Laser prostatectomy

Laser prostatectomy is a new and innovative technique with very positive results in patients with benign prostatic hyperplasia (BPH). It is a very effective and safe procedure. The laser solves the obstruction of urine flow due to benign prostatic hyperplasia (BPH).

Benign prostatic hyperplasia is the enlargement of the prostate gland that has not become cancerous. An enlarged prostate can lead to several urinary tract symptoms, such as frequent urination, difficulty starting urination, loss of bladder control, or the inability to urinate.

Laser is used to remove enlarged prostate tissue that prevents urine flow, thus eliminating the blockage that causes those symptoms.

Laser treatment does not require surgical incisions in the skin. Rather, the procedure is performed through the urethra without incisions or blood loss. A laser is passed through the endoscope, delivering energy through special fibers that destroy excess tissue in the prostate.

Laser therapy also permits the treatment of large prostates, which until now could only be performed by traditional surgery through a surgical incision in the abdominal wall.

 

More than 40 percent of men over 60 develop benign prostatic hyperplasia, which represents the leading cause of urination problems. Their symptoms worsen with age. As a result, an intervention is required.

• Documenting the medical history, performing physical examinations to determine the severity of symptoms, measuring urine flow rate, and performing a test to determine the amount of urine left in the bladder after urination to determine the level of urinary tract obstruction.

• Laboratory tests such as blood tests, PSA levels, and urine analysis. Cases with high PSA levels may undergo a biopsy to check for cancer.

• A transrectal ultrasound measures the amount of enlargement of the prostate gland. This test helps Prof. Mahmoud AbdElHakim and his medical team determine the time required to perform the surgery. The larger the prostate, the longer the surgery will take.

• Before the procedure, the patient must stop taking blood-thinning medications for up to 10 days to prevent excessive bleeding during or after surgery.

• It is forbidden to eat or drink after midnight before surgery.

• Laser treatment requires the patient to undergo general anesthesia. In cases who can not undergo general anesthesia, spinal anesthesia may be applied, allowing them to stay awake and preventing sensation from the waist down.

• An antibiotic injection is administered to the patient to reduce the chances of infection.

• The patient lies on his back with a raised legs during the procedure.

• An endoscope is inserted through the urethra, the tube that carries urine from the bladder. The endoscope, equipped with a tiny camera, shows the surgeon the details of the prostate gland.

• A fiber-optic laser is inserted into the scope to remove the enlarged prostate tissue. The laser seals off any blood vessels to ensure non occurrence of bleeding, without the need for a surgical incision. 

• The laser is removed from the endoscope and replaced with a suction device to remove the tissue.

• When tissue removal is complete, the suction device is retracted and a urinary catheter is put in place.

 

• The patient is subjected to observation and catheterization care in the hospital until he can go home the day after the surgery.

• Tissue removed during surgery is tested in the pathology laboratory to ensure that the enlarged cells are normal and not cancerous.

• Food and drinks are allowed on the day of the procedure as soon as the patient can do so safely.

• After making sure there is no excessive bleeding during the first night following surgery, the catheter is often withdrawn.

• The patient is then evaluated to ensure that he can urinate well at least two to three times after removing the catheter, in this case he can go home without the catheter. If he is unable to urinate normally, a temporary catheter may be inserted to help get rid of urine and drain the bladder.

• Prof. Mahmoud AbdElHakim examines the patient after surgery to monitor his recovery. The pre-surgical tests are repeated to determine the effectiveness and success of the surgery, such as urine flow rate, bladder examination, and symptoms' severity.

Laser prostatectomy helps reduce symptoms of benign prostatic hyperplasia, such as difficulty starting urination, the need for frequent urination, slow (prolonged) urination, and urinary tract infections. With laser surgery, the patient can also avoid kidney or bladder damage, kidney stones, or hematuria. The bladder function is gradually restored and controlled.

The use of laser in different countries of the world has shown that it is a safe and effective procedure. Although many types of BPH surgeries are available, laser surgery offers the unique advantage of removing a large amount of tissue without making any incisions in the body, even in very large prostates, those over 200 grams. This is in addition to the following advantages:

• Reduce the risk of bleeding, which diminish the need for blood transfusions during surgery. Low risk of bleeding is one of the most important points for patients with cardiovascular or cerebrovascular problems.

• Faster catheter removal and shorter hospitalization period.

• Laser surgery reduces the risk of complications such as urinary tract infections and urinary retention.

• Decreased need for post-surgical care.

• Faster recovery and return to daily life.

• Rapid results with rapid improvement in urinary symptoms. Laser surgery reduces BPH symptoms such as frequent urination, nocturnal urination, sudden urge to urinate, weak bladder, slow urination, and difficulty starting urination.

• When the patient is discharged from the hospital, he is given a series of instructions by Prof. Mahmoud AbdElHakim, Professor of Urology, Cairo University. Recovery time depends on following these instructions, but full recovery usually takes 2 to 4 weeks.

• Most patients need at least 1-2 weeks of rest at home before returning to work.

• Some patients may need 3 to 4 weeks to recover before returning to work if their job is physically demanding. 

• You should not attempt to lift heavy objects during the recovery period. You can just walk and do light activities.

Yes, there is a continuous follow-up from Prof. Mahmoud AbdElHakim, where:

• The patient receives medical advice and care in the first days immediately after the procedure.

• The first consultation after surgery is scheduled 2 to 4 weeks after surgery.

• In the first year after treatment, the patient undergoes, on average, three further consultations.

• After the first year, the patient is usually monitored annually for evaluation and PSA levels monitoring.