fragments and removed in a safe way. This method has a minimal amount of side effects and avoids complications after surgery. The operation lasts within 1-2 hours.
- After the operation, the patient is inserted for a day with a catheter for urine outflow. The fragments themselves removed after laser enucleation of prostate adenomas are sent to the laboratory to detect the presence or absence of malignant tumors.
The operation is quite safe, so complications arise in rare cases.
The most common include:
- a slight burning sensation or bleeding, which eventually goes away on their own,
- ingestion of seminal fluid into the bladder,
- in 14% of cases after surgery, a weak erection may develop,
- very rarely an infection of the genitourinary system occurs
- urinary incontinence, which after surgery passes independently after 1-2 months,
- bladder weakness, which requires a temporary catheter,
- minor disorders during urination.
- The procedure can be carried out even with very large sizes of the diseased organ up to 200 grams or more.
- Manipulations can be carried out for patients with diabetes mellitus and with bleeding disorders.
- Due to the balance during the intervention of aqueous solutions, TUR syndrome does not develop.
- Prostate tissue does not completely collapse during enucleation, which makes it possible to conduct a study to detect cancer cells.
- The catheter is installed for no more than 24 hours.
- Minimum time required for recovery after surgery.
- Short term hospitalization of the patient.
When laser vaporization of prostate adenoma is used, special equipment with a nozzle, where a laser is located at the end of a special endoscope. He begins to generate during the operation thermal waves that have the ability to penetrate into the necessary tissue to a depth of 2 mm. Due to this, the operation is carried out without injuries, without affecting adjacent tissues and other organs during manipulations.
The thermal wave of the laser is detrimental to the affected areas of the prostate gland, evaporating the damaged foci of the prostate.
With this type of operation, the risk of bleeding is excluded, since simultaneous sealing occurs during the process of nearby capillaries and blood vessels.
With laser vaporization of the prostate, there is no need to make incisions, since the surgeon inserts an endoscope with a nozzle into the small pelvis, and the endoscope penetrates the urogenital canal to the prostate.
Due to this, the patient recovers quickly after the procedure. The procedure lasts about 30 minutes.
Thermal waves begin to gradually exfoliate the affected organ tissues, due to which the shell does not break.
After the operation, a temporary catheter can be inserted, since not all patients can immediately recover the diameter of the urogenital canal.
There are several rules that the patient is recommended to observe before enucleation and vaporization:
- Make a biochemical and general blood test, undergo an ECG or do an ultrasound of the heart.
- 8-10 hours before surgery, stop eating food and liquids.
- 2 hours before surgery to conduct a cleansing enema.
- Exclude blood thinners.
Indications and contraindications
The main indication for the treatment of prostate adenoma with a laser is the growth of the tumor and squeezing the urethra with it. In this situation, the outflow of urine is disturbed, which can lead to acute renal failure and the death of a man. There are no drugs that can reduce the volume of the tumor, therefore the only method of therapy is surgery.
In this case, contraindications should be considered:
- previous myocardial infarction or stroke,
- use of pacemakers,
- a number of pathologies of the cardiovascular system,
- acute liver or kidney failure,
- an increase in body temperature above normal values,
- bleeding disorders.
To reduce the risk of infection, laser removal of prostate adenoma is not carried out in case of any infectious diseases of any nature.
In some cases, if there are contraindications, needle ablation can be performed. This is a treatment technique in which the thinnest needle electrodes are inserted into the prostate for local exposure to a laser or electric current.
Laser removal of benign prostatic hyperplasia (BPH) does not require general anesthesia and can be performed after local anesthesia. This is one of the advantages of a modern technique over classical resection methods. Laser exposure to tissues also reduces the risk of internal bleeding and organ infections.
Most often, one of four methods of laser exposure is used in surgery:
- Plasma ablation
Despite the high “aiming” and sparing effect in relation to healthy tissues, these techniques can cause complications, so you need to strictly follow the recommendations regarding the rehabilitation period. Let's consider each method in more detail.
A modern minimally invasive endoscopic technique in which an adenoma is vaporized using a laser beam. It is prescribed if BPH is small (less than 80 cm 3), performed in a hospital under general anesthesia or spinal anesthesia.
They do not make cuts on the skin, all manipulations are performed through the urethra, this reduces the duration of the rehabilitation intervention and reduces the risk of infection.
- A resectoscope equipped with a video camera and a light source is inserted into the urethra.
- Through the tube of the device, a green laser is supplied to the prostate gland.
- Using a laser pulse, the altered prostate tissue evaporates.
If BPH is large, an additional retrograde resection may be required.
Laser vaporization reduces the risk of erectile dysfunction, prevents bleeding in the area of manipulation and retrograde ejaculation. However, the cost of treatment, in comparison with classical resection, will be significantly higher. The average price is from 10 000 r in the regions to 20 000 r in Moscow, while the final amount depends on the level of the clinic and the professionalism of the doctor.
The technique is based on the ability of a plasma beam to dissect affected tissue without affecting nearby healthy areas. The main method of HoLAR ablation is the introduction of a needle-electrode into the tissue of the prostate gland, to which a plasma, radio wave or laser beam is supplied. As a result, the tissue coagulates (burns out), together with the blood vessels adjacent to the treated area. In place of necrotic and distant tissue, microscopic scars appear that prevent further growth of the adenoma.
Using HoLAR ablation, doctors treat prostate adenoma in the early stages when there is no serious threat to the patient’s life. The technique is performed under local anesthesia and allows you to restore the normal process of urination, including in older men who are contraindicated in other ways.
Plasma ablation allows you to cure prostate adenoma in one session. However, the likelihood of acute urinary retention or urethral stricture is extremely low. During rehabilitation, a man may complain of thirst, nausea, dizziness. This signals a slight intoxication caused by the presence of decay products of prostate tissue in the blood. After a few days, the symptoms will disappear if there are no deviations from the doctor's recommendations.
Laser removal of prostate adenoma
Today, the laser can be safely included in the list of the most commonly used methods of surgical treatment of various pathologies. The main advantages of this method are that it has a small number of postoperative complications, and there is no blood during laser removal of the prostate adenoma.
During such surgery, a resectoscope is introduced through the urethral canal, which is a tube in which the main systems are concentrated for such an operation. This should include an electric loop, a laser, and an optical system.
During treatment of prostate adenoma with a laser, the parenchyma of the prostate gland is eliminated by evaporation, in which the pathological area is irradiated with its subsequent destruction. Due to the effect of the laser, heating of the cytoplasm in the cells of the adenoma is observed, after which they are brought to the boiling point and destroyed. Currently, laser treatment of prostate adenoma is carried out using the Green Ray system, which is a fiber optic tube.
In order to minimize injuries of healthy tissues surrounding the tumor, the prostate gland is constantly irrigated with a special fluid that is delivered through a special system inside the resectoscope. This liquid is also removed through this system. In parallel with this, particles of destroyed adenoma tissue are brought out with the fluid. Evaporation during laser removal of prostate adenoma is carried out by a specialist in layers at a depth level of about 1 mm.
There are three lobes in the prostate gland; during surgical intervention, hardware is applied sequentially to all three parts of the prostate gland, starting from the middle, since it is located at a minimum distance from the bladder. During laser removal of prostate adenoma, the operation takes no more than two hours. Despite this speed of the procedure, laser vaporization of the prostate gland is minimally invasive and very low traumatic.
Due to the fact that the method of removing a prostate adenoma by a laser is bloodless, a specialist can stop the operation at any stage. The advantage of this method can be considered the sealing of blood vessels, which occurs together with the removal of tumor tissue on the prostate gland.
Thus, laser surgery to remove prostate adenoma is characterized by the removal of fluid from the tissues of this organ.
The principle of laser resection is the same as that of TUR adenomas, but the effect is a focused laser beam of certain parameters. The technique is most often used as a treatment, with small amounts of BPH. Using laser resection, the outflow of urine is restored and the load on the kidneys is reduced, thereby improving overall well-being.
The duration of the operation and the rehabilitation period depends on the size of the adenoma and the state of health of the man. In especially severe cases, the intervention lasts up to two hours, and the patient is discharged home after 2 weeks. If the tumor was small and the man had a good surgery, he can be referred for outpatient treatment within 24 hours.
All methods of laser removal of prostate adenoma are performed using special devices that are inserted into the bladder through the urethra. For this reason, in the first days after treatment, edema of the urethra can develop, so a urinary catheter is installed in the patient.
Within a day after the removal of benign hyperplasia, blood flakes may appear in the urine. This is a normal process, which should not be scared. There is also the possibility of a temperature increase of up to 37.3 degrees. If the indicator is higher and the man complains of chills, antibacterial therapy is necessary to eliminate the onset of infection.
Food after removal of the adenoma by the laser in the first 8 hours is completely excluded, then there is a ban on fried foods and salty foods. Also banned will be:
- sausages, convenience foods, smoked meats,
- spices and spices
- sparkling water,
- products containing preservatives and dyes.
It is good if the diet contains enough fiber. For this you need to regularly eat pearl barley, oatmeal and buckwheat cereal, berries, fruits, vegetables and nuts.
It is important to observe the drinking regimen - a man should drink at least 2.5 liters of water per day.
After discharge within 10 days, you will need to donate blood and urine for analysis and visit the urologist at the appointed time. If the doctor prescribed any drugs, you can not deviate from the dosage and duration of treatment.At the slightest deterioration in well-being, you should immediately consult a doctor.
Laser is prohibited for 3-4 weeks after removal of prostate adenoma by a laser:
- to lift things weighing more than 4 kg,
- lead a sexual life (with the exception of cases when there are no deviations in the blood and urine tests),
- do sport,
- attend a bath or sauna,
- swim in open ponds and pools.
Also prohibited are various stimulants of erection or libido (Viagra, Cialis, Urethroactive, Sildenafil, etc.). These drugs can cause bleeding in the prostate gland. As for drugs - the need for their intake should be considered by the attending physician. It is impossible to “appoint” yourself something yourself.
Light loads help to recover well. A man is recommended to walk more, take evening walks in the fresh air, and do Kegel exercises.
Features of laser prostate removal
Laser therapy stands out against other methods of removing prostate adenoma. This type of operation from the other types of surgical intervention is distinguished by the following features:
- after the operation, there are no adhesions that often form during the healing of tissues injured by a surgical scalpel,
- lack of severe postoperative pain,
- minimum blood loss
- after manipulation, no scars remain on the body,
- this method does not lead to impotence,
- fast healing of the postoperative wound,
- the patient does not have to stay in the hospital for a long time (on average, hospitalization lasts 3 days),
- the operation takes place under local anesthesia, which has much less contraindications than general anesthesia,
- low probability of relapse.
Cases where laser adenoma removal is recommended
Laser resection is indicated for a man if:
- there is no effect of drug treatment of adenoma,
- urine accumulates (sometimes it happens that an adenoma is reached of gigantic proportions, then the formation blocks the urinary tract, and urine cannot exit),
- blood stasis formed in the pelvic organs,
- serious kidney disease
- there is blood in the urine.
Laser removal of adenoma, in contrast to classical surgery, can be performed for patients with:
The disadvantages of the method include its high cost. The price of surgery for many men can not afford. It is also not suitable for cases where there is a suspicion of cancer and it is necessary to send particles of excised adenoma for histological examination.
Types of Laser Surgery
Laser removal of adenoma is of four types:
- Ablation During this manipulation, the laser burns a tumor that blocks the urinary ducts. Due to this, the lumen of the channel expands, and stagnation of urine is eliminated,
- Vaporization. The laser beam vaporizes the enlarged prostate in whole or in part,
- Full resection. An iron or tumor is cut off by a laser beam like a scalpel,
- Holmium method. A new technique called enucleation or Holep.
Appointment and indications
Laser vaporization of prostate adenoma has strict indications for completion. The main ones are as follows:
- Male organ volume increase from 30 to 80 ml. If the size is larger, then removal of the adenoma with a laser will be combined with transurethral resection of the prostate gland.
- Ineffectiveness of the prescribed conservative treatment.
- Soreness during urination.
- Urination dysfunction.
It should be noted that laser therapy of prostate adenoma is divided into three types:
- Contact evaporation, if the prostate adenoma in the volume exceeded 30 ml.
- Laser contact removal.
- Interstitial laser coagulation.
Adenoma burning with a holmium laser beam
Prostate hyperplasia is most effectively eliminated by holmium laser enucleation. This type of laser surgery is considered less traumatic, because during the manipulation the prostate gland itself is not affected. A benign tumor is burned, the ends of the vessels that supplied blood to it are “sealed”, so they don’t bleed. The removed adenoma enters the urinary canal and painlessly leaves the body of the man during the first emptying of the bladder.
The benefits of holmium laser enucleation include the following:
- the method is suitable for cutting out hyperplasia of any size, while other types of operations, for example, laparoscopy, are performed if the size of the prostate is not more than 120 cm 3,
- urination is restored three days after surgery,
- It is possible to send material for research.
Like any other type of surgery, laser intervention also has some contraindications. This procedure is prohibited for patients who have a malignant neoplasm. It is also impossible to remove prostate adenoma in patients who have an inflammatory process in the acute period. It is forbidden to carry out laser vaporization of prostate adenoma to those men whose organ volume is more than 120 ml. With great care, patients who have pathology of the liver and heart are selected.
Laser surgery to remove prostate adenoma is performed with anesthesia. After talking with the patient, the anesthesiologist should determine the type of anesthesia based on the information received about the absence or presence of concomitant diseases. The type of anesthesia is greatly influenced by the man's tolerance of a particular drug, which is part of the group of anesthetics. In addition, factors of psychological discomfort are taken into account.
As a rule, in medicine distinguish between general and local anesthesia. With local anesthesia, anesthetics are injected into the epidural space, which is located in the lumbar spine. During this, the patient is conscious, but does not feel his body, but only below the waist. This type of anesthesia is considered much better, since it does not have an extensive list of consequences, which cannot be said about general anesthesia.
During general anesthesia, anesthetics are injected into a vein or injected into the body using a special mask for inhalation. At the same time, the patient is in an unconscious state, and the artificial lung ventilation apparatus is breathing for him.
Laser ablation is prescribed for very large sizes of the prostate. A low temperature laser is used for the operation, because such a beam penetrates much deeper than hot.
After surgery, dead particles of adenoma remain in the prostate. They are excreted from the body of a man during urination or are removed by a doctor.
During resection, the entire prostate is removed as a whole. The technique is prescribed only when partially removing the adenoma is not possible or meaningful. In urology, it is used very rarely, but with advanced prostate hyperplasia this is the only way out.
The cost of the operation varies from 50 thousand to 100 thousand rubles.
After laser removal of prostate adenoma, the following types of complications may occur:
- urination becomes more frequent, the process is accompanied by burning,
- inability to hold urine appears, but this is a temporary phenomenon,
- urinary tract infections develop,
- blood appears in the urine
- potency is violated.
Tips to facilitate postoperative recovery
To make the rehabilitation period faster, a man needs:
- take all medications prescribed by your doctor
- do not have sex before the month after the operation,
- give up alcohol and fatty foods,
- eliminate spicy spices from the diet and reduce salt intake,
- drink about 2 liters of water per day,
- do not play sports the first 15 days after discharge from the hospital,
- do not lift weights
- Minimize car driving
- sit as little as possible.
Laser Adenoma Removal Reviews
I removed the adenoma with a laser. I do not regret that I chose this method. Rehabilitation is quick, there were no complications.
Ablation saved me from problems with stagnation of urine. After the operation, aching pains in the lower abdomen passed. Potency is also good.
The operation took place under local anesthesia. He was conscious, but did not feel pain. Recovered in a short time.
Despite the relatively high safety, laser BPH removal can cause various complications. Most often, one has to face the following problems:
- retrograde ejaculation
- burns of the urinary tract mucosa,
- complaints of burning in the lower abdomen that occurs when urinating,
- temperature increase
- the appearance of blood in the urine.
In very rare cases, the development of erectile dysfunction is possible. All health problems should be reported to the doctor as soon as possible, this will help to more effectively deal with the complication. Normally, such deviations should go away after 2-3 days.
Laser removal of prostate adenoma is a modern method that gives excellent results. In many men, after treatment for 15 years, benign prostatic hyperplasia does not appear. If you follow the doctor’s instructions, this period can be increased by another 5-10 years. If, despite all the measures taken, an adenoma relapses with signs of impaired urine outflow, a different approach is required. A ureteral stent is installed on the patient in the area undergoing obstruction, which ensures the outflow of urine even with a strong overgrowth of the adenoma.
Prostate adenoma, which has a pronounced clinical character, must be removed. In medicine, the term "benign prostatic hyperplasia" is used to define this disease.
Surgery performed on the prostate is carried out using various methods: both with a laser and with the use of plasma and radio waves. The possibility of traditional, surgical intervention is not excluded.
Modern technologies have stepped far forward and today it is possible to treat prostate adenoma in one visit to a specialist.
The essence of the methodology
Under laser vaporization understand the form of endourological surgery. It consists in the introduction of a special instrument into the affected organ. This is done through the urethra and helps to avoid incisions. The procedure is carried out under the supervision of a surgeon who carries out the manipulation and monitors its progress. All necessary information is displayed on the monitor.
Laser treatment of the prostate allows you to quickly and efficiently cope with unpleasant symptoms of pathology and partially restore urination. The method rarely leads to unpleasant consequences for health and practically does not cause complications. The undoubted advantage of the technique is its short duration - it usually does not exceed 1 hour. The rehabilitation period after the intervention does not last long and does not provoke pain.
The essence of the technique lies in the removal of enlarged prostate tissue by performing evaporation. There are several types of intervention:
- Contact vaporization. It is used for neoplasms in the prostate with a volume of less than 30 ml,
- Contact laser resection. In this case, the prostate is removed by laser. The use of this method requires a highly qualified doctor,
- Interstitial laser coagulation. It leads to a change in the structure of damaged areas of the prostate. This normalizes urination and eliminates other manifestations of the disease.
Laser methods for removing prostate adenoma (laser enucleation)
Adenomectomy. The surgical method of intervention, which is carried out under general anesthesia. This treatment method has some contraindications:
- Prostate cancer
- Chronic adhesions in the pelvis
- Cardiovascular diseases,
- High body temperature,
- Diabetes at all stages,
- Heart attack
- Diseases of the respiratory system,
- Inflammatory processes in the body,
- Postponed adenomectomy.
Transurethral resection is performed by removing a section of the hyperplastic organ tissue, by introducing a special instrument through the urethra.
In addition to the above methods for removing prostate adenoma, various manipulations are applied, which include needleablation. To conduct local coagulation, special bipolar electrodes are introduced into the soft tissues of the prostate gland directly.
In addition, prostate treatments are currently available, such as vaporizationwhich uses a laser, and ablation.
Vaporization method can conditionally be called one of the most sparing treatment methods, since it is carried out exclusively under local anesthesia.
The pluses of this type of surgical intervention using a green laser include the minimal risk of bleeding and infection.
The rehabilitation period for the physical recovery of the patient after vaporization is not as long as after other types of surgical intervention.
Using a laser, procedures such as ablation, resection, vaporization and enucleation are performed. Their main difference is in how the effect on the affected area of the tissue occurs.
As a rule, laser surgery is prescribed if the patient has concomitant diseases. For example, high blood pressure, diabetes, and other diseases.
Laser vaporization of the prostate is carried out 40-60 minutes - it all depends on the severity of the pathology. Manipulation can be carried out on an outpatient or inpatient basis.
After removing the formation and normalizing the structure of the lumen of the urethra, the patient should be in the hospital for several hours. Doctors should monitor the condition of the man.
The basis of the method is the influence of light flux on prostatic hyperplasia. The procedure is carried out using endoscopic instruments. Laser vaporization of the prostate implies the following stages:
- The patient is anesthetized
- A special fiber is placed in the urethra, which provides access to damaged fragments of the prostate,
- Since the laser is small, the doctor focuses the beam pointwise. This is done in the areas where the adenoma is located,
- Under the influence of thermal waves of the laser, a gradual exfoliation of the affected tissue occurs. The vessels are quickly sealed and treated with antiseptics,
- After the procedure is completed, a special catheter equipped with a urine collector is placed in the urethra. This device helps to avoid channel contraction. If the function of the bladder is immediately restored, there may be no need for catheterization.
Possible complications after surgery
Despite the fact that laser vaporization to remove adenoma is the safest and most optimal method of eliminating this ailment, it also has some complications. The main ones are as follows:
- Throwing an ejaculant into the bladder. As a rule, almost every surgical intervention on the prostate gland forms the wrong ejaculant current during sexual intercourse. It flows into the bladder, from where it comes out.
- Impotence development.However, this probability is much less when compared with other methods of treating prostate adenoma.
- There is a likelihood of developing a relapse of the disease, as well as the need for repeated treatment.
- Possible urethral stricture. Laser therapy, like any surgery, can cause a narrowing of the prostate due to scarring.
To reduce the likelihood of the above complications, it is necessary to strictly observe all the recommendations of a specialist at the end of the laser operation.
When all surgical procedures are completed, the patient will be under constant supervision of medical personnel for some time. But just a few days later he was discharged. It is forbidden to eat food during the day after laser surgery to remove prostate adenoma. The amount of fluid should be increased to about 3 liters per day. This reduces the risk of narrowing of the urethra. In addition, for some time, the patient should take anti-inflammatory drugs, as well as antibiotics.
The bladder is washed without fail. If the patient has a catheter, then this manipulation is much faster. Rinsing is performed with chlorhexidine or furatsilinom. After this action, a change in the urinal is required. And if there is no catheter, then flushing is carried out using a special nozzle.
Laser Adenoma Evaporation
Using laser evaporation of prostate adenoma, there are practically no complications, and the procedure itself has many advantages:
- Light load on the cardiovascular system,
- Preventive procedure for the prevention of retrograde ejaculation,
- Does not affect sexual function and bladder function,
- Suitable for patients taking anticoagulants
- No blood transfusion needed
- Control of unforeseen bleeding,
- Minimum side effects
- There is no discomfort after treatment,
- Local anesthesia
- Quick recovery after surgery
- Limited need for postoperative catheterization,
- No postoperative hospitalization needed.
The method of laser evaporation of prostate adenoma has fewer limitations than traditional TUR, due to which the patient practically does not lose blood, and also does not require deep anesthesia. Therefore, such an operation can be performed with an adenoma mass of more than 60 ml, as well as at a young age, when it is extremely important for the patient to maintain sexual function.
What happens during laser exposure?
When laser vaporization of the tissue of the enlarged prostate is removed by evaporation. For the operation, special laser systems are used that emit a powerful light beam of a certain length and are equipped with a flexible light guide with a tip for evaporation. Benign adenoma tissue is selectively removed, while coagulation (cauterization) of blood vessels and layers is performed. This significantly reduces the risk of bleeding in the postoperative period.
Laser radiation is able to penetrate into the tissue of the prostate adenoma to a depth of not more than 1 mm, so vaporization occurs in layers, while the desired area is removed with high accuracy. This eliminates the perforation of the capsule of the prostate, abdominal cavity and bladder.
The adenoma as a result of the operation is partially excised, the narrowed lumen in the urethra is restored in size. Laser vaporization allows you to remove significant amounts of adenoma tissue almost bloodless, which significantly reduces the risk of postoperative complications.
Preparatory measures consist in a detailed conversation with your doctor. He must tell the patient in detail about all the intricacies of this operation, about the possible risks and consequences, after which the patient signs a consent. Next, the doctor gives him a list of required tests.
Mandatory are a general analysis of urine and blood, a biochemical blood test, a Rhesus factor and a blood group, it is recommended to do a blood coagulation test (coagulation). An electrocardiogram and an ultrasound scan of the heart are also needed. These two examinations are performed five days before ablation. In case of abnormalities in the cardiovascular system, an examination by a cardiologist is necessary.
And what is the price of prostate laser surgery? The cost of this treatment method will depend on the particular clinic, as well as on the region of residence. For example, in Moscow, removal of prostate adenoma by a laser will cost an average of 40-50 thousand rubles. However, in the capital there are also such clinics where this operation can be performed for about 25 thousand rubles.
Feasible side effects
- Erectile disfunction,
- The appearance of a strong burning sensation when the bladder is empty,
- Burn of the external tissues of the ureters,
- Retrograde ejaculation (a common side effect with any type of surgery on prostate adenoma, which takes place on its own within a few days).
Reviews about the removal of prostate adenoma by laser indicate that most patients prefer to use this particular method of treating the disease. The fact is that such an operation has a minimal number of complications, the absence of bleeding. The only drawback is that for some patients the cost of laser vaporization is high.
In conclusion, it is worth noting that laser surgery to remove adenoma is one of the most sparing methods. Every man should remember that prostate adenoma needs timely treatment.
A complete review of laser enucleation of the prostate: methods and cost
Good reviews of patients who underwent surgery on the prostate using a laser received a method of using a holmium laser.
Laser enucleation is a process that involves the removal of overgrown glandular tissue of prostate adenoma, which prevents the normal passage of urine. In medical practice, this method has another name: Holmium laser enucleation of the prostate gland, abbreviated (HoLEP).
The operation to remove prostate adenoma by laser is as follows:
- the genitals are treated with an antiseptic
- after that, with the use of a laser, overgrown tissues of the prostate gland are removed in parts, which are transferred to the bladder during surgery,
- for their subsequent removal, a morcellator is used, by which the tissues are divided into small parts and subsequently removed from the patient's bladder.
- Laser enucleation of prostate adenoma is performed almost similarly to an adenectomy, which is performed using a scalpel.
- Laser removal of prostate adenoma is an effective method of removing prostate adenoma, but since this operation requires a qualified specialist and special equipment, not all clinics perform it.
- Laser enucleation of prostate adenoma, the price of which varies depending on territoriality, is approximately 30-40 thousand.
- Basically, this method is practiced in large cities of the country.
- The cost of treating prostate adenoma with laser enucleation abroad is from 5 to 20 thousand dollars.
The rehabilitation period lasts at least 14 full days - right up to the discharge itself. At this time, it is imperative to adhere to the following rules:
- Heavy drink
- Moderate exercise
- Avoid sudden movements
- A special diet that promotes good deformation (to avoid constipation),
- Refusal of fatty, fried and spicy,
- Giving up alcohol
- Sexual abstinence.
If necessary, the doctor prescribes antibiotics to the patient.
After surgery, swelling of the mucous membrane lining the bladder may occur. In this regard, there is a need to use a special urinary catheter, which contributes to the smooth passage of urine from the bladder.
During the rehabilitation period after the prostate adenoma has been removed, the patient should be under the supervision of his attending physician.
Video about how laser prostate adenoma is being operated on:
Contraindications for laser vaporization
Laser vaporization is contraindicated in patients suffering from:
- Infectious diseases in the acute stage of inflammation,
- Liver diseases (in particular, liver failure),
- Kidney disease (in particular, kidney failure),
- Diseases of the bronchi (in particular, bronchial asthma),
- Patients who have had a stroke or myocardial infarction.
Laser vaporization of prostate adenoma is a modern effective treatment method that is rapidly gaining popularity due to its effectiveness and safety. If you need treatment for adenomas, be sure to discuss with your doctor the possibility of laser neoplasm evaporation.
Vaporization of the prostate with a laser beam takes place in this way:
- The operation is performed by the endoscopic method, while all manipulations are carried out through the lumen of the urethra,
- Hyperplasia is removed by a directed light beam when the beam is focused at a certain point,
- After the operation on vaporization of the prostate adenoma is completed, the patient may have a urethral catheter,
- If the work of the bladder is satisfactory and the size of the prostate gland is average, the doctor may cancel the catheter.
By a method of vaporization, an adenoma with a volume of up to 80 ml can be operated on.
What happens after surgery?
After operating the prostate adenoma and restoring the urethra, bladder lavage is also prescribed with a disinfectant solution (for example, furatsilinom) to remove residual blood clots. In this case, a second catheter is used to remove fluid. This system is usually installed by a doctor for several days after performing vaporization of the prostate gland. After removal of the catheter, the patient immediately resumes natural urination.
The results of the observation show that in men who have undergone vaporization of the prostate gland, the fullness and speed of bladder release are significantly increased. All urodynamic indicators are effectively and quickly improved.
Patient reviews indicate a rare, in comparison with other types of surgical interventions, violation of erectile function. In cases where the prostate is operated on with a laser, cases of subsequent urinary incontinence are extremely rare.