Pace Hospitals

LASER PROSTATECTOMY

LASER PROSTATECTOMY
A Boon to prostate patients


Most men over the age of 50 experiences symptoms of prostate gland enlargement.  The symptoms of frequency, urgency, poor urinary stream, dribbling after urination and perhaps the most troublesome of all is nocturnal (getting up at night to urinate). Many patients have loss of sleep because of an enlarged prostate gland. Here we will discuss about the prostate gland, symptoms of prostate enlargement and what treatment options are available for the same.


INTRODUCTION: 


The prostate gland is typically the size and shape of a walnut and is located below the bladder. It encircles the urethra, the tube through which urine flows from the bladder out of the body. When the prostate gland enlarges it compress the urethra and make it difficult to pass urine.


Benign enlargement of the prostate gland is non cancerous and does not lead to prostate cancer, but If symptomatic and left untreated, BPH can lead to urinary retention and cause bladder, urinary tract and kidney problems.


SYMPTOMS:-


Prostate enlargement can lead to few or all of irritative and obstructive symptoms as follows, Irritative symptoms:- 



  • Nocturia 

  • Increased frequency of urination

  • Increased night time frequency (nocturia)

  • Burning sensation while passing urine

  • Urgency


Obstructive Symptoms:-



  • Hesitancy

  • Poor stream

  • Thin flow of urine

  • Interrupted flow of urine

  • Straining while passing urine

  • Sense of incomplete voiding


Sequelae of prostate enlargement if left untreated are:-



  • Acute urinary retention 

  • Bladder stones

  • Renal failure

  • Bladder weakness

  • Recurrent UTI


Treatment options:- 



  • Lifestyle changes

  • Medical treatment 

  • Surgical treatment



  1. Lifestyle changes:-


Try behavioral changesPerhaps the easiest suggestion is limiting your fluid intake at night and not drinking anything for two hours before bedtime.  I also caution to decrease those foods and beverages that are diuretics (and will therefore prompt you to urinate more), such as coffee, caffeinated tea, herbal tea, lemon juice, chocolate, pineapple, grapes and cherries.



  1. Medical treatment:-


If those behavioral changes don’t help much, consider medication. A change in habits will help some but not all men with BPH, and for those whose symptoms aren’t relieved, medication is an option.  The most commonly used medications are alpha blockers, which can relax the muscle at the base of the bladder and the prostate, and 5 alpha reductase inhibitors, which can, over a period of months, shrink the prostate.  Like nearly all medications, they do have side effects.  For example, alpha blockers can lead to hypotension by decreasing his blood pressure when moving from laying down to standing upright quickly.  Alpha blockers also can cause sexual side effects like decreasing the volume of the ejaculate or having no ejaculation at all.  The 5 alpha reductase inhibitors can cause sexual dysfunction, such as impotence.



  1. Surgical treatment:-


If behavioral changes and medication don’t work or cease to be effective, surgical procedures are an option.  Until recently the two most common procedures are a transurethral resection or TURP, in which an instrument is inserted up the urethra to cut out the part of the prostate that’s blocking urine flow, and a laser prostatectomy, which vaporizes the tissue obstructing the urethra. Both procedures are typically effective but carry the risk of side effects such as erectile dysfunction. 


Laser prostatectomy has distinct advantages over conventional TURP as:-  



  • Less bleeding

  • Early recovery 

  • Can be used for large sized prostate

  • Can be used for anti coagulant patient 

  • Can be used safely for cardiac high risk patients 

  • Shorter hospital stay


Bottom Line:  The enlarged prostate gland affects millions of Indian men.  It significantly impacts a man’s quality of life.  Help is available. Meet urologist today. 


Dr. Shyam Varma


Consultant Laparoscopic Urologist and Transplant Surgeon,
Pace Hospitals