What is prostate, where is it located in our body?
Prostate is a glandulous organ found in men located below the bladder around the urethra in the size of 15-20 gr. which produces fluid protecting and enriching sperm.
What is BPH?
Benign prostate hyperplasia is the state of prostate cells multiplying without becoming cancerous and extending in size. It may occur after the age of 45-50.
Is each BPH patient operated?
Such options as follow-ups with certain intervals and medications are available.
What are the surgical treatment options?
It can be stated as open and closed surgery. Inner part of prostate is removed and the outer part is left in both surgical methods.
Open surgery is considered for the prostates above the size of 150 gr. An incision is made through the lower abdomen.
Closed surgery is applied by inserting endoscopic devices in the width of a pen through the urinary meatus. There is no incision or suture in the body.
In which ways are the closed prostate surgery applied?
Mostly applied, standardized method with a recognized success is TUR (transurethral resection).
Prostate is removed by cutting in small pieces. There are also TUR methods that will remove the side effects.
The alternative method with an equivalent effect is laser method.
Despite not being equivalent to the abovementioned surgeries, there are also such procedures as methods based on heating the prostate and its shrinkage, stents placed inside the urinary canal where the prostate is located and placing the prostate to the sides out of the urinary canal.
Other treatment methods with fewer side effects have been searched as the age group is advanced in prostate and additional health problems are frequent in this age group and due to the characteristics of the solution used in the TUR method and such side effects as water poisoning and possibility of too much bleeding in cases of big prostates in which surgery lasts long. Laser prostatectomy has been stated as a treatment method with fewer side effects and comparable efficiency.
What is laser treatment of prostate, how is it done?
Laser treatment of prostate is applied as a method yielding successful results equivalent to TUR method and with fewer side effects than TUR.
It can be named as green light and red light laser by the color of laser light’s wave length.
Prostate gland is evaporated with laser light by inserting endoscopic devices into the urinary canal. There are some types of laser with fast and high evaporation power.
There is also a method in which prostate is cut and removed in pieces with laser power.
Commonly used method is evaporation method. It is conducted by sending laser light within a specially designed fiber optic system. This fiber optic prob is reached to the prostate via an endoscope. Light is directed to prostate tissue and evaporation is applied without bleeding.
In evaporation method-as in all other types of
surgeries-, patients must be examined for prostate cancer before the surgery as no tissue is taken from prostate and pathological examination cannot be made.
What are the advantages of laser method?
Advantages of laser method (in comparison to TUR method):
- As can be general, spinal/epidural anesthesia, it can also be conducted under local anesthesia or sedation according to the patient.
- Duration of hospital stay is shorter.
- Duration of catheterization is shorter or not placed.
- Bleeding is less during and after the operation (blood vessels are burnt and evaporated) and it can be performed on high-risk patients with bleeding disorder receiving anticoagulant. Therefore overload risk on heart is less for those with a heart disease. It is advantageous in patients with heart and lung problem.
- It can also be used in those with big prostates (under 150 gr).
- Retrograde ejaculation is rarely seen. While the risk of retrograde ejaculation is 75-95% in TUR method, this is 25-50% in laser method.
- Its effect on sexual performance is less rare.
- The image is clearer during the operation and sharper tissue distinction can be made as bleeding is prevented.
- Frequently used laser methods are approved by the internationally recognized device monitoring institution US Food and Drug Administration (FDA).
Which patients are suitable for laser treatment?
It is suitable for every prostate patient whose TUR surgery need is determined and who doesn’t carry the risk of prostate cancer following the tests at that
moment. It can also be preferred for the risky patient group who may have bleeding problem and heart circulation disorder. It is a less risky method in terms of side effects.
What is the last developed system in laser systems?
Faster, more secure and effective results with less bleeding can be yielded with the newly developed systems and devices in 180 watt power.
Kudret International Hospital puts laser treatment in prostate disorder into your service with the devices in accordance with the last technological development.
Prof. Dr. Semih Y. Sargın
Department of Urology