Going For Surgery

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 About the Surgery

Laser prostatectomy is an alternative to Transurethral Resection of the Prostate, TURP. It is used to treat patients with urinary symptoms due to benign prostate enlargement (Benign Prostatic Hypertrophy, BPH). Instead of using electrical energy, it uses a high-energy laser to remove the core of the prostate from inside the gland to create an open channel, whilst avoiding the muscles and nerves that are important to maintain urinary continence and erectile function. The types of laser surgery include:

• Holmium laser enucleation of the prostate (HoLEP). In general this technique can be used for large prostates. It provides results similar to TURP, but with less chance of bleeding and a shorter recovery time. Therefore, it works best for patients with bleeding problems or multiple other health conditions.

 Aim of Surgery

Relief of urinary symptoms – stronger flow, less frequent toilet visits day and night, less urgency to urinate.

 How Long is Surgery

90 min

 Anaesthetic

General Anaesthetic is the preferred method for this procedure.
(You are put to sleep for the whole operation and will feel no pain or discomfort during the procedure)
OR
Spinal anaesthesia – injection into the back (numb below waist)

 Incision/Cut

No skin incisions – the entire operation is performed through the opening of the penis

 Description of Surgery

An instrument called a resectoscope is inserted through the opening of your penis. It has a telescope and an electrical cutting loop at the end which enables the surgeon to view and remove the part of the prostate that is causing the blockage. The loop “cores” out the inside of the prostate one piece at a time to create an open channel. Irrigating fluid flows through the resectoscope continuously, removing tissue debris from the bladder. A urinary catheter (a narrow tube that is passed through the opening of the penis into the bladder) is inserted at the end of surgery

 Complications of Surgery

“Dry ejaculation” (Retrograde ejaculation) – semen passes backwards into the bladder during ejaculation instead of passing down the urethra

Excessive bleeding - may occur up to 6 weeks after surgery (even after your urine is normal in colour)

Not able to pass urine – due to clots, swelling of bladder or bladder weakness requiring reinsertion of the urinary catheter for up to 2 weeks.

Loss of bladder control (Incontinence) – usually improves in a few weeks but may be permanent (very rare)

Erection problems 3-10%

Infection 5%

Scarring of the bladder neck causing narrowing (stricture)

Injury to rectum (very rare)

TURP syndrome – excessive absorption of irrigating fluid (less common compared to conventional TURP surgery)

 Duration of Hospital Stay

1-2 days (usually shorter stay compared to TURP surgery)