Laser Surgery for Prostate and Stones

Prostate laser surgery is a minimally invasive procedure to treat urinary symptoms caused by an enlarged prostate, also known as benign prostatic hyperplasia (BPH). During prostate laser surgery, a laser is used to remove prostate tissue that blocks urine flow. Prostate laser surgery has been developed to speed treatment and recovery while avoiding complications that can occur with other types of prostate surgery. There are several types of lasers and laser surgery used in prostate laser surgery. All lasers work the same way, using concentrated light to generate precise and intense heat. The type of prostate laser surgery your doctor will use depends on several factors, including the size and location of your prostate enlargement and the type of laser equipment available. The four types of laser surgery are:

Transurethral Evaporation of the Prostate (TUEP). The prostate tissue is destroyed by laser energy. It is generally a safe procedure, and causes a small amount of bleeding.

Visual Laser Ablation of the Prostate (VLAP). This treatment uses great amounts of laser energy to dry up and destroy excess prostate cells. It can cause some complications and patients may also experience a burning sensation during urination.

Photosensitive Vaporization of the Prostate (PVP). This is one of the newest forms of laser treatment for prostate gland enlargement and one of the most effective ones. PVP uses laser energy to destroy prostate tissue. In general, PVP is better for smaller prostates.

Holmium Laser Enucleation of the Prostate (HoLEP). A newer laser procedure, which has shown to provide results similar to classical surgical methods, but with less chance of bleeding and a shorter recovery time.

For stones, laser surgery is most often prescribed for very small kidney stones averaging 5 mm in diameter or smaller. Though quite small, these kidney stones can still become caught in the ureter on their way to the bladder. Because they block the ureter, this can prevent urination. Typically, a course of excessive fluid consumption and pain relievers is prescribed, but if this does not get the kidney stone dislodged, laser surgery, specifically laser lithotripsy, is the next step. To remove stones, including kidney stones, a small, camera is inserted up the length of the urethra, through the bladder and into the ureter. The camera, called a uteroscope, is used to locate the kidney stone. A small laser, as thin as a fiber-optic cable, is set alongside the uteroscope. The laser fires in a continuous stream, which is played over the surface of the kidney stone, breaking it into smaller fragments. The uteroscope is retracted, and the fragments are allowed to pass when the patient next urinates.