Prostate laser surgery
Prostate laser surgery
Prostate laser surgery is a procedure to ease urinary symptoms caused by an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). During prostate laser surgery, a combined visual scope and laser is inserted through the tip of your penis into the tube that carries urine from your bladder (urethra). The urethra is surrounded by the prostate. Using the laser, your doctor removes prostate tissue that's squeezing the urethra and blocking urine flow, thus making a new larger tube for urine to pass through.
All lasers use concentrated light to generate precise and intense heat. There are two basic types of prostate laser surgery:
The type of prostate laser surgery your doctor will use depends on several factors, including the size of your prostate, your health, the type of laser equipment available and your doctor's training.
Some types of laser surgery are also used to treat prostate cancer (which is unrelated to BPH).
Why it's done
Prostate laser surgery helps reduce urinary symptoms in most men with BPH. BPH symptoms can include:
Laser surgery may be done to treat or prevent complications due to blocked urine flow, such as:
Nonlaser enlarged prostate treatments include transurethral needle ablation (TUNA), transurethral microwave therapy (TUMT), transurethral incision of the prostate (TUIP), transurethral resection of the prostate (TURP) and open prostate surgery (open prostatectomy).
Prostate laser surgery has several potential advantages over transurethral resection of the prostate (TURP) and open prostatectomy, the enlarged prostate procedures to which others are generally compared. The advantages generally include:
Transurethral needle ablation (TUNA), transurethral microwave therapy (TUMT) and transurethral incision of the prostate (TUIP) share some of the advantages of laser surgery. They're less involved (less invasive) than traditional surgery, so healing is generally faster and there is typically less of a risk of complications. However they generally do not work as well as tissue-removing options and often have to be repeated in three to five years. These procedures are only done in men with certain types of prostates.
Serious long-term complications are less likely with prostate laser surgery than with traditional surgery. Risks of laser surgery include:
How you prepare
Follow your doctor's instructions on what to do before your treatment.
Your doctor may also give you other steps to follow.
What you can expect
Laser surgery techniques for enlarged prostate are all done by inserting viewing scopes and instruments through the tip of the penis into the urethra. This makes surgery possible without making any cuts (incisions) on the outside of your body. Exactly what you can expect during and after the procedure can vary somewhat depending on your surgeon and the particular type of laser and technique used.
Holmium laser enucleation of the prostate (HoLEP)
HoLEP results are similar to those achieved with the most effective nonlaser prostate removal surgeries and open prostatectomy. HoLEP generally has a lower risk of complications than open surgery or TURP.
One advantage of HoLEP over other laser treatments is that removed prostate tissue can be examined for signs of prostate cancer.
The HoLEP technique is difficult for surgeons to learn and is only done at a few advanced medical centers.
Photosensitive vaporization of the prostate (PVP)
PVP is also called green light laser therapy, because the wavelength that the laser emits appears as green light.
More research is needed to better understand the safety and long-term results of PVP, particularly in men who need to continue taking blood-thinning medications during the procedure and in men who have large prostates. The depth of tissue penetration by the green light or KTP laser is much deeper than that with the holmium laser.
Holmium laser ablation of the prostate (HoLAP)
Prior to surgery
During the procedure
Laser procedures for enlarged prostate generally take from 30 minutes to an hour.
After the procedure
You may need to have a urinary catheter in place after the procedure because urine flow is blocked by swelling. If you're unable to urinate after the tube is removed, your doctor may give you catheters that you can insert on your own a few times a day until swelling goes down and you can urinate again normally.
It can take some time to recover fully from laser surgery. After the procedure, you may notice:
Prostate laser surgery improves urinary flow in most men. Often, results are quickly apparent. In some cases, laser surgery doesn't completely remove all of the prostate tissue blocking urine flow, or tissue grows back, and further treatment is needed.
Laser surgery techniques are still being developed, and more studies are needed to determine which ones work best and their long-term effectiveness.
Last Updated: 2011-07-22
© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.
Terms and conditions of use