Who is a candidate for laser prostate surgery?

• Laser prostate surgery is performed on men with an enlarged prostate and its associated problems, such as difficulty urinating, urinary tract infections or pain.
• Among the methods used to perform prostate surgery, there are three types of laser, adapting the method to the particular characteristics of the patient and those of the prostate. 
• Some of the benefits of laser treatments are: the speed of the procedure, very low chance of complications, minimally invasive treatment and rapid recovery.

As you know, prostate enlargement occurs over the years, causing obstruction of the urethra and discomfort such as difficulty in emptying the bladder completely or even the need for permanent catheterisation.

Although pharmacological treatments exist, they are only palliative in nature, i.e. they help to relax the muscles around the prostate to facilitate urination, but the prostate does not stop growing. This is why specialists resort to surgical treatments, with surgery being the only remedy to shrink the prostate.

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You should know that there are currently several surgical techniques, on the one hand, the conventional ones such as transurethral resection or open prostatectomy, on the other hand, the ureteral release operation with the urolift system (effective only in prostates of a certain size, we explain more about this here); and finally, laser prostate surgery, the most recommended and which we talk about in this article.

To give you a better understanding of the differences between the types of laser for prostate surgery, below is a brief explanation of each process:

• Greenlight laser: The main use of the Green laser is to perform prostate photovaporization, allowing the size of the prostate to be reduced, but it is not possible to extract prostate tissue for analysis.
• Holmium laser: The use of this type of laser makes it easier for the surgeon to perform techniques such as enucleation and vaporresection, which makes it possible to obtain prostate tissue for analysis. In addition, it is also possible to perform photovaporization of prostate tissue. With this type of laser it is possible to operate on any size of prostate.
• Thulium laser: With this laser it is possible to operate on almost any size of prostate depending, generally, on the surgeon's criteria and the particular characteristics of the patient. In addition, Thulium laser surgery can significantly reduce operating theatre time, hospitalisation, catheterisation and recovery. As with the Holmium laser, it is also possible to perform vaporisation and vapour resection techniques.

If you need more information about the procedure and other details to consider, you can read the following article:

Laser prostate surgery: cost, duration and step-by-step

Next, we will try to explain the most important factors that are taken into account when performing laser prostate surgery.

When determining which laser treatment is best suited to your situation, the specialist will first consider the severity of your symptoms, the effects they have on your lifestyle and the presence of other medical conditions. With this in mind, laser prostate surgery is generally recommended when you have the following symptoms:

• Incontinence: Inflammation or infection of the prostate can cause you to leak urine suddenly or over the long term, and you may even be unable to hold any urine at all.
• Recurrent blood in the urine: Haematuria is usually due to infections in the prostate or elsewhere in the urinary tract.
• Urinary retention: This is when you are unable to empty your bladder completely or partially, and you may have difficulty urinating, urine leakage, urinary hesitancy or frequent urination.
• Recurrent urinary tract infections: Associated in many cases with the inability to empty the bladder.
• Kidney failure: If not treated in time, more serious problems such as urinary tract infection, bladder stones or problems with the kidneys filtering toxins and other wastes from the blood can occur.
• Kidney stones: Associated with the accumulation of urine as well, as the compounds can become sediment.
• Large prostates: Very large prostates are considered to be larger than 60 cc. If you have a large prostate, the possibility of having the above symptoms is much greater, so surgery is absolutely necessary.

In addition to the aforementioned circumstances, you must also take into account other particularities that determine the type of laser most recommended for your treatment. 

The most important of these are the size of your prostate, your age and whether you suffer from other pathologies associated with the prostate. 

Depending on the size of the prostate

The prostate never stops growing, although it is from the age of 30 onwards that growth becomes more accelerated, mainly due to hormonal disorders.

Prostate growth can occur in the muscle tissue and part of the glandular tissue, seriously affecting the urethra. The urethra is located just between the prostate walls, resulting in its strangulation due to the pressure exerted by the prostate, seriously impeding the passage of urine.

Therefore, and taking into account the possibilities offered by the different lasers, we can say that the Greenlight laser can operate on small prostates up to less than 80 cc, while the Holmium laser allows the surgeon to reduce prostates of any size, even large ones. 

As for the Thulium laser, it is possible to use it in cases of medium to large prostates, without complications and in less time than with conventional techniques.

Depending on the patient's age

As we have already mentioned, the prostate is in continuous growth throughout a man's life, although it is not until after the age of 30 that its size begins to increase more noticeably. Even so, as a general rule, it is not until the age of 50 that growth becomes much more accelerated. At least in patients who suffer from it, as it does not affect all men.

You should bear in mind that your prostate can grow by an average of 1.6% per year between the ages of 30 and 50. Once you reach this age, the rate of growth increases to an average of 0.4 grams per year.

With regard to laser treatments, the type of technique to be used will depend on the characteristics of your prostate, i.e. its size and symptoms. In addition, your specialist will weigh up the advantages of each technique depending on your age and what your health can withstand in the operating theatre, although as we have already mentioned, modern laser methods present minimal complications and are much more effective, quicker and with a more bearable and simpler recovery process than conventional techniques.

Depending on other associated pathologies

In addition to the progressive enlargement of the prostate, the passage of time may have brought other types of problems. There are some pathologies that can also influence prostate enlargement, such as obesity or hypertension. These pathologies cause discomfort and difficulties when carrying out daily activities and, therefore, can seriously affect your quality of life. This can determine the technique to be used during your surgery and even whether the intervention is viable or not.

Unlike conventional treatments, laser surgery is recommended for any type of patient, even those who may suffer from heart conditions or are of advanced age.

It is important to mention that all these factors are of a general nature and may vary according to the exceptional characteristics of each case, so you should bear in mind that your specialist will be the best person to determine the best treatment and technique for your operation. We recommend that you request a free surgical assessment consultation and discuss it with the specialist.

Advantages of laser prostate surgery

After discussing the factors to be taken into account when performing laser surgery, we will now mention its advantages. The most important ones to highlight are:

• Faster surgery: The Tulio laser stands out. This allows the surgery to be performed in just 30-45 minutes.
• Less intraoperative bleeding: Thanks to the use of the laser, it is possible to produce a haemostatic effect (cauterisation) of the tissue around the vaporised area, thus minimising bleeding as much as possible and considerably reducing hospitalisation and recovery time.
• Reduced hospital stay: The time you spend in hospital is reduced from 3 to 6 days after TUR to just 24 hours, in most cases, after laser prostate surgery.
• Minimal complications: The characteristic properties of each of the lasers and the precision achieved with these techniques ensure that the process is minimally invasive and with minimal complications.
• Allows treatment of patients at risk: Thanks to the singularities of the laser method, patients with heart conditions, advanced age or anticoagulant receptors are possible candidates to undergo prostate surgery with laser, something that is almost totally inadvisable for conventional surgeries.

If you need more information, do not hesitate to contact our patient care team through our contact form or by calling on +34 91 141 33 56.

In any case, you can request a free surgical assessment consultation with one of our specialists, so that you can get to know them, familiarise yourself with your case and decide the best way to solve your large prostate problems. 

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Do you need laser prostate surgery?

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