Laser surgery for prostate adenoma: indications, pros and cons of the procedure, preparation

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

The health of a man after 40 is at risk, since at this age pathologies of the genitourinary system often develop. One of these diseases is prostate adenoma, laser surgery in which is a quick and effective way to solve this problem.

Indications for removal of the gland

The prostate plays an important role in the sexual function of men, and also affects the urinary system. Treatment of prostate adenoma begins with establishing the degree of pathology. In the initial stages, the operation is rarely used. At this stage, it is more advisable to use medications, physiotherapy and some folk remedies.

Indications for removal of the prostate can be:

• severe pain provoked by the tumor;
• the large size of the neoplasm, which leads to a narrowing and complete blockage of the urinary tract (stagnant urine);
• development of infection;
• the appearance of bloody impurities in the urine (hematuria);
• acute renal failure.

Modern methods of surgical intervention are based on minimizing patient trauma. That is why, in most cases, a laser is used to restore the normal size and function of the prostate gland. It opens up new possibilities for solving the problems of this system.

Advantages and disadvantages

Laser surgery is gradually replacing conservative techniques. There is a logical explanation for this: the effectiveness of the procedure is much higher while reducing the risks of complications and side problems.

In the treatment of prostate adenoma in this way, a number of advantages can be distinguished:

• high efficiency - immediate elimination of symptoms and the problem itself;
• the speed of manipulation;
• low trauma - reduced blood loss and no scars;
• minimizing the risks of complications - in comparison with other methods, depends on the characteristics of a particular case;
• quick recovery of the patient - rehabilitation takes from 3 to 7 days;
• preservation of sexual function - it is possible to maintain a full sexual life.

Of the shortcomings, it is worth noting only that some techniques require a high qualification of a doctor and have a high cost. It is necessary to consider each of them in more detail.

Preparing for surgery

The procedure for preparing for the operation is standard and consists in identifying possible contraindications and clarifying the analyzes.

For this, the following studies are carried out:

• clarification of the intensity of symptoms of disorders in the prostate;
• biochemical analyzes of blood and urine;
• bacterial sowing;
• identification of the volume of residual urine;
• ultrasound examination of the pelvic and abdominal region;
• biopsy of the prostate.

The exact list of diagnostic methods is clarified on an individual basis. Particular attention should be paid to patients with blood clotting problems, since not all surgical techniques are suitable for them.

Coagulation method

Interstitial coagulation is considered the least effective method. In this case, the doctor makes punctures in the bladder in order to start the laser in them. The rays affect the prostate in such a way that the adenoma is reduced in size due to tissue atrophy.

This method of removing a prostate tumor is rarely prescribed, since it is very traumatic and requires a long recovery after surgery. Due to the development of dysuria at the beginning of rehabilitation, the patient needs a bladder drainage. In addition, there is a high risk of complications and re-enlargement of the prostate.

Enucleation method

Laser enucleation is considered a more effective method. Its essence lies in the removal of an enlarged prostate, as is done with traditional surgery. The differences are only in the way such manipulation is carried out.

Laser enucleation is divided into two types:

• Holmium laser enucleation. With the help of special equipment and tools, the adenoma is crushed into small pieces. This is a very sophisticated laser treatment method;
• Holmium laser resection. For contact removal of a prostate tumor, a laser is inserted through the penis and crushes the adenoma, which is removed piece by piece. Due to the existing risks and low efficiency, this approach is practically not used anywhere today.

Enucleation allows you to remove large neoplasms in the prostate, but it is still a somewhat problematic method with the risk of complications in case of poorly performed surgery.

Ablation method

The most advanced and effective method of surgical treatment for prostate adenoma is ablation. This also includes modern green laser vaporization.

In total, three options for the operation can be distinguished:

• Holmium laser ablation. This method is suitable for the treatment of small tumors. It belongs to the contact category, the device is inserted through the urethra. In addition to resection of adenoma, holmium laser ablation is also used to treat diseases associated with the formation of stones or tumors in the kidneys and urinary system;
• Photosensitive laser vaporization. Safe approach for reducing the size of the prostate gland. It is recommended for men at a young age, as it is low-traumatic and absolutely harmless, guarantees the preservation of sexual function. The essence of the intervention lies in the fact that the laser pulse is directed to the pathological areas and the tissues in this place are evaporated. Additionally, endoscopic instruments are used to control this process as much as possible. However, if the size of the prostate gland exceeds 30 cubic centimeters, ablation methods are powerless;
• Non-contact photo-specific vaporization. The most expensive, but also the most effective and safest, is tumor vaporization with a green laser. For him, powerful modern equipment is used that can evaporate the overgrown prostate gland by a non-contact method. This avoids scars and all sorts of injuries accompanied by bleeding, guarantees the preservation of potency and full restoration of sexual function. In addition, rehabilitation takes only a few days and in about a third of cases does not even require a urine diversion catheter. The procedure completely relieves a man of adenoma and reduces the risk of its reappearance to zero. Due to the absence of open cuts and bleeding, such an operation is allowed for patients with diabetes mellitus, hypertension and other health problems associated with low blood clotting.

It is these techniques that are favorites in the surgical treatment of prostate pathologies. Before deciding on an operation, make sure that the clinic and the particular specialist have a medical license and a high reputation. This will help avoid unpleasant consequences in the future.

Recovery and possible complications

No doctor is able to provide accurate predictions about the consequences of the operation. Much depends on the general health of the patient and the method of treatment used.

In general, the following complications are possible:

• recurrence of prostate adenoma;
• urinary incontinence;
• narrowing of the urethra;
• impurities of blood in the urine;
• pain when urinating;
• decreased libido;
• erectile disfunction;
• retrograde ejaculation;
• introduction of infection.

Problems with urination are the norm during the first days of the rehabilitation period.

If they do not disappear, you need to see a doctor immediately. Relapses after laser surgery are exceptional cases and are mainly associated with the coagulation technique. Complications are possible with enucleation, which is associated with the complexity and obsolescence of the technique.

The lowest risk is associated with the vaporization of the prostate with a green laser. It does not leave scars, postoperative bleeding is minimized, and therefore the recovery time is 2-3 days. After completing the treatment of the prostate gland in this way, the patient is allowed to go home on the first or second day. Other methods require observation in the early days, and then adherence to bed rest for a while.

Modern methods aimed at treatment allow you to quickly get rid of a problem such as prostate adenoma. The main thing is to consult a qualified doctor in time and control the course of the disease!