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Laser Prostatectomy

You have an enlarged prostate gland. This can cause problems with urination. To relieve your symptoms, your doctor may recommend laser prostatectomy. During this procedure, a laser (concentrated light energy) is used. The laser removes prostate tissue from around the urethra. This allows urine to flow more freely. Note that the laser destroys the prostate tissue. So it can’t be examined for signs of cancer. Your doctor will rule out cancer before the procedure is performed.

Cross section of prostate showing cystoscope inserted into urethra and prostate. Laser in cystoscope is removing prostate tissue.

Preparing for the Procedure

  • The night before your procedure, don’t eat or drink anything after midnight.

  • When you arrive for the procedure, you will be given an IV line. This provides fluids and medications.

  • You will be given anesthesia (medication to prevent you from feeling pain) before the procedure. You may have one or more of the following:

    • Local anesthesia.Your bladder and urethra are numbed.

    • Regional anesthesia. Your body below the waist is numbed.

    • General anesthesia.You are in a state like deep sleep.

During the Procedure

  • The procedure itself usually takes about 45 minutes.

  • cystoscope (a thin, tubelike telescope) is put through the opening in your penis and into your urethra. This tool lets your doctor view your urethra and your prostate, either through the cystoscope or on a video screen.

  • The laser is inserted through the cystoscope. The laser is then used to destroy excess prostate tissue.

  • You may receive a urinary catheter. This helps your bladder drain for a short time after the procedure. It’s removed when it’s no longer needed.

Retrograde Ejaculation

In some cases, a muscle involved in ejaculation must be cut during surgery. If this happens, semen may travel into the bladder instead of out of the penis during ejaculation. This side effect is called retrograde ejaculation. It is harmless. The feeling of orgasm won’t change. But very little semen will leave the body during ejaculation. Note that retrograde ejaculation can also be a side effect of certain medications.

Risks and Complications of Laser Prostatectomy

  • Bleeding

  • Infection

  • Pneumonia

  • Blood clot

  • Scarring of the urethra

  • Only partial relief of symptoms

  • Erectile dysfunction (rare)

  • Loss of bladder control (very rare)

 

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