Laser Prostate surgery is used to relieve urinary obstruction caused by enlarged prostate after appropriate evaluation. The evaluation is done with different parameters like Ultrasound for prostate size, post void residual urine and uroflowmetry. It is also used to defragment stones in the ureter or kidneys with less chances of retropulsion. Lasers use concentrated light to generate precise and intense heat.
The surgery is minimally invasive and requires no incisions on your body. Once you are asleep, a small lighted instrument (ureteroscope) is placed into your urethra and bladder to access your ureter and kidney.
Once the stone is seen, a laser fiber is used to transmit Holmium energy to break up your kidney stones. The surgeon removes some pieces through the urethra with a small basket, and smaller pieces can be passed later with urination. The surgeon may also use a high-powered holmium laser with high-frequency emissions that “dust” the stones into a fine powder. You can then pass the fine particles in your urine after surgery. An even more efficient way of transmitting the holmium laser is by modulating the pulse using the Moses effect, which may result in more efficient stone dusting or fragmentation.
The surgeon will likely insert a tube called a stent between the kidney and urethra. This promotes healing and lets small stone fragments pass more easily. Most importantly, this stent allows your kidney to drain during the healing process. The stent is removed about 1 week after surgery. The length of surgery is generally under 1 hour, depending on the size and number of your kidney stones. Use of the dusting technique combined with the Moses effect may decrease the need to remove stones with a basket, thereby minimizing the need to use a stent.
Prostate laser surgery is used to relieve moderate to severe urinary symptoms caused by an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH).
During prostate laser surgery, your doctor inserts a scope through the tip of your penis into the tube that carries urine from your bladder (urethra). The urethra is surrounded by the prostate. A laser is passed through the scope. The laser delivers energy that is used to shrink or to remove the excess tissue that is blocking the urethra and preventing urine flow.
All lasers use concentrated light to generate precise and intense heat. Laser surgery removes excess prostate tissue by:
– Ablation. The laser melts away excess tissue.
– Enucleation. The laser cuts away excess prostate tissue.
There are different types of prostate laser surgery, such as:
– Photoselective vaporization of the prostate (PVP). A laser is used to melt away (vaporize) excess prostate tissue to enlarge the urinary channel.
– Holmium laser ablation of the prostate (HoLAP). This is a similar procedure to PVP, except that a different type of laser is used to melt away (vaporize) the excess prostate tissue.
– Holmium laser enucleation of the prostate (HoLEP). The laser is used to cut and remove the excess tissue that is blocking the urethra. Another instrument, called a morcellator, is then used to chop the prostate tissue into small pieces that are easily removed.
The type of laser surgery your doctor will perform depends on several factors, including the size of your prostate, your health, the type of laser equipment available and your doctor’s training.
Laser lithotripsy is a procedure to break apart kidney stones in the urinary tract. It is done with a ureteroscope passed into the tubes of the urinary tract. Incisions are not needed. The laser breaks the kidney stones into smaller pieces that can either be removed by the surgeon or pass out of the body in the urine.
Kidney stones can become trapped anywhere in the urinary tract, including the kidney and the ureter. The ureter is a tube that carries urine from the kidneys to the bladder. If a stone gets stuck in the ureter it can cause a blockage and the back-up of urine into the kidney. They can also be quite painful.
Laser lithotripsy is used to break apart the kidney stone so that it can pass through the ureter. The pieces will either be removed by the surgeon using a special basket or left in place where they will move from the ureter to the bladder, then out of the body with the urine. Laser lithotripsy may be chosen if other non-surgical treatments have failed or if kidney stones are:
– Too large to pass
– Irregular in shape
– Causing bleeding or damage to surrounding tissue
Ureteroscopy with laser lithotripsy is nothing serious, instead a very safe effective solution with fast recovery. As such there are no risks and complications associated with the surgery, but at times some rare repercussions may occur like nausea and shortness of breathing.
Call your doctor if any of these occur:
– Inability to urinate
– Pain that cannot be controlled with the medications you were given
– Redness, warmth, excessive bleeding, or drainage
– Signs of infection, including fever or chills
– Persistent nausea or vomiting
– Increasing or large amounts of blood in the urine
– New or worsening symptoms
If you think you have an emergency, call for emergency medical services right away.
Dr Rahul Yadav is one of the best experts in India in the selection of the correct type of laser prostate surgery basis the identification of the patients’ indications.