Laser surgery for an enlarged prostate can take from 30 minutes to a couple of hours depending on the size and anatomy of the prostate being treated.
Before the surgery begins, you will be given either general anesthesia, which means you'll be unconscious during the procedure, or spinal anesthesia, which means you'll remain conscious during the procedure.
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 the particular type of laser and technique used.
During the procedure
A narrow fiber-optic scope is inserted through the tip of your penis into the urethra. By accessing the prostate through your penis, your doctor won't need to make any cuts (incisions) on the outside of your body. The doctor will use the laser to destroy, vaporize or cut out the prostate tissue blocking urine flow. Depending on the procedure, your doctor may also use instruments to remove cut pieces of prostate tissue from the bladder.
After the procedure
After the procedure, you may have a urinary catheter in place because urine flow is blocked by swelling. If you're unable to urinate after the tube is removed, your doctor may replace the catheter for some time to allow you to heal or 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.
You may also notice:
- Blood in your urine. You may see blood for a few days to weeks after the procedure. But if the blood in your urine is thick like ketchup, bleeding appears to be worsening or if blood clots block your urine flow, call your doctor.
- Irritating urinary symptoms. You may feel an urgent or frequent need to urinate, or you may have to get up more often during the night to urinate. Generally most men experience burning, especially at the tip of their penis, near the end of urination. With some types of laser surgery, these symptoms can last for weeks or even months depending on how you heal and the size of your prostate.
- Difficulty holding urine. This can occur because your bladder is used to having to push urine through a urethra narrowed by enlarged prostate tissue. For most men, this issue improves with time.
Follow your doctor's instructions about any specific restrictions or steps you need to take after the procedure. These may include:
Jul. 23, 2013
- Take it easy. Don't do any strenuous activity, such as heavy lifting, until your doctor says it's OK. This can be up to two weeks after HoLEP, but as short as a few days with procedures such as PVP.
- Hold off on sex. Don't have sex until your doctor says it's OK. For most men, this is a week or two after the procedure. Having an orgasm (ejaculating) too soon may cause pain and bleeding.
- Watch for blood in your urine. You may see blood for a few days to weeks after the procedure. But if the blood in your urine is thick, the bleeding appears to be worsening or if a blood clot block your urine flow, call your doctor.
- Take medication as prescribed. If your doctor prescribed antibiotics, make sure to take the full course of exactly as your doctor says.
- Management of benign prostatic hyperplasia (BPH). American Urological Association. http://www.auanet.org/education/clinical-practice-guidelines.cfm. Accessed April 16, 2013.
- Gravas S, et al. Critical review of lasers in benign prostatic hyperplasia (BPH). BJU International. 2011;107:1030.
- Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-6/0/1445/0.html. Accessed April 16, 2013.
- Lee J, et al. Advances in laser technology in urology. Urology Clinics of North America. 2009;36:189.
- Rieken M, et al. Complications of laser prostatectomy: A review of recent data. World Journal of Urology. 2010;28:53.
- Ahyai SA, et al. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. European Urology. 2010;58:384.
- Gnessin E, et al. An update on holmium laser enucleation of the prostate and why it has stood the test of time. Current Opinion in Urology. 2011;21:31.
- Prostate enlargement: Benign prostatic hyperplasia. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement. Accessed April 16, 2013.
- McVary KT, et al. Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia. Journal of Urology. 2011;185:1793.
- Cunningham GR, et al. Surgical and other invasive therapies of benign prostatic hyperplasia. http://www.uptodate.com/home. Accessed April 16, 2013.
- Preparing for your operation and recover. American College of Surgeons. http://www.facs.org/patienteducation/surgery.html. Accessed April 16, 2013.
- Humphreys MR (expert opinion). Mayo Clinic, Phoenix, Ariz. May 22, 2013.