Where is laser surgery done for prostate adenoma

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:

Removal of prostate adenoma by laser

Treatment of a tumor in the prostate gland can be carried out using various techniques. One of the ways to treat a disease with severe clinical manifestations is the removal of prostate adenoma with a laser.

This disease most often overtakes men over the age of forty. With age, there is a slowdown in all processes in the body, a decrease in the volume of sex hormones. Among the reasons that contribute to the development of adenoma are hereditary predisposition, a sedentary sedentary lifestyle, bad habits and frequent stress.

Indications for deletion

Strongly disturbing symptoms and insufficient effectiveness of prescribed drugs may be a reason for the doctor to suggest surgery.

The following conditions, which are caused by the development of adenoma, become direct indications for surgical intervention:

• hematuria (there is blood in the urine);
• acute renal failure;
• stagnation of urine;
• infectious processes in the urinary organs;
• impossibility to empty it due to compression of the adenoma of the urinary canal.

Before the treatment of prostate adenoma with a laser, the patient is prescribed studies:

• ultrasound;
• biopsy;
• it is necessary to take urine and blood for analysis;
• testing for prostate disorders;
• Determination of residual urine volume.

"Green laser"

This method refers to non-contact photospective vaporization. It has a wide circulation. Treatment is performed using a special device "Green Light Laserscope". The penetration of the beam into the tissue of the adenoma occurs to a depth of 0.1 cm. By heating the affected tissues, they evaporate, which is carried out layer by layer. Under the supervision of a surgeon who monitors all stages of instrument manipulation, the operation is of high quality.

Pros of this procedure:

• short hospital stay;
• Installation of the catheter is performed only for one day;
• improvement of the general condition within a few days after the intervention;
• the likelihood of postoperative complications is minimal;
• preservation of erectile function;
• It can be used in patients with diabetes and high blood pressure.

The disadvantages of this type of intervention include high cost. Expensive equipment is not available for purchase by every clinic, which affects the price of the treatment itself.

Types of laser surgery

Surgical treatment can be performed using traditional methods and with the participation of modern new technologies, including radio wave therapy and laser. Laser removal of prostate adenoma can be of several types, the use of which depends on the capabilities of the clinic, the specialization of the doctor and the patient's condition. These are rarely used interstitial laser coagulation and more common methods that are adopted by modern clinics: burn-based laser ablation and enucleation.

Interstitial Coagulation

The introduction of the laser is performed through punctures. The principle itself is based on tissue atrophy. The result is a reduction in the size of the prostate and a decrease in squeezing of the urethra by the adenoma. After this manipulation, the man will be able to empty the bladder completely.

Improvement can be minimal and only come after a long time. It may be necessary to re-intervention. The low efficiency of the method and the long recovery period affect the fact that this method is used quite rarely.

Enucleation

Manipulation consists in removing the tumor. The likelihood of complications is thus minimized. This technique is often chosen in cases where removal of a large prostate adenoma is required.

Resection is carried out by inserting the device through the penis. Removal of the adenoma is performed in small parts. This method is now deprecated and is rarely used.

Enucleation has an advantage over the previous method. The use of special hardware makes it possible to grind the adenoma and then remove the tissues.Upon completion of the treatment with an antiseptic, laser work is performed through the transurethral access. The detachable lobes are excreted into the bladder. With the help of a morcellator, these parts are divided into smaller ones and removed.

This complex manipulation must be performed by a doctor with extensive experience and qualifications. Reputable medical institutions with the appropriate base specialize in such interventions.

Laser ablation

In this way, the tumor is eliminated by carefully calibrated burning.

Laser ablation of prostate adenoma can be performed in two ways:

• Evaporation-based photosensitive laser vaporization.
• Pulsed holmium laser ablation

With photosensitive laser vaporization, the method of evaporation of the adenoma itself is taken as the basis. Under the control of the endoscope, such operations can be performed only if the size of the tumor tissue is less than 30 cm3.

Heating tissues and their subsequent evaporation makes it possible to minimize blood loss. This option is most often recommended for young men to maintain fertility.

Holmium laser ablation is performed using a special device, the impulse from which conducts a contact resection. The Auriga apparatus is used not only for the treatment of prostate adenoma, but also for the removal of tumors and kidney stones, and for the treatment of the bladder.

Efficiency and scope are limited by the small size of the adenoma. Otherwise, other methods are used. The operation to remove prostate adenoma with a laser relieves squeezing of the urethra and helps to restore functions.

Preparation for surgery and rehabilitation

Before removing the adenoma, some procedures are performed.

• cleansing enema;
• Stop eating at least 8 hours in advance.

The intake of any drugs should be agreed with the doctor, especially when it comes to drugs that affect blood clotting. It is important to provide the doctor with information about chronic and recent diseases, allergic reactions.

Some of the laser surgeries are performed under local anesthesia. This makes it possible to use for the treatment of adenoma in patients with an allergic reaction to anesthesia and those who do not want to create an additional load on the heart. Depending on the size of the adenoma, the doctor decides on the choice of the most appropriate method for the patient to perform the operation.

Recovery after laser treatment of prostate adenoma takes about 14 days. Despite the low invasiveness, the patient must adhere to some medical recommendations and observe restrictions.

During this period, the patient who has undergone the procedure is recommended:

• drink enough fluids;
• do exercise therapy;
• limit physical activity;
• rational nutrition (minimum salty and fried foods, complete exclusion of alcoholic beverages);
• monitor the regularity of the chair, avoid constipation;
• First time use of urinary catheters;
• exclude heating of the groin area;
• avoid sudden movements.

In some cases, an additional course of antibiotics is prescribed. The recovery process after surgery should be under medical supervision

Advantages and disadvantages of adenoma removal

Benefits of laser treatment of adenoma:

• rare occurrence of complications and relapses;
• preservation of sexual function;
• possibility after surgery to live without symptoms for more than 10 years;
• less pain than with traditional operations;
• makes it possible to remove adenoma of various sizes;
• no age limit;
• quick recovery.

• high cost;
• retrograde ejaculation in which sperm enters the bladder;
• Not every clinic offers laser treatment.

In the majority of cases, the complications that have arisen are eliminated without intervention within a short period of time. If they are preserved, a doctor's consultation is necessary.

Side effects of adenoma treatment also include:

• possible drop in libido;
• erectile dysfunction;
• repeated illness;
• constriction of the urethra.

Prices for transactions

Prices for laser removal of prostate adenoma vary depending on the specific medical institution, city and country.

In the capital of the country, Kiev, prices are higher than in cities of regional significance.

In Israel - from 16 thousand dollars, in Germany - from 14 thousand euros.On average, treatment abroad will cost from 5 thousand dollars.

Conclusion

Surgery is the most effective way to eliminate the symptoms of prostate adenoma. Despite the fact that there can be no absolute guarantee of a cure, the likelihood of complications with this method of treatment is minimal. Before deciding on a laser intervention, it is necessary to carefully weigh all the arguments and read the doctor's explanations about the course of the manipulations.

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Laser vaporization of prostate adenoma.

Removal of prostate adenoma by laser.

Laser vaporization of prostate adenoma is the vaporization of prostate adenoma using a laser. The operation goes without incisions. A laser light guide is passed through the urethra and the adenomatous tissue is evaporated. When carrying out laser vaporization of prostate adenoma, absolutely any size of the adenoma is removed, there are no restrictions on the volume!

For laser vaporization of prostate adenoma, we use the latest laser system EVOLVE 180 from biolitec, 180 W, manufactured in Germany. For a laser of such high power, a flexible light guide with a curved tip has been specially developed for more perfect and efficient contact evaporation. The EVOLVE 180 high power laser has a prostate adenoma tissue removal rate of 3-4g/minute. The wavelength of our diode laser is 980 nm. it is well absorbed both in water and in hemoglobin, which allows you to quickly evaporate and simultaneously coagulate the underlying deep layers, avoiding bleeding. Due to the high water absorption, the use of the EVOLVE 180 laser system eliminates accidental damage to the bladder and other non-target areas.

How does laser vaporization of prostate adenoma work?

A laser light guide is passed through the urethra into the prostate, where the prostate adenoma is evaporated. Evaporation is carried out by contact, in layers. The evaporated tissue is washed out together with the washing liquid, the penetration depth of the laser beam is constant, more than 1 mm.

Thanks to the high power of our laser and the latest curved light guide, vaporization of even large adenomatous nodes and their hard-to-reach areas is not difficult. High-efficiency vaporization combined with deep coagulation allows large volumes of tissue to be quickly removed with virtually no bloodshed. The operation is under the control of the eye, the surgeon sees the operation on the monitor screen, which in turn allows the surgeon to control every movement of the light guide in order to avoid damage to the sphincter apparatus and seminal tubercle. The operation lasts about an hour, depending on the size of the prostate. The patient stays in the hospital for 2 days, urinates on his own and goes home with prescriptions.

As a result, after laser evaporation of all adenomatous nodes, we get a channel in the prostatic part with a diameter of about 3-3.5 cm. This will allow the patient to urinate with high quality for the next 15-20 years. At the same time, without experiencing such problems as urinary incontinence, retrograde ejaculation and erectile dysfunction. According to our observations, the quality of erection is not only preserved, but also enhanced.