LASER ENUCLEATION OF THE PROSTATE (HoLEP) - THE "GOLD STANDARD" OF TREATMENT
A PSA test can help detect prostate cancer at an early stage. Cancer is easier to treat and much better managed if it is detected in its early stages.
It will also tell you whether you are at risk of getting prostate cancer in the future.
A high PSA level does not always mean you have prostate cancer (a false positive). Other conditions you may have can raise your PSA level, such as an enlarged prostate or prostate infection.
In some cases, the PSA level may be low even if cancer is present (a false negative result).
PSA testing can detect cancer that would never have had symptoms. This is called overdiagnosis: the discovery of a cancer that is unlikely to cause ill health or pose a threat to a man's life.
The PSA test helps detect prostate cancer at an early stage, when the chance of cure is much higher.
Remember that not everyone with a high PSA level will have cancer, and not everyone who is diagnosed with cancer will need treatment.
Talk to your family doctor about the risks and benefits and whether this test is right for you.
Laser prostate surgery may be performed as an outpatient procedure, or you may need to stay overnight in the hospital to ensure the surgery is successful.
You will be given one of two types of anesthesia:
General anesthesia means you will be unconscious during the procedure.
Spinal anesthesia means that you will have an anesthetic injected into your spine to relieve pain. With this type of anesthesia, you will be conscious during the operation, but will not feel pain.
The advantages of this method of operation are undeniable:
No cuts.
Unlimited size of prostate adenoma.
There is no need to discontinue blood thinning medications.
Minimal blood loss.
Minor postoperative pain.
Short bladder catheterization time.
A short stay (less than 1 day) in the clinic or the operation is performed on an outpatient basis.
Fast rehabilitation.
Blood in the urine (hematuria) for a few days to a week after the procedure
Irritative urinary symptoms such as painful urination, difficulty urinating, an urgent or frequent need to urinate, or the need to get up frequently during the night to urinate for several days after surgery. These signs are more typical after electrical resection (TURP surgery) compared to laser enucleation and disappear within a short time
Urinary incontinence after surgery. This may occur due to the fact that your bladder is accustomed to displacing urine through the urethra narrowed by the prostate adenoma and a short adaptation period is required.
Retrograde ejaculation. After any operation on the prostate for adenoma, sperm may be thrown not forward, as before, but back into the bladder. During the next urination after ejaculation, sperm comes out along with urine
Urinary retention. Some men experience difficulty urinating after laser surgery. If this happens, you will need to have a urinary catheter installed for several days to drain urine from the bladder. The risks are the same as with all other treatments for prostate adenoma.
Urinary tract infection. Urinary tract infection is more likely with prolonged use of a urinary catheter.
Narrowing (stricture) of the urethra (urethra). This condition makes it difficult for urine to flow out of the bladder through the urethra and may require additional treatment. Just as scars form on the skin of the body, internal scars can form after prostate surgery. The risk is the same as with all other methods of treating prostate adenoma, does not exceed 2%.
Retrograde ejaculation. Retrograde ejaculation is a condition in which sperm enters the bladder during ejaculation. It is not painful or harmful. If you have retrograde ejaculation, then at the moment of orgasm, little or no sperm is released from the penis. This is important if you are planning to have children, since retrograde ejaculation interferes with the release of sperm from the penis. The risks are the same as with all other treatments for prostate adenoma.
Erectile dysfunction. After laser surgery for prostate adenoma, the risk of erectile dysfunction is minimal and much lower than with TURP of the prostate, which is an advantage of laser therapy, since the laser does not penetrate deep into the prostate gland and does not damage the nerves that pass next to the prostate gland.
Ask your doctor about any restrictions or recommendations to follow after surgery.
Avoid strenuous physical activity, such as heavy lifting, for two weeks after laser prostate enucleation.
Refrain from sexual intercourse until your doctor gives you permission. Most men can resume sexual activity within a week or two after the procedure.
Watch your urine. Drink plenty of fluids and avoid strenuous exercise unless your urine is light (or pink) and some time has passed since surgery.
Take antibiotics as recommended. If your doctor has prescribed you antibiotics, you must complete the full course of antibiotics as recommended by your doctor.
You may need a urinary catheter after surgery because the flow of urine may be blocked due to swelling.