Laser Prostatectomy:

Help for a Problem Prostate:

An enlarged prostate gland can cause frustration and annoying symptoms. You may need to urinate often, including several times during the night. You may leak a small amount of urine, or feel the urge to urinate, but only manage a small trickle. To help treat your enlarged prostate gland and relieve your symptoms, your doctor may recommend a surgical procedure called laser prostatectomy.

What is Laser Prostatectomy?

During laser prostatectomy, a laser (concentrated light energy) is used to destroy the part of the enlarged prostate gland that is squeezing the urethra. No incisions are made in your skin, so it's different from open surgery. Because the laser destroys the obstructing prostate tissue, it can't be examined for signs of cancer. Your doctor will rule out the possibility of cancer before the procedure is performed.

Risks and Complications

Possible complications of laser prostatectomy include:

• Bleeding
• Infection
• Only partial relief from symptoms
• Inability to control urine flow (rare)
• Retrograde ejaculation - ejaculation into the bladder instead of out the penis (rare)
• Permanent inability to urinate (very rare)
• Impotence - inability to have an erection (very rare)

THE LASER PROCEDURE

Laser prostatectomy may be done in a hospital or outpatient surgery center. You may go home the same day, or you may stay one or two nights in the hospital.

Preparing For the Procedure

The night before your procedure, don't eat or drink anything after midnight.To keep you from feeling discomfort during the procedure, your bladder and urethra may be numbed (local anesthesia), your body below the waist may be numbed (regional anesthesia), or you may be completely asleep (general anesthesia). An intravenous (IV) tube may provide you with fluids and medication.

During the Procedure

The procedure itself usually takes between 45 minutes and an hour. To perform the procedure, the doctor inserts a cystoscope (a thin, tubelike telescope) through the urethral opening in your penis and into your urethra. Your doctor can view your urethra and your prostate, either through the cystoscope or on a video monitor. The laser is inserted through the cystoscope to the area of the prostate. The laser is then used to destroy excess prostate tissue. This treatment often causes swelling, so a catheter may be inserted temporarily into your urethra or directly into your bladder to help your bladder drain.

After Your Surgery

To hold the urine drained by the catheter, you may wear a leg bag for a week or so. Your doctor may also prescribe antibiotics to prevent infection and pain medication to ease any discomfort. In about a week, you'll visit the doctor to have your catheter removed. If swelling still makes urination difficult, the catheter may be left in for another week. A leg bag is worn under clothes to hold fluid drained by the catheter.

Healing

For the first few weeks after your surgery, you may notice that your urine is cloudy or that you have blood or blood clots in your urine. This is normal while your bodv rids itself of the treated tissue. Your symptoms may begin to improve during the first few weeks, but it may take up to three months before they improve completely. Your doctor can give you further instructions, such as when you can resume sexual activity and how soon you can return to work.

When to Call Your Doctor

• Fever over 100.4 F
• Excessive bleeding
• Pain not relieved by medications
• No urine draining from the Cd' theter
• Frequent of excessive urge to urinate

YOUR PROSTATE

The prostate is a small gland about the size of a walnut. It wraps around your urethra, the canal that carries urine from your bladder out of your body. Your prostate's job is to produce some of the fluid that carries sperm through the urethra during ejaculation.

WHEN THE PROSTATE IS ENLARGED

The prostate is likely to enlarge as a man ages. This is called benign prostatic hyperplasia (BHP) In some men, the enlarged prostate squeezes the urethra blocking the flow of urine. This can lead to bladder and urination problems.

FEELING BETTER

To get the best results from your laser prostatectomy, follow your doctor's instructions and keep your follow-up appointments. Before long, you'll be feeling better and be able to get back to enjoying your life.

This information is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem.