Laser Prostate Surgery,Laser Prostatectomy, TURP (Transurethral Resection of the Prostate)-Technologically Advanced Prostate Treatment.
Transurethral resection of the prostate (TURP) is a surgical procedure performed to remove the whole or only a portion of the prostate gland that is enlarged.
- TURP is now the second most common surgical procedure in men over age 65.
- Today Laser TURP is considered as the “Gold Standard” among all available treatments for Benign Prostatic Hyperplasia (BPH). BPH is a very common condition wherein the prostate gland becomes enlarged as a man ages.
- In United States more than 30,000 men die because of prostate cancer each year
- TURP is a surgical procedure for men with symptomatic bladder outlet obstruction secondary to benign prostatic hyperplasia, cancer, or bladder neck contracture.
- This patient population has a greater anaesthetic risk because of a greater prevalence of coexisting cardiovascular and pulmonary problems.
- TURP carries unique complications because of the need to use large volumes of irrigating fluid for the endoscopic resection.
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Types of Highly Advanced Minimally Invasive Laser Prostate Surgery at World Class Hospitals in India
1. Green Light Laser PVP : Photoselective Vaporization of theProstate is a procedure used in the treatment of Benign Prostatic Hyperplasia (BPH), an enlargement of the prostate gland, resulting in urethral restriction.
The prostate is a small gland circling the urethra immediately below the neck of the bladder. It has a vital function in the male reproductive system bysecreting a fluid into the urethra during ejaculation. The advantages of this approach over the traditional TURP (transurethral resection of the prostate) are many:
- PVP is done on an outpatient basis.
- Blood loss is virtually nothing.
- Patients live with a urinary catheter postop for only one day.
- The irrigant used is much less likely to cause electrolyte abnormalities.
2. Holmium Laser : Holmium laser procedures use laser energy to alleviate BPH symptoms with fewer complications than invasive surgery by ablating or removing enlarged prostate tissue with high powered laser energy. Holmium laser procedures are generally performed under spinal, epidural or general anesthesia.
After receiving anesthesia, your urologist will pass a camera through a tube placed in your urethra, enabling him or her to view the bladder and prostate. The Holmium laser fiber (small flexible tube) is also passed through the same tube. The enlarged prostate tissue is then ablated with a very high degree of precision. The treatment is usually done in an outpatient setting and may require a catheter for up to 23 hours following the procedure.
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Advantages of Laser Prostate Surgery or Laser TURP/ Prostatectomy
- No Blood Loss and Shorter Hospital Stay.
- High success rate- surgery reduces symptoms in 88% of BPH patients.
- Most patients usually notice improvement in urine flow as soon as the catheter is removed.
- Cardiac patients who are on blood thinning agents.
- Patients with renal dysfunction who have a tendency to bleed profusely.
- Prostate gland size of more than 60 gm.
- Patients with Diabetes, Hypertension & high risk for anesthesia.
- Patients who have undergone joint replacement surgery.
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How Laser TURP is superior to conventional TURP?
Blood thinning agents have to be stopped a week to 10 days before the procedure. This puts the heart at risk for a second attack.
Conventional TURP allows tissue removal at 1gram/min. Hence gland size more than 60 gm is converted from an endoscopic to open procedure.
conventional TURP utilizes electrical energy thereby making it unsafe & slow procedure.
Since it is a open procedure it requires large amount of blood and chances of blood loss are more.
Not an ideal option for Large Prostate Glands.
Shorter Hospital Stay
DIODE laser can vaporize 3-4 grams/min. Here normal saline is used as an irrigant which on absorption does not cause TURP syndrome. Hence prostate gland beyond 100 grams can also be managed endoscopically using laser energy.
Laser TURP in general is safer and faster.
The benefits of this procedure are that there is no blood loss.
An ideal procedure for large prostate glands.
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