Laser removal of the prostate

Removal of prostate adenoma by laser: operation cost

Prostate adenoma, which is of a pronounced clinical nature, must be removed. In medicine, the term "benign prostatic hyperplasia" is used to define this disease.

Surgical intervention on the prostate is carried out using various methods: both laser and plasma and radio waves. The possibility of traditional, surgical intervention is not excluded.

Modern technologies have stepped forward and today it is possible to treat Prostate adenoma in one visit to a specialist.

Methods for removing prostate adenoma with a laser (laser enucleation)

Adenomectomy. An operative method of intervention, which is performed under general anesthesia. This treatment method has some contraindications :

• Prostate cancer;
• Chronic adhesive processes in the pelvis;
• Cardiovascular disease;
• High body temperature;
• Diabetes mellitus at all stages;
• After a heart attack;
• Diseases of the respiratory system;
• Inflammatory processes in the body;
• After adenomectomy.

Transurethral resection is performed by removing a section of hyperplastic tissue of the organ by introducing a special instrument through the urethra.

In addition to the above methods for removing prostate adenoma, various manipulations are used, which include needle ablation. For local coagulation, special bipolar electrodes are inserted into the soft tissues of the prostate by a direct method.

Laser-assisted vaporization and ablation are also available for prostate treatment.

The vaporization method can be conditionally called one of the most sparing methods of treatment, since it is carried out exclusively under local anesthesia.

The advantages of this type of surgery using a green laser include a minimal risk of bleeding and infection.

The rehabilitation period for the physical recovery of the patient after vaporization is not as long as after other types of surgical intervention.

NOTE!

With the use of a laser, procedures such as ablation, resection, vaporization and enucleation are performed. Their main difference is how the effect on the affected area of the tissue occurs.

As a rule, laser surgery is prescribed if the patient has concomitant diseases. For example, high blood pressure, diabetes, and other diseases.

Full review of laser enucleation of the prostate: methods and cost

The method of using a holmium laser received good feedback from patients operated on the prostate using a laser.

Laser enucleation is a process that removes the overgrown glandular tissue of an adenoma of the prostate that prevents normal urine output. In medical practice, this method has received another name: Holmium Laser enucleation of the prostate, abbreviated (HoLEP).

The operation to remove prostate adenoma with a laser is as follows:

• Laser enucleation of prostate adenoma is performed in much the same way as adenectomy, which is performed using a scalpel.
• Laser removal of prostate adenoma is an effective method for removing prostate adenoma, but since this operation requires a qualified specialist and special equipment, it is not performed in all clinics.
• Laser enucleation of prostate adenoma, the price of which varies depending on the territory, is approximately 30-40 thousand.
• Basically, this method is practiced in large cities of the country.
• The cost of treatment of prostate adenoma by laser enucleation abroad is from 5 to 20 thousand dollars.

Laser vaporization (removal of prostate adenoma by laser): how much it costs and how it is performed

In the treatment of prostate adenoma with a laser, the popular method of Laser vaporization is widely practiced.

• The green laser acts on the glandular tissue of the prostate, removing prostate adenoma by vaporizing it. At the same time, the capsule itself and the stroma are not affected by the laser.
• Due to the fact that the laser does not penetrate to a depth exceeding 1 mm, vaporization of the adenoma with a laser is carried out in layers, literally one millimeter each. The entire process of the operation is displayed on the monitor.

NOTE!

Vaporization of prostate adenoma with a green laser is performed exclusively by the method of local anesthesia and is carried out through the transurethral opening.

Pros of the laser vaporization method:

The advantages of this innovative method of removing the prostate include a minimal risk of possible complications, such as bleeding and infection, since the removed pieces of glandular tissue are not excreted into the bladder, but are evaporated.

Disadvantages of the laser vaporization method:

The disadvantages of laser vaporization of prostate adenoma include the impossibility of histological examination of the excised tissue material.

The time spent by the patient on the operating table depends on the size of the formation to be vaporized. On average, the whole procedure takes about 60 minutes.

As in other cases, the price of vaporization of prostate adenoma using a surgical laser is determined by the location of the clinic and its level.

Method of execution

Laser resection of prostate adenoma has some similarities with transurethral resection, abbreviated (TUR), but is performed using the Holmin laser, abbreviated (HoLRP).

Today, this method is one of the most productive methods of surgical intervention, which allows you to act on the gland by resection to reduce its volume. The surgeon piece by piece removes the tissues of the overgrown prostate gland and brings them out of the body.

Plasma ablation: main differences

Plasma ablation of prostate adenoma is a method of cold plasma ablation. This method differs from the above-described Holmin laser ablation in that plasma is used here to influence the glandular tissue of the prostate.

• The process of removing prostate adenoma occurs by local burning of the glandular tissue of the prostate.
• To perform needle ablation, a needle is inserted through the transurethral canal into the prostate tissue, which is an electrode that has a local action with plasma, radio waves or a laser.
• As a result of this exposure, microfoci of tissue necrosis are formed.

Using this technology, you can solve the problem of difficulty urinating and get rid of the accompanying symptoms of the manifestation of the disease. In particular, the method of plasma ablation of prostate adenoma is recommended for older patients, as it is minimally invasive. Laser ablation is performed under the influence of local anesthesia.

Pros of plasma ablation with a laser:

The advantages of the above method include an extremely low percentage of postoperative complications, such as hematuria, critical urinary retention or urethral stricture.

Disadvantages of plasma ablation:

After the surgical intervention for the removal of prostate adenoma, symptoms of intoxication are possible. This phenomenon is caused by the entry into the blood of necrotic tissues formed after their cutting off during the operation. To improve well-being, you need to take more fluid.

WARNING!

Plasma ablation on prostate adenoma is highly discouraged for those individuals who have been diagnosed with impaired renal function.

Which laser treatment for BPH is the safest?

Of all currently available methods for removing prostate adenoma with a laser, the vaporization method can be called the most productive.

Cost of surgery to remove benign hyperplasia

The price of this service varies greatly and depends primarily on the level of the clinic and its regional affiliation. Since the equipment for this type of manipulation is expensive, it is not offered everywhere.

• In Belarus, laser surgery can be performed in its capital - the city of Minsk
• Abroad, the removal of prostate adenoma will cost even more. But the level of service here is much higher. In Israel, laser surgery costs about 17,000 euros. A little cheaper (about 5 thousand dollars) in South Korea, and in Germany about 15 thousand euros.

It is known that with a properly performed surgical intervention, the asymptomatic period will last from 10 to 15 years. If you adhere to preventive measures for prostate adenoma, then even longer. As a rule, repeated surgery may be required only in rare cases, for example, when the disease recurs. In this case, palliative intervention is performed: a stent is installed in the bladder, namely at the site of its compression, which expands the prostate tissue.

Rehabilitation period

The rehabilitation period lasts at least 14 full days - until the very discharge. At this time, it is imperative to adhere to the following rules:

• Plentiful drink;
• Moderate exercise;
• Avoid sudden movements;
• A special diet that promotes good defecation (to avoid constipation);
• Rejection of fatty, fried and spicy foods;
• No alcohol;
• Sexual abstinence.

If necessary, the doctor prescribes antibiotics to the patient.

NEED TO KNOW!

After surgery, swelling of the mucous membrane lining the bladder may occur. In this regard, it becomes necessary to use a special urinary catheter, which contributes to the unhindered discharge of urine from the bladder.

During the rehabilitation period after the prostate adenoma has been removed, the patient should be under the supervision of his attending physician.

Video on how laser prostate adenoma is operated on:

Prostate treatment methods by laser adenoma removal

Removal of prostate adenoma by laser refers to minimally invasive methods of surgical intervention. Treatment in this way allows you to minimize the risk of postoperative complications, including bleeding. Vaporization, ablation, enucleation and transurethral resection are distinguished according to the method of action on the tissues of the gland. Each of the methods differs in the targeting of the impact, the possibility of performing the operation under local anesthesia, but has its own indications and contraindications for performance.

Indications for surgery

In case of prostate adenoma, laser surgery is prescribed if conservative therapy is ineffective against the background of a deterioration in the patient's condition. A direct indication for surgical intervention is:

An indication for urgent surgical intervention is acute urinary retention due to pressure exerted by the adenoma on the urinary canal.

To exclude postoperative complications, the man first undergoes a medical examination. For a qualitative intervention, the surgeon needs the results of ultrasound of the prostate, biopsy, laboratory tests of urine and blood. The patient is obliged to provide the attending physician with complete information about the presence of concomitant diseases taken in connection with this medication.

Preparing for the procedure

If during the 3 months preceding the operation, a man had an exacerbation of a chronic disease, an acute allergic reaction, then a week before the intervention, it is recommended to conduct an examination for blood clotting, check the body's response to the action of drugs.

7 days before the intervention, blood thinners are canceled. In the same period, the patient is recommended to follow a diet that excludes the appearance of constipation. If necessary, a mild laxative is attributed to a man.

8 hours before the operation, the patient should refuse to eat, make a cleansing enema. If it is planned to perform an operation using local anesthesia, then a possible reaction of the patient's cardiac vascular and immune systems should be foreseen in advance.

Enucleation of prostate adenoma

The operation is indicated for large adenomas. The intervention is carried out on the basis of a medical institution that has highly qualified experienced specialists and the necessary equipment.

The operation to remove prostate adenoma with a laser comes down to separating the tissues of the prostate and moving them into the bladder. The separated lobes are crushed with a morcellator so that they can be removed from the body of a man. Manipulation allows you to reduce the size of the gland by removing that part of it that puts pressure on the bladder.

The introduction of innovative techniques in the field of minimally invasive surgery makes it possible to turn to enucleation only in extreme cases

Laser vaporization

Surgical intervention is indicated for patients with severe comorbidities, such as hypertension, diabetes mellitus. The advantage of the method is the minimal risk of bleeding, preservation of the capsule and stroma of the gland.

Laser vaporization of prostate adenoma provides for layer-by-layer evaporation of areas of the prostate that have undergone changes. The procedure is performed through a transurethral access under local anesthesia. The duration and cost of the operation depends on the degree of damage to the gland.

Manipulations for adenoma evaporation have a minimum rehabilitation period. Removal of the catheter and improvement of the general condition of the body occurs within 24 hours after the intervention. Men consider the preservation of erectile function to be a big plus of the technique.

The disadvantages include high cost due to the need to use expensive equipment and the lack of the possibility of histological examination of the removed material.

Laser ablation

The intervention provides for a local thermal effect on the damaged areas of the prostate gland without damage to the adjacent tissues. Burning can be carried out using a needle-electrode to destroy small foci of necrosis, due to which the gland tissue decreases, and the process of its growth stops.

Laser ablation of the prostate is used for small adenomas.The advantages of the method include:

In the postoperative period, necrotic tissues partially penetrate the bloodstream, which causes intoxication of the body. E is removed with heavy drinking, so a contraindication to intervention is a malfunction of the kidneys.

Peculiarities of the rehabilitation period

The price for adenoma removal and prostatitis surgery with a laser is higher than for traditional intervention. The high cost of the procedure allows a man to return to his usual way of life after 2 weeks.

Even a minimally invasive intervention cannot protect tissues from injury, therefore, after surgery, a man is recommended:

• monitor digestion;
• limit physical activity;
• keep a diet and consume the required amount of clean water;
• Perform the exercises prescribed by the attending physician.

If necessary, the patient may be prescribed a course of antibacterial drugs. The rehabilitation period should take place under the supervision of a doctor in a hospital setting. After discharge from a medical institution, a man must come for a follow-up examination to a urologist, lead a healthy lifestyle, avoid excessive physical exertion for a month, and follow a diet.

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 important to observe and drinking mode - a man must drink at least 2.5 liters of water in a day.

After discharge within 10 days, it will be necessary to donate blood and urine for analysis and at the appointed time to visit the urologist. If the doctor prescribed any drugs - it is impossible to deviate from the dosage and duration of treatment. With the slightest deterioration of well-being, you need to immediately contact the doctor.

For 3-4 weeks after removal of the prostate adenoma laser is prohibited:

• raise things, weighing more than 4 kg;
• lead sexual life (exceptions are cases when there are no deviations in blood and urine analysis);
• play sports;
• visit the bath or sauna;
• swim in open water bodies and pools.

Also under the ban, various erection or libido stimulants (Viagra, Cialis, urethroactive, Sildenafil, etc.). These drugs may cause bleeding in the prostate gland. As for medicinal substances - the need for their reception should be considered by the attending physician. It is not impossible to "appoint" yourself.

Light load help to recover well. A man is recommended to walk more on foot, make evening walks in the fresh air, do cuegus exercises.

Possible consequences

Despite enough safety, laser removal of DGPA can cause various complications. Most often have to deal with the following problems:

• retrograde ejaculation;
• burns of urinary tract mucosa;
• burning complaints at the bottom of the abdomen, occurring when urination;
• temperature increase;
• the appearance of blood in the urine.

In very rare cases, the development of erectile dysfunction is possible. We need to provide a doctor as soon as possible about all health problems, it will help more effectively cope with complication. Normally, such deviations must pass in 2-3 days.

Conclusion

The removal of the prostate adenoma laser is a modern method that gives excellent results. In many men, after treatment, for 15 years, a benign prostate gland hyperplasia does not appear. If you comply with the prescriptions of the doctor - this period can be increased for another 5-10 years. If, despite all the measures taken, there was a relapse of adenoma with signs of violation of the outflow of urine - a different approach is required. The patient on the area undergoing obstruction is set by a ureteral stent, providing urine outflow even with strong abrasion of adenoma.