What you should know
- Laser prostatectomy is a surgery done to treat benign prostatic hypertrophy, also called BPH. BPH is not a type of cancer. BPH is a condition where the prostate gland becomes larger than normal. The prostate is a male sex gland that helps make semen. It is located below the bladder and wraps around the urethra like a donut. The urethra is the tube that carries urine from the bladder into the penis. The urine flows through as it is passed out of the body. With BPH, an enlarged prostate can squeeze the urethra and block urine flow making it harder to urinate (pass urine).
- A laser prostatectomy may be done on an out-patient basis or during a hospital stay. During this surgery, no incisions (cuts) are made in your abdomen (stomach) or genital area. Caregivers insert special tools and scopes through your penis and urethra to do the surgery. A scope is a long metal tube with a light and tiny video camera on the end. This gives caregivers a clear view of the prostate area while watching the images on a monitor. Different types of lasers (powerful light beams) may be applied to open blocked channels or destroy excess prostate tissues. You and your caregiver will decide which type of surgery for your BPH is right for you. With laser prostatectomy, your prostate may become smaller and the symptoms of BPH may be relieved.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
- Problems may happen during your laser prostatectomy that may lead to an open prostate surgery. Since the laser will be hot, it may cause irritation or damage in and around the prostate. Your prostate or other parts of the urinary tract may get injured during surgery. There is also a danger that a blood or nerve supply may be cut off. This may cause you more problems in passing urine or trouble in having an erection. Even after having surgery, there is a chance that your prostate may get big again. This may make your symptoms come back or not be completely relieved.
- Without treatment, your prostate may continue to grow and push on other structures near it. If this happens, you may not be able to pass urine. You may get infections and your urinary tract may be damaged, especially your kidneys. If waste products are not removed, you may get sepsis (blood infection) or your kidneys may fail (stop working). This may lead to more serious and often life-threatening problems, such as heart, liver, or brain damage. Ask your caregiver if you are worried or have questions about your surgery, condition, or care.
The week before your surgery:
- Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
- Ask your caregiver if you need to stop using any of your present medicines. These may include aspirin, ibuprofen, or blood thinners.
- Ask your caregiver before using any over-the-counter or herbal medicine or supplement. If you regularly use these medicines or supplements, tell your caregiver.
- You may be asked to stop smoking. Ask your caregiver for more information if you have trouble stopping smoking.
- You may need to have blood and urine tests, a transrectal ultrasound, cystoscopy, or prostate biopsy. You may also need other tests, such as chest x-ray or electrocardiogram (ECG). Ask your caregiver for more information about these and other tests that you may need . Write down the date, time, and location of each test.
- You may need to stop driving, lifting heavy things, having sexual intercourse (sex), or doing strenuous or tiring activities.
- Your caregiver may give you certain medicines to relieve your symptoms. These medicines relax the muscles in your prostate and bladder and may help you urinate more easily. Ask your caregiver for more information about these medicines.
The night before your surgery:
- Ask caregivers about directions for eating and drinking.
- Your bowel may need to be emptied and cleaned out before the surgery. Caregivers may give you a liquid medicine called an enema. This will be put into your rectum (rear end) to help empty your bowel. Your caregiver will teach you how to do this.
- You may be given a pill to help you sleep.
The day of your surgery:
- Write down the correct date, time, and location of your surgery.
- Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
- Do not wear contact lenses on the day of your surgery. You may wear glasses. Wear socks to help you stay warm.
- If you are staying in the hospital after your surgery, bring your personal belongings with you. These include your bathrobe, toothbrush, denture cup (if needed), hairbrush, and slippers.
- Caregivers will insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery.
- You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the surgery. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.
What will happen:
- You may be given medicine to help you relax or make you drowsy. You will be taken on a cart to the operating room and then moved onto a special bed. Caregivers may give a local, spinal, or general anesthesia to keep you numb or completely asleep during surgery. Caregivers will help you put your legs up in stirrups (leg holders). Your abdomen and genital area will be cleaned with soap and water. Sheets will be put over you to keep the surgery area clean.
- During your surgery, your caregiver will insert a scope and other instruments through your penis and urethra. Lasers will then be passed to the different areas of your prostate. These lasers will help cut, shrink, or destroy excess tissues to make your prostate smaller. Your caregiver can also remove a part of the prostate and pass it in your bladder. Once the piece of your prostate is in your bladder, it will be broken into tiny pieces. These pieces of prostate will be sucked out immediately or left to be passed out in your urine. Your caregiver may also use a laser to open blocked channels and seal blood vessels to stop any bleeding. After your surgery is completed, a catheter (long, soft tube) may be inserted to help drain your urine.
After your surgery:
You may be taken to a recovery room until you are completely awake. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are OK, you will be taken back to your hospital room. Your catheter may be removed if you can freely pass your urine. Ask your caregiver for information on how to take care of your catheter.
This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.
Contact a caregiver if
- You cannot make it to your appointment on time.
- You have a fever.
- You have questions or concerns about your surgery, condition, or care.
Seek Care Immediately if
- You cannot urinate, or if you have a catheter, no urine is filling the bag.
- You have lower abdominal (stomach) pain or back pain that does not go away.
- Your symptoms are getting worse or coming back.
- Your urine becomes red, very cloudy, and foul (bad) smelling.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.