Laser Surgery for BPH: In the Spotlight

Written by Stephanie Watson | Published on March 24, 2014
Medically Reviewed by George T. Krucik, MD, MBA on March 24, 2014

Learn about the types of laser surgeries that relieve enlarge prostate (BPH) symptoms.

The Growing Prostate

There comes a time in nearly every man’s life when he’ll have to deal with the effects of an enlarged prostate, also called benign prostatic hyperplasia (BPH).

The prostate gland is small early in life, but grows with age. As it grows, it presses down on the urethra, the tube through which urine travels out of the body. That pressure makes it harder for men with BPH to fully empty their bladder, leading to more frequent bathroom visits.

Ways to Treat BPH

Doctors can choose from many different treatments, ranging from medication to surgery, to shrink the prostate gland and relieve urinary symptoms of BPH. Drugs like finasteride (Proscar) block a hormone that causes the prostate to grow.

Other drugs relax the bladder muscle to improve the flow of urine. Heat and concentrated energy can be used to burn off extra prostate tissue. Surgery also removes extra prostate tissue.

Laser Surgery

In the 1990s, doctors started using lasers to remove extra prostate tissue. The laser is thin enough to pass up the urethra, which runs through the center of the penis. Once inside, it cuts or burns off the enlarged tissue. This creates a wider channel for the urine to pass through.

The laser has a few advantages over other BPH procedures. For example, there’s very little blood loss, and the recovery time is shorter.

Types of Laser Prostate Surgery

There is a variety of procedures that involve laser prostate surgery, including:

  • photoselective vaporization of the prostate (PVP): uses a high-powered laser to burn off the extra prostate tissue
  • holmium laser ablation of the prostate (HoLAP): similar procedure to PVP, but involves a different type of laser
  • holmium laser enucleation of the prostate (HoLEP): uses the same laser as HoLAP, but cuts the prostate tissue instead of burning it

Choosing a Laser Surgery

Your doctor will help you decide whether laser surgery is a viable treatment option for you, and if so, which type of laser surgery is most appropriate for your condition.

Factors that your doctor will consider include how much extra prostate tissue needs to be removed and your general health.

Not every medical center will have access to all types of lasers, so availability of equipment may also determine the procedure you undergo.

What to Expect

The entire laser procedure takes about an hour. You’ll receive either general anesthesia to make you sleep, or local anesthesia, which will numb you. Your doctor won’t make any cuts directly into your body.

Both the laser and scope will be threaded up the urethra, which is where the cutting or burning will occur. You should be able to go home within a few hours after surgery. Some men stay in the hospital overnight.

Possible Risks

All procedures come with possible risks, including laser surgery. Talk to your doctor before you have surgery to find out what problems might occur.

For example, some men who have had laser surgery have trouble urinating for a few days following the procedure. If this occurs, you might need to have a catheter inserted to help you urinate until you can do it on your own.

Other risks include:

  • infections
  • narrowing of the urethra
  • trouble having an erection or orgasm

After Your Procedure

You’ll have to take it easy for a couple of days before returning to your normal routine. Your doctor might recommend that you hold off on exercise and sexual intercourse until you’re fully healed.

For a few days, you may have trouble urinating or see blood in your urine. Although these are normal symptoms after laser surgery, you should let your doctor know if you’re in a lot of pain, you’re running a fever, or can’t urinate at all.

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