How to treat prostate adenoma with a laser

Principles of laser treatment of prostate adenoma

Surgical treatment of prostate adenoma with a laser is a medical technique that allows you to safely remove the affected tissues of the overgrown prostate gland. The innovative procedure has a lot of advantages over the traditional excision of individual sections of the internal organ. Laser therapy is recommended for many men with benign hyperplasia who have no contraindications to it.

The benefits of laser treatment

Surgery to remove benign prostate adenoma with a laser has its advantages over other existing types of prostate surgery. It is because of them that this technique has become so popular.

Laser excision of the tissues of the overgrown prostate gland has the following advantages:

In order for the recovery after the procedure to be faster, the patient will have to adhere to a number of requirements that relate to his lifestyle and behavior. The attending physician will tell him about all this.

Types of laser surgery

Modern urology offers several methods for laser removal of Prostate adenoma. Some of them are based on traditional surgery. Others are innovative developments. Each type of laser therapy has its own advantages and disadvantages, which must be taken into account when choosing the optimal treatment method.

Contact laser vaporization

This technique is suitable for the treatment of adenoma, which does not exceed 30 ml in size. It is also called photoselective vaporization. For the procedure, you need to use 2 types of laser:

Surgical intervention is based on the endoscopic method through transurethral access. The laser beam penetrates into the cavity of the affected area to a depth of 1 mm. After that, it begins to actively heat the tissues to a critical temperature. Because of this, they evaporate. This manipulation is carried out until all pathogenic layers of the adenoma are destroyed.

An optical device is necessarily inserted through the urethra, which allows the specialist to observe every action of the laser unit. Thanks to this, the operation is of the highest quality and accuracy.

Laser ablation

For problems with the prostate gland, and specifically with the growth of its tissues, patients are offered to treat the organ by laser ablation. With its help, you can achieve a safe release of the gland from adenoma. After the operation, the patient safely gets rid of the symptoms of the pathological condition.

The operation uses a holmium laser. With its help, the specialist destroys the harmful cells of the prostate gland, which narrow the lumen of the urethra. This technique also provides for transurethral access to the problem area.

The laser beam leads to the development of tissue necrosis. All the cells that were destroyed during the surgical intervention freely leave the body of a man during urination. This is why patients notice small flakes in their urine for some time after laser therapy.

Laser enucleation

Laser enucleation uses a holmium laser. During the procedure, the prostate gland is separated from the capsule, and its tissues are crushed into separate fragments. They are then simply excreted from the body naturally. Grinding takes place with the help of a special tool - a morcellator.

This technique has few differences from the method by which adenomectomy is performed. However, laser adenoma removal has a number of advantages compared to it, including a minimal risk of postoperative complications.

Stages of eculation

Laser contact resection

The surgical technique, in its principle, resembles transurethral resection of the prostate. But in this case, not an electric loop, but a laser beam is used to remove the affected tissues.

Laser resection provides the surgeon with the opportunity to remove an adenoma that has a large volume. Particles of the glandular organ are dissected into several small particles, after which they move to the bladder. The remnants of the adenoma come out of it during urination.

Laser interstitial coagulation

The ideal way to remove a small adenoma. This operation allows you to correct the size of the prostate gland, which, due to its abnormal growth, narrows the lumen of the urethra.

The doctor makes small incisions with a laser that partially destroy the affected prostate tissue

Side effects and disadvantages

Prostate adenoma can be removed by any of the methods listed above. But you need to remember that laser surgery on the prostate gland has side effects. They manifest themselves in the form of the following pathological disorders:

• Hematuria.About a couple of weeks after the operation, the man ceases to notice the presence of blood in the urine;
• Frequent urge to urinate;
• Painful urination. Like the previous symptom, it worsens at night;
• Urine leakage. Usually observed due to the fact that the patient is accustomed to emptying the bladder through a narrowed channel.

Surgical procedure is known not only for its merits. It has a number of disadvantages that force patients to choose another treatment for themselves. The disadvantages of laser excision of prostate adenoma are:

The doctor may recommend Laser treatment to his patient with prostate adenoma in order to eliminate its unpleasant symptoms. If a man is satisfied with the conditions of the operation, then he can begin preparations for the upcoming procedure.

Not every clinic has such equipment at its disposal

When choosing a method for laser surgery, patients pay attention to what its price is. The cost of the operation depends on a number of factors, including the level of the clinic, its location and the type of equipment used to remove the adenoma.

If a person has the opportunity to have an operation to remove a benign prostate adenoma abroad, then he will have to pay a higher cost for this

When choosing the removal of prostate adenoma with a laser, men always look at the price of the surgical procedure proposed by the doctor. The patient must understand that he will have additional costs for related services and procedures, for example, staying in the ward and treatment with various medications. The final cost must be discussed with the attending physician in advance.

In most cases, laser removal of benign prostate adenoma passes without negative consequences for a man's health. The modern technique allows you to quickly and safely remove the overgrown prostate tissue, which causes severe discomfort to the patient.

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Features and methods of the operation to remove prostate adenoma with a laser

Prostate laser therapy is an effective treatment.

Due to the use of radiation, a persistent bactericidal effect and high-quality destruction of cancer cells are produced.

The procedure helps to get rid of adenoma, normalizes metabolism in the prostate, improves tissue regeneration, and removes infectious foci.

Laser operation to remove prostate adenoma

Prostate laser treatment should only be carried out in the subacute period.

The operation of prostate adenoma with a laser is divided into several types:

Laser enucleation of the prostate, or endoscopic method

Treatment of prostate adenoma with a laser consists in evaporating the overgrown prostate tissue with the help of rays.

Transurethral enucleation of prostate adenoma allows to reduce the recovery period of the patient and exclude injuries during surgical intervention.

Laser surgery on the prostate takes place without burn lesions of the organ and allows the use of the smallest and most subtle manipulations at the exact location of the organ lesion.

Laser vaporization of the prostate During the operation, with the help of radiation, a fast and high-quality evaporation of pathologically overgrown tissues occurs in a transurethral way.

The operation is gentle and is indicated even for those patients who are not able to undergo another type of surgery 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 a complete restoration of the genitourinary system.

Laser enucleation

Laser enucleation of prostate adenoma is performed if the tumor in a man has reached a significant size. A holmium laser is used for prostate surgery, which can be used to qualitatively remove a large formation with minimal risk to the health and life of the patient.

On the prostate, a surgeon performs laser surgery through the urethral canal, removing all the necessary lobes of the gland damaged by the disease. At the same time, 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 using the screen.

When working with a laser, tissues are heated, therefore, during the operation, the diseased area is irrigated to cool it to the required temperature.

Adenoma removal by this method is carried out in two stages:

At the first stage, the diseased tissues are removed, and then the diseased lobes are divided into fragments and removed in a safe way.This method has a minimum number 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 a catheter for the outflow of urine. The fragments themselves, removed after laser enucleation of prostate adenoma, are sent to the laboratory to determine the presence or absence of malignant tumors. Complications after the operation is quite safe, so complications occur in rare cases.

The most common are:

• slight burning or bleeding that will go away on its own over time;
• ingress of seminal fluid into the bladder;
• In 14% of cases, a weak erection may develop after surgery;
• genitourinary tract infection is very rare;
• urinary incontinence, which resolves on its own after 1-2 months after surgery;
• bladder weakness requiring temporary catheterization;
• Minor urination problems

Benefits

Vaporization

For Laser vaporization of prostate adenoma, special equipment is used with a nozzle, where a laser is located at the end of a special endoscope. It begins to generate heat waves during the operation, which have the ability to penetrate into the necessary tissues to a depth of 2 mm. Due to this, the operation is performed without injury, without affecting neighboring tissues and other organs during manipulations.

The thermal wave of the laser has a detrimental effect on the diseased areas of the prostate gland, evaporating the damaged foci of the prostate.

With this type of operation, the risk of bleeding is excluded, since there is a simultaneous sealing of nearby capillaries and blood vessels during the process.

With laser vaporization of the prostate gland, there is no need to make incisions, since the surgeon inserts the endoscope with a nozzle into the small pelvis, and the endoscope penetrates through the urogenital canal to the prostate.

Due to this, the patient recovers quickly after the procedure. The procedure lasts about 30 minutes.

Heat waves begin to gradually exfoliate the affected tissues of the organ, due to which the shell does not break.

Temporary placement of a catheter is possible after surgery, as not all patients may immediately recover the diameter of the urogenital canal.

Preparation

There are several rules that the patient is advised to follow before enucleation and vaporization:

Benefits

Prostate adenoma in men is a serious disease that requires treatment and, if necessary, removal of the tumor. Laser treatment of the prostate eliminates many problems in the future, making a man's life full and fulfilling.

Methods for removing prostate adenoma with a laser

If the symptoms of prostate adenoma are pronounced, and pathological processes threaten the life of a man, treatment is carried out with the help of surgical intervention. Removal of a section of hyperplastic prostate tissue can be carried out in the classical (open) way or using modern techniques - laser or plasma exposure.

Such an intervention is more easily tolerated by patients, and the targeted destruction of the adenoma makes it possible to cure the disease in one session. Let's consider what methods are used to remove a neoplasm of the prostate gland and give information about the postoperative period.

Indications and contraindications

The main indication for the treatment of prostate adenoma with a laser is the growth of the tumor and its compression of the urethra. In such a 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, so the only method of therapy is surgery.

Contraindications should be taken into account:

• 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;
• blood clotting disorders.

To reduce the risk of infection, laser removal of prostate adenoma is not performed in case of existing infectious diseases of any nature.

In some cases, if there are contraindications, needle ablation can be performed. This is a treatment technique during which the thinnest needle-electrodes are introduced into the prostate for local exposure to a laser or electric current.

Preparing for therapy

Preparation for the treatment of prostate adenoma with a laser is almost the same as for classical operations.If we are talking about a planned intervention, the examination begins several weeks in advance and consists of several stages:

• surgeon's appointment to take an anamnesis and inform the patient about the course and possible complications;
• donating blood and urine for laboratory tests;
• coagulogram;
• ECG or ultrasound of the heart;
• Detection of allergic reactions to painkillers and anesthesia.

If a man takes any drugs, the doctor should know about it. 1-2 weeks before the appointed date, it is necessary to stop taking certain drugs, especially those that affect blood clotting. 3 days before the removal of the adenoma, antibiotics are prescribed in a prophylactic dosage. On the day for which the treatment is scheduled, you can not eat.

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Methods of laser treatment

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 modern techniques over classical methods of resection. Also, laser exposure to tissues reduces the risk of internal bleeding and infection of organs.

Most often, one of the four methods of laser exposure is used in surgery:

Despite the high "targeting" and sparing effect on 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.

Laser enucleation

The technique is based on the use of a holmium laser (HoLEP) and is relatively well tolerated by men of all ages, which is why it is popular in domestic surgery. Its essence lies in the exfoliation (removal) of the affected tissues along the anatomical capsule using the radiation of holmium crystals. The operation is performed under the control of an endoscope and allows you to work with the prostate gland of any size. At the same time, it takes less time to delete.

Approximate course of surgery:

Enucleation allows you to remove hyperplastic tissue as carefully as possible, so a man's erection is not disturbed. However, the HoLEP technique is more complicated than traditional TURP, and therefore is not available to many clinics.

Laser vaporization

Modern minimally invasive endoscopic technique, during which the adenoma is evaporated using a laser beam. It is prescribed if BPH is small (less than 80 cm 3 ), is performed in a hospital under general anesthesia or spinal anesthesia.

Skin incisions are not made, all manipulations are carried out through the urethra, this reduces the duration of the rehabilitation intervention and reduces the risk of infection.

If BPH is large, retrograde resection may be additionally required.

Laser vaporization reduces the risk of erectile dysfunction, prevents bleeding in the manipulation area and retrograde ejaculation. However, the cost of treatment, in comparison with classical resection, will be much higher

Plasma ablation

The technique is based on the ability of a plasma beam to cut through the affected tissues without affecting nearby healthy areas. The main method of HoLAR ablation is the introduction of a needle-electrode into the tissues of the prostate gland, to which plasma, a radio wave or a laser beam is supplied. As a result, the tissue is coagulated (burned out), together with the blood vessels adjacent to the treated area

With the help of 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. In this case, 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 were no deviations from the doctor's recommendations.

Laser resection

The principle of laser resection is the same as that of TUR adenoma, but the effect is a focused laser beam of certain parameters. The technique is most often used as a treatment, with small volumes of BPH. With the help of laser resection, urine outflow 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 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 operation, he can be sent to outpatient treatment within a day.

Rehabilitation

All laser removal methods for prostate adenoma are carried out using special devices that are inserted into the bladder through the urethra. For this reason, urethral edema may develop in the first days after treatment, so a urinary catheter is installed for the patient.

During the 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 a possibility of a rise in temperature to 37.3 degrees. If the indicator is higher and the man complains of chills, antibiotic therapy is needed to eliminate the infection that has begun.

Nutrition after removal of the adenoma by laser in the first 8 hours is completely excluded, then there is a ban on fried foods and salty foods. Also banned will be:

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• alcohol;
• sausages, shop semi-finished products, smoked meats;
• spices and spices;
• sparkling water;
• Products containing preservatives and colorants.

It is good if the diet contains enough fiber. To do this, you need to regularly eat barley, oatmeal and buckwheat porridge, berries, fruits, vegetables and nuts.

It is also important to observe the drinking regime - 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 a urologist at the appointed time. If the doctor has 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.

Within 3-4 weeks after laser Removal of prostate adenoma, it is prohibited:

• lift things weighing more than 4 kg;
• be sexually active (with the exception of cases where there are no abnormalities in blood and urine tests);
• do sports;
• visit a bath or sauna;
• swim in open water bodies and pools.

Various erection or libido stimulants (Viagra, Cialis, Uretroactive, Sildenafil, etc.) are also prohibited. These drugs can cause bleeding in the prostate gland. As for medicinal substances, the need for their intake should be considered by the attending physician. You cannot "assign" anything to yourself.

Light loads help to recover well. A man is recommended to walk more, take evening walks in the fresh air, do Kegel exercises.

Possible consequences

Despite the relatively high safety, laser removal of BPH can cause various complications. The most common problems you encounter are:

• retrograde ejaculation;
• burns of the urinary tract mucosa;
• complaints of burning in the lower abdomen during urination;
• temperature increase;
• the appearance of blood in the urine.

In very rare cases, erectile dysfunction may develop. All health problems should be reported to the doctor as soon as possible, this will help to cope with the complication more effectively. Normally, such deviations should pass in 2-3 days.

Conclusion

Removal of prostate adenoma with a laser 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 extended by another 5-10 years. If, despite all the measures taken, there is a recurrence of adenoma with signs of a violation of the outflow of urine, a different approach is required. A ureteral stent is installed on the area subject to obstruction, which ensures the outflow of urine even with a strong growth of the adenoma.