Laser vaporization of prostate adenoma and features of the procedure

Laser vaporization of prostate adenoma is an effective procedure that is actively used to combat pathology. The basis of the technique is the use of laser exposure: it is used to remove gland tissue. During the procedure, coagulation of blood vessels is simultaneously performed.

The essence of the technique

Laser vaporization is understood as a form of endourological surgery. It involves inserting a special instrument into the affected organ. This is done through the urethra and helps avoid incisions. The procedure is carried out under the supervision of a surgeon who performs the manipulation and monitors its progress. All necessary information is displayed on the monitor.

Laser treatment of the prostate allows you to quickly and efficiently cope with the unpleasant symptoms of the pathology and partially restore urination.

The method quite rarely leads to unpleasant health consequences and practically does not cause complications. The undoubted advantage of the technique is its short duration - it usually does not exceed 1 hour.

The rehabilitation period after the intervention does not last long and does not provoke pain.

The essence of the technique lies in the removal of enlarged prostate tissue by performing evaporation. There are several types of intervention:

1. Contact vaporization. It is used for prostate tumors with a volume of less than 30 ml;
2. Contact laser resection. In this case, the prostate is removed with a laser. The use of this method requires a highly qualified doctor;
3. Interstitial laser coagulation. It leads to changes in the structure of damaged areas of the prostate. This normalizes urination and eliminates other manifestations of the disease.

Advantages

Treatment of prostate adenoma with a laser has many advantages compared to conventional manipulations. This operation is highly accurate and helps to avoid perforation of the prostate capsule, bladder, and peritoneum. As a result, the adenoma is partially removed, which helps restore normal urethral patency.

Due to bloodless tissue removal, negative consequences of the intervention are extremely rare. Vaporization of the prostate has a number of advantages:

• bloodlessness of the procedure;
• short rehabilitation period;
• preservation of erectile function;
• rapid recovery of all organs, including the prostate;
• the ability to perform the operation on an outpatient basis;
• the need to install a catheter for just a day.

Indications

Laser vaporization surgery is performed for the development of prostate adenoma measuring 30-80 cm3. Also, additional indications for intervention include conditions that indicate decompensation of the pathology. The following symptoms fall into this category:

1. lack of results from conservative therapy;
2. stones in the bladder;
3. permanent infectious lesions of the organ;
4. residual urine in the bladder;
5. hematuria.

Since laser treatment of adenoma is much less likely to provoke bleeding, this technique is needed for people who have been taking anticoagulants for a long time , have lung pathologies, as well as damage to the heart and blood vessels.

If the prostate enlarges to 30 cm3, contact vaporization is performed. In more complex cases of hyperplasia, contact resection using a laser is used. Interstitial laser coagulation can also be performed.

Preparation

Before performing laser vaporization, a conversation with the surgeon must be held. It is important that the patient receives the necessary information about the specifics of the procedure. At the stage of preparation for the operation, the following studies must be performed:

• Analysis of urine;
• biochemistry;
• Ultrasound of the prostate;
• general blood analysis;
• Ultrasound of the heart;
• electrocardiogram;
• coagulogram;
• chest x-ray;
• consultation with a therapist.

8-10 hours before the procedure, the patient must completely refuse food . 2 hours before the procedure, a cleansing enema . After this, it is forbidden to even drink water.

It is necessary to check the condition of the heart 5 days before laser vaporization. If the need arises, you should consult a cardiologist. If bleeding disorders are detected, special therapy is needed. 2 days before vaporization, medications containing aspirin are discontinued.

Before choosing anesthesia, you should also consult with a doctor who can help diagnose possible abnormalities. Depending on the physical condition of the patient, the doctor selects anesthesia. Anesthesia can be local or general. The second type of anesthesia is used in exceptional situations.

Features of the event

Laser vaporization of the prostate is carried out for 40-60 minutes - it all depends on the severity of the pathology. The manipulation can be carried out on an outpatient or inpatient basis.

After removing the formation and normalizing the structure of the lumen of the urethra, the patient must stay in the hospital for several hours. Doctors must monitor the man's condition.

The basis of the method is the influence of light flux on prostate tissue hyperplasia. The procedure is performed using endoscopic instruments. Laser vaporization of the prostate gland involves the following stages:

1. The patient is given anesthesia;
2. A special light guide is placed in the urethra, which provides access to damaged fragments of the prostate;
3. Since the laser is small, the doctor focuses the beam to a point. This is done in the areas where the adenoma is located;
4. Under the influence of thermal waves of the laser, gradual detachment of the affected tissue occurs. The vessels are quickly sealed and treated with antiseptics;
5. After completion of the procedure, a special catheter equipped with a urine collector is placed into the urethra. This device helps to avoid contraction of the canal. If bladder function returns immediately, catheterization may not be necessary.

Rehabilitation

Rehabilitation after vaporization of the prostate gland takes only 1 day. However, a more precise period depends on the development of complications. After the manipulation, men’s urination is restored and pain is reduced.

 During the rehabilitation period, a man can be under outpatient supervision. On the first day, the patient should completely refuse food and increase the amount of fluid consumed to 3 liters.

This helps to quickly restore the diameter of the urethra.

After laser vaporization, doctors often prescribe anti-inflammatory drugs to patients. Antibiotics may also be prescribed. This helps speed up the process of tissue repair.

 In the first 3 days, a man should rinse his bladder with antiseptic solutions. This will help clear it of bloody clots and other impurities. If you have a urethral catheter, this manipulation is much faster and easier.

If the device is not used, a special attachment should be used.

During the rehabilitation period after laser vaporization, you need to follow a diet. It involves avoiding fatty and fried foods. Sexual contacts and sports activities are also prohibited. This restriction is valid for 3 days.

Complications

After performing laser vaporization, there is a risk of unpleasant health consequences. Despite the fact that the procedure is a gentle treatment method, it can lead to the following complications:

1. Recurrence of adenoma and the need for re-therapy using vaporization after 5-10 years;
2. Erectile dysfunction . It is worth considering that this risk is minimal in comparison with other methods of adenoma removal;
3. Development of retrograde ejaculation . This complication is accompanied by a violation of the outflow of sperm during sexual intercourse. In this case, the fluid enters the structure of the bladder;
4. Scar narrowing of the urethra . This is due to the appearance of scar changes in the intervention area.

To prevent the listed complications and relapses of the disease, you must strictly follow all the recommendations of your doctor.

Contraindications

Laser surgery for prostate adenoma has a small number of contraindications. These include the following diseases and conditions:

• kidney pathologies;
• lesions of the upper respiratory tract;
• liver dysfunction;
• pathologies of the heart and blood vessels;
• history of heart attack or stroke;
• malignant tumors.

Laser vaporization is an effective procedure that helps to cope with prostate adenoma and avoid dangerous health consequences. To achieve good results, you need to properly prepare for the intervention and strictly follow the doctor’s recommendations after it.

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Source: https://MedProstatit.ru/lazernaya-vaporizatsiya-adenomy-prostaty.html

Vaporization of prostate adenoma

Benign prostatic hyperplasia (BPH). More than half of males over 55 years of age have heard this diagnosis. The risk of the disease increases in direct proportion to increasing age, and over time, more than 80% of men become victims of the disease.

Among the currently widely used methods of treating prostate adenoma, endoscopic operations should be highlighted, which are not inferior in effectiveness to open surgery and are superior to any medications. Transurethral vaporization of prostate adenoma is currently one of the leading advances in the treatment of BPH.

Anatomical features and causes of development

The prostate gland is one of the parts of the male reproductive apparatus, adjacent directly to the bladder.

Due to the fact that the enlarging prostate forms a rather elastic capsule from healthy tissue, its enlargement occurs mainly towards the bladder, which causes compression of the urethra and subsequent problems with urination.

The growth of prostate adenoma is characterized by the formation of one or more nodules and occurs in 3 stages:

1. Microscopic. It is characterized by the absence of pronounced symptoms with obvious enlargement of the gland.
2. Macroscopic. There is pain, difficulty urinating, and the appearance of residual urine.
3. Clinical. At the third stage, atony of the muscular layer of the bladder occurs, complications develop (urolithiasis, pyelonephoitis, renal failure).

To this day, the reasons that provoke increased division of glandular cells of the prostate have not been fully studied, but presumably the following factors play a certain role in the growth of adenoma:

• imbalance in the ratio of male and female sex hormones (androgens and estrogens) in the male body;
• an increase in the concentration of dihydrotestosterone, which activates the synthesis of substances that stimulate cell growth (adenoma formation);
• smoking;
• overweight;
• low sexual activity.

Important! Despite the lack of reliable information about the influence of all of the above factors on the formation of prostate adenoma, it has been proven that an increase in its volume occurs only in men with normal levels of male sex hormones.

The formation of adenoma is characterized by the formation of nodules consisting of glandular tissue

Transurethral vaporization of prostate adenoma is a bloodless surgical intervention performed, like all minimally invasive methods, through the urethra. Today, this method rightfully occupies a competing position relative to such widely used methods as:

• transurethral resection (TUR);
• holmium laser enucleation of adenoma;
• open adenomectomy.

This type of surgical intervention can be considered the safest, since it allows the procedure to be performed even in the presence of severe concomitant pathologies:

• acute renal failure;
• cardiac ischemia;
• heart failure;
• diabetes.

The essence of the vaporization method is the so-called “evaporation” of tissue using electricity or a laser. Depending on the technology used for vaporization, the following types are distinguished:

• electrovaporization;
• laser vaporization with coagulation (photoselective);
• laser vaporization using EVOLVE180 technology.

Transurethral electrovaporization (TUV)

This surgical method is based on the technology used in transurethral resection (TUR), but unlike the latter, it does not use a steel loop to which high-frequency current is applied, but a miniature roller electrode called a vapotrode.

Vapotrod is a unique design equipped with grooves that promote expansion of the urethra.

When the vapotrode comes into contact with prostate tissue, an instant increase in the temperature of the intracellular fluid occurs, leading to the formation of steam.

The TUV method, along with TUR, provides complete and immediate elimination of all symptoms when removing prostate adenoma. The positive side of the electrovaporization method is:

• relative affordability;
• the ability to fully preserve sexual function;
• minimal number of side effects;
• fast recovery.

A significant difference between electrovaporization and electroresection is the creation of a larger coagulation zone, which reduces the risk of bleeding several times.

Photoselective laser vaporization

Treatment of prostate adenoma using the high-tech Green Light system is the least traumatic method of all used today.

The Green Light system consists of fiber optic equipment that delivers high-power radiation in the form of an 80 W laser beam through a cystoscope into the prostate gland.

The direction of the beam ensures vaporization of the prostate in three directions at once, affecting the middle and lateral lobes of the gland.

The wavelength of 532 nm and the beam absorption depth of 800 µm provides high power inside the tissues, which contributes to high intensity “evaporation”. An extremely effective addition to the laser is the thin sutures formed in the tissues, which, in combination with hemostasis, create the possibility of a virtually bloodless procedure.

Surgery is performed when the size of the prostate gland does not exceed 60 ml, on an outpatient basis. After completing the procedure, patients feel significant relief and positive dynamics in assessing their existing symptoms. All negative sensations after surgery are assessed as minimal and short-lived.

Important! The catheter is installed for 24 hours after surgery, after which the patient is sent home.

Possible complications include:

• diuretic phenomena;
• retrograde ejaculation (throwing sperm into the bladder cavity);
• recurrent growth of adenomatous tissue.

The negative side of removing an adenoma using photoselective laser vaporization is the limited size of the prostate, this is due to the small depth of penetration of the laser beam.

Fiber optic laser cystoscope used in the Green Light system

Laser vaporization using EVOLVE180 technology

The technique for performing endoscopic intervention is almost identical to similar operations. However, the use of the latest laser technologies with a power of 180 W and a wavelength of 980 nm can significantly increase the effectiveness of the procedure.

Surgical treatment of prostate adenoma

The laser unit has a curved tip located on a flexible light guide, with the help of which evaporation is carried out under the control of the surgeon’s eye. The doctor sees the entire process on a video monitor. Due to the high power of the laser used, tissue is evaporated at a rate of about 4 g per minute, with the simultaneous formation of a coagulation zone.

The increased wavelength, in comparison with the Green Light system, allows not only to increase the evaporation rate, but also to minimize the risk of damage to nearby tissues. This effect is due to the high absorption of radiation by water and hemoglobin.

Evaporation of adenomatous tissue is carried out layer by layer. Tissues that have undergone destruction are washed out of the bladder cavity with washing liquid. Due to the fact that the laser absorption depth is constant and is 1 mm or more, there is no risk of excessive tissue cutting, which often occurs when working with a hot loop during TUR.

Laser vaporization of enlarged lobes of the prostate is performed simultaneously (using Green Light technology) or alternately (using EVOLVE180 technology). In the latter case, they start with the most pronounced lobe, deep into the bladder (usually the middle lobe). After removing the middle lobe, proceed to evaporation of the side lobes.

The curved light guide allows you to avoid damage to the seminal tubercle and sphincter apparatus during the procedure. As a result of the work done, the urethra acquires a normal width of about 3 mm and the absence of side effects such as erectile dysfunction, urinary incontinence and retrograde ejaculation.

The result of the operation depends entirely on the professionalism of the surgeon, since the entire procedure is performed under his control

Recovery period

The recovery period after endoscopic surgery can take the same amount of time as after open surgery to remove the prostate, that is, about 2 months. However, due to the absence of incisions, minimal blood loss, and spinal anesthesia, the recovery period is much easier for the patient.

During the rehabilitation period, the following rules should be observed:

• completely eliminate heavy lifting and sudden body movements;
• drink plenty of fluids;
• adhere to a diet that excludes salty, fried and smoked foods;
• conduct a course of antibiotic therapy;
• abstain from sexual activity for 1 month;
• completely give up alcohol and cigarettes;
• include mandatory walks in the fresh air or exercise in your daily routine.

Regular visits to the doctor are also a mandatory part of the recovery period, even if negative sensations are minimal or completely absent

Despite such great advances in medicine, in rare cases surgery does not achieve the desired results. This usually occurs in the case of rapid recurrent growth of adenomatous tissue. When the patient returns repeatedly, a prostatic stent is used to dilate the urethra, which does not allow blocking the lumen of the urethra.

Reviews

Tatyana:
I began to notice that my husband had become irritable, silent and was constantly in the toilet for a long time. It was with difficulty that I dragged him to the hospital. At the hospital, immediately after the ultrasound, they said that he had a prostate adenoma measuring 40 ml.

The doctor said that it was impossible to do without surgical intervention, since the husband did not take any medications, and suggested TUR or electrovaporization. We agreed to vaporization. Thank God, everything turned out well.

Six months have passed and my husband has not complained about anything.

Andrey:
I had a prostate adenoma removed using laser vaporization - “green laser” technology. While I was in the clinic, I saw a lot of different things... Those who had a TOUR, sometimes walked around with a stent for a long time, but after 20 hours they removed it for me. There was pain and burning, of course, but it was tolerable. The main thing that especially worried me was that the erection was normal, even better. Perhaps this is due to improved well-being.

Yuri:
I’m 68 years old and had a hard time deciding to have surgery. While I was stalling for time, I can say that I did not live a normal life. And after vaporization, the pressure of the stream was restored almost immediately, I don’t get up to go to the toilet at night, I feel like I was in my youth. If I had known that medicine could create such miracles, I would not have suffered for so long.

Source: https://sochi-mebel.ru/lechenie/vaporizaciya-adenomy-predstatelnoy-zhelezy

Laser vaporization of prostate adenoma: procedure progress and rehabilitation

Laser vaporization is a highly effective method for treating prostate adenoma.

Laser vaporization is one of the most highly effective and safe methods of treating prostate adenoma

This procedure is based on the use of an endoscope with a laser at the end. The waves emitted by the laser penetrate tissue to a depth of 2 mm. Thus, the damaged tissue is “evaporated.”

When performing this procedure, the likelihood of bleeding is significantly reduced due to the fact that the edges of the damaged tissue, blood vessels and capillaries are soldered together.

The vaporization process is absolutely safe and does not injure nearby organs.

Surgery usually requires an external incision, but laser vaporization does not require this. The endoscope is inserted into the patient's urethra, where a heat wave penetrates the prostate. This technique allows you to reduce the duration of the rehabilitation period.

Advantages and disadvantages of the operation

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Compared to other methods of treating adenoma, laser vaporization has quite a lot of positive aspects . Among them:

• fast rehabilitation;
• minimum relapse rate;
• a small number of contraindications;
• minimally invasive procedure;
• no problems in the sexual sphere.

The most important distinguishing feature of the operation is the short recovery period. The patient returns to his home lifestyle the very next day.

Minimally invasive procedure with minimal interference in the functioning of tissues and organs. The process of “evaporation” of the adenoma takes place without bleeding. The likelihood of internal blood loss is also significantly reduced.

The prostate gland heals quickly after laser vaporization.

Carrying out a conventional operation does not guarantee the absence of future recurrences of the disease. Vaporization is much more effective in this regard. Prostate adenoma reappears only in 3% of cases. For the most part, the cause of relapses may be non-compliance with the surgeon’s recommendations for restoring the body after surgery.

With laser vaporization, tumor tissue is “evaporated,” as well as blood vessels and damaged tissue are cauterized.

Very often, after surgery, the patient complains of emerging problems in the intimate area - erectile dysfunction. It appears due to disturbances in the blood supply to the genital organ.

With laser vaporization, such problems are diagnosed much less frequently - in 5% of patients. Dysfunction in most cases develops if the patient wears a urinary catheter for a long time after surgery.

It is worth noting that after 2-3 months, the sexual function of men is completely restored.

Laser vaporization, in addition to its advantages, also has contraindications, but there are very few of them. This procedure is performed even in men with diseases of the cardiovascular system. Problems arise only in cases of an oncological form of adenoma or low blood clotting. In all other cases, the need for surgical intervention can be determined by the attending physician.

Indications for surgery

The main indications for laser vaporization include:

• problems with urination;
• tumor volume is 30-80 ml;
• pain and discomfort during urination and during sexual intercourse;
• lack of results after medication treatment.

Preparatory stage

Preparation for the operation involves a number of manipulations, namely:

Vaporization technique

The surgical procedure is non-contact and involves the use of local anesthesia. The tumor is partially “evaporated”, the lumen of the urethra is restored. The entire process takes no more than an hour. After the operation is completed, doctors monitor the patient's condition for several hours.

The laser vaporization method is based on the use of a laser system. This technology allows you to release a beam of the desired length through the tip of the light guide. This laser beam “evaporates” the tumor tissue, and also cauterizes blood vessels and damaged tissue. The beam penetrates 1-2 mm into the tissue depth, so the procedure for removing adenoma is carried out layer by layer.

Laser vaporization provides highly precise elimination of the damaged area. As a result, the adenoma is partially excised, and the lumen of the urethra is restored. Bloodless surgery to remove an adenoma reduces the likelihood of complications developing after surgery.

Contraindications to laser vaporization

The operation of laser removal of pathology is contraindicated for men with certain health problems. Among them:

• acute inflammatory processes;
• kidney disease (renal failure);
• diseases of the respiratory system (acute bronchitis, asthma);
• liver pathologies;
• strokes and heart attacks.

Complications after laser vaporization of prostate adenoma

Any surgical process involves the possibility of complications. The only difference is how strongly they are expressed. It is important for the patient to choose the treatment method that has fewer disadvantages. Almost all men choose laser vaporization for the treatment of adenoma, having previously studied its negative aspects and positive characteristics.

Possible complications after tumor removal surgery may include:

• Urinary incontinence. This phenomenon occurs as a sign of post-traumatic syndrome. This symptom is temporary and goes away after a few days.
• A burning sensation in the urethra during urination and in the rectum during defecation. Pain may last up to 4 weeks.
• Blood in the urine is common. However, if bloody discharge appears after a week, you should be wary.
• Erectile dysfunction is also temporary. Normal intimate life is restored in about 1-1.5 months.
• Damage to the prostate and bladder. There is always a risk of such damage occurring. However, in most cases, these problems are caused by surgeon error.

As for spotting, its duration over 2 days is an incentive to undergo additional examination. The incidence of internal bleeding after surgery for laser removal of adenoma is up to 8%.

Most complications after laser vaporization are temporary. To reduce the risk of their development, it is important to follow all the surgeon’s instructions. Laser treatment is a minimally invasive therapy that greatly shortens the rehabilitation period. The probability of re-operation is very small and is only 10%.

Rehabilitation stage

Postoperative rehabilitation is a set of procedures to restore normal functioning of the body. The patient can independently speed it up if he strictly follows medical recommendations.

During the first day after the operation, you cannot eat anything, you are only allowed to drink water in an amount of at least 2.5 liters. This is necessary to remove dead tissue from the body.

There may be a temporary deterioration in the patient's well-being within 48 hours. Intoxication of the body may occur due to the entry of tissue debris into the patient’s blood.

In this case, rinsing with furatsilin or chlorhexidine is prescribed.

When the doctor allows you to eat food, you will need to follow a special diet that excludes everything fatty, salty, peppered and fried. On the recommendation of the surgeon, it is worth reviewing your diet and lifestyle in general.

If the patient had bad habits, then to achieve a positive effect of treatment it is worth giving up them and starting to exercise.

Judging by the reviews of patients who have undergone vaporization of an adenoma, this technique is one of the safest and most effective. The disadvantage is its high price, which is why it is not widely used.

The qualifications of the attending physician is one of the indicators of the success of the operation. That is why, before making a choice in favor of a particular clinic, it is advisable for a patient to read the reviews of other patients about it.

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Source: http://MenQuestions.ru/urologiya/lazernaya-vaporizatsiya-adenomy-prostaty.html

Laser vaporization of prostate adenoma

BPH is a benign tumor of the prostate gland. Another disease is called prostatic hyperplasia. As the tumor grows, it compresses the urethra, which makes urination difficult. A urologist treats this disease.

The center of the Central Clinical Hospital of the Russian Academy of Sciences employs urologists, among whom there are doctors of medical sciences and specialists of the highest qualification category. 

When is it necessary to carry out diagnostics and tests?

 A man should think about visiting a urologist if he observes symptoms of prostate adenoma. These include:

• Frequent urination at night
• Painful difficulty urinating
• Burning sensation after urination
• Feeling of incompleteness of the act of urination
• Increased urination time
• Painful ejaculation
• Weak urine pressure
• Presence of impurities in urine
• Dry mouth
• Lack of appetite
• Constipation
• Fatigue and irritability.

The sooner a person sees a doctor, the better. This way you can avoid the unwanted consequences that this disease leads to. For example, acute urinary retention, requiring the installation of a urethral catheter, cystitis, pyelonephritis, urethritis and other inflammatory processes of the urinary system, urolithiasis, renal failure, and so on.

Laser removal of prostate adenoma

Laser vaporization of prostate adenoma at the Central Clinical Hospital of the Russian Academy of Sciences is the removal of overgrown tissue by evaporation. Performed endoscopically. This is an endourological operation that involves passing an instrument through the urethra, i.e. no cuts. The operation is carried out under eye control. This means that the surgeon sees the evaporation zone on the monitor screen.

For this operation we use the latest laser system . The use of a flexible light guide with a curved tip for more advanced and efficient contact evaporation.

This method has a rate of removal of prostate adenoma tissue of 3-4 g/minute, while maintaining the most effective coagulation zone to minimize the risk of side effects. The wavelength of the diode laser is 980 nm.

It is well absorbed both in water and in hemoglobin, which allows it to quickly evaporate and simultaneously coagulate the underlying deep layers, avoiding bleeding.

Due to the high water absorption, the use of such a unique system eliminates accidental damage to the bladder and other non-target areas. In contrast to the green laser with a wavelength of 532 nm, which is well absorbed only in hemoglobin and poorly in water. This means poor evaporation and good coagulation, which is no longer enough these days.

However, the evaporation efficiency of the green laser is lower, since the 532 nm wavelength penetrates tissue only superficially.

Layer-by-layer and non-contact evaporation using this method is effective for prostate adenoma with a volume of up to 60-80 cm3. For large volumes 100-120 cm3.

, in clinics they use a combination of green laser and transurethral resection (TUR) of prostate adenoma, and this is a different operation with other complications.

How is evaporation treatment performed?:

This procedure is carried out by contact, layer by layer. The evaporated fabric is washed out along with the washing liquid. The penetration depth of the beam is constant, more than 1 mm, in contrast to TUR, when the surgeon can cut off 1.5 - 2 mm with a hot loop, or can “cut” 3 -4 cm, depending on experience.

Deep resection can lead to perforation of the capsule of the prostate gland, bladder, abdominal cavity and rectum and subsequently to pertonitis in combination with water intoxication of the body, i.e. TUR syndrome, which already poses a threat to the patient’s life.

Typically, such complications require open surgical revision and correction.

Evaporation of all three lobes of prostate adenoma is carried out one by one. Usually they start with the middle lobe, which can be quite pronounced and extend deep into the bladder. Here one should be wary of the proximity of the ureteric orifices. After evaporating the middle lobe, you can proceed to removing the side lobes.

Thanks to the high power of the device and the curved light guide, evaporation of even large adenomatous nodes and their hard-to-reach areas is not difficult. Highly efficient vaporization combined with deep coagulation allows you to quickly remove large volumes of tissue almost bloodlessly.

Which in turn allows the surgeon to control every movement of the light guide in order to avoid damage to the sphincter apparatus and seminal tubercle.

Who is at risk

The disease mostly affects men over 45 years of age.

Although scientists cannot be 100% sure what causes the development of adenoma, many of them agree that the disease appears mainly due to hormonal imbalance. Those. The amount of male hormones decreases and the proportion of female hormones increases.

Other causes of prostate adenoma include:

• Inflammation of the urethra
• Kidney inflammation
• Physical inactivity or decreased body activity
• Atherosclerosis
• Alcohol abuse, smoking, unhealthy diet
• Excess weight 

 Advantages of vaporization of prostate adenoma at the Central Clinical Hospital of the Russian Academy of Sciences

As a result, after laser evaporation of all adenomatous nodes, we obtain a channel in the prostatic part with a diameter of about 3 -3.5 cm. This will allow the patient to urinate efficiently for the next 15-20 years. At the same time, without experiencing problems such as urinary incontinence, retrograde ejaculation and erectile dysfunction.

According to our observations, the quality of erection is not only maintained, but also enhanced. 

Photos of the department

• The urology department of the Central Clinical Hospital of the Russian Academy of Sciences treats patients:
• The main areas of work of the urology department:

• restoration of patency of the urinary tract of all parts of the urinary system, installation of a stent catheter, surgery to eliminate urinary incontinence;
• percutaneous minimally invasive nephrostomy, partial nephrostomy, nephrectomy for renal masses, puncture, laparoscopic and traditional surgery for renal cysts;
• endourological surgery for urolithiasis;
• cystectomy, transurethral resection (TUR) of the bladder;
• plastic surgery for strictures of various localizations;
• plastic surgery on the penis and scrotum;
• transurethral resection (TUR);
• laser vaporization of the prostate gland;
• prostatectomy;
• external shock wave lithotripsy (ESWL);
• contact (endoscopic) laser lithotripsy;
• Microwave therapy of the prostate gland;
• laparoscopic surgery (nephrectomy, adrenalectomy, prostatectomy, resection of kidney cyst and bladder diverticulum, reconstructive plastic surgery on the organs of the urinary system);
• contact lithotripsy.

Source: https://www.ckbran.ru/cure/urologicheskoe-otdelenie-2/lazernaya-vaporizaciya-adenomy-prostaty

Laser vaporization of prostate adenoma: advantages and disadvantages

To treat prostate hyperplasia in the early stages of the disease, a man may be recommended laser vaporization of the prostate adenoma (another name for this method is enucleation of the adenoma). The laser evaporation method is considered one of the least traumatic for the patient, and it can be used as an independent therapy or combined with other treatment methods.

Glad to see you again on the blog, dear readers. Alexander Burusov is in touch and today we continue to talk about prostate adenoma. In this article, I suggest you consider the features of vaporization, as well as familiarize yourself with additional treatment methods.

How is the treatment carried out?

The technique of laser enucleation of prostate adenoma can be briefly described as follows:

• a flexible endoscope with an LED is inserted through the urinary canal to the location of the prostate gland (data on the progress of the LED is displayed on the screen and the urologist can visually monitor the progress of the operation);
• layer-by-layer evaporation of hyperplastic tissue is carried out (the laser acts precisely and does not injure healthy gland cells);
• evaporated tissues are removed from the urethra using a sterile washing liquid and sent for analysis (to determine the cellular structure of the removed tissues);
• After completion of the medical procedure, the probe is removed from the urethra.

The mini-operation is performed under local anesthesia, but if desired, the patient can be given general anesthesia.

Removal of overgrown structures begins with the middle, larger lobe of the prostate, then the lateral lobes are treated. The targeted laser action ensures the destruction of the cytoplasm of adenoma cells, treatment of inflamed areas of the gland and sealing of vessels damaged during the intervention.

After removal of hyperplasia, the prostate quickly returns to normal size, but some patients may experience spasm of the urinary canal, which impedes the outflow of urine. The readiness for spasm is noticeable even during the operation, and such patients are advised to install a urinary catheter for several hours after removing the endoscope.

Advantages and disadvantages of the method

Laser vaporization of prostate adenoma is considered a low-traumatic and easily tolerated method of surgical intervention. The advantages include:

• Constant control . The urologist sees on the monitor screen where it is necessary to direct the intervention and, if there is a risk of complications, can always stop the intervention without causing injury to the patient.
• Low injury rate . Non-contact destruction of pathological cells and the absence of the need to make incisions does not injure healthy gland tissue.
• There are no restrictions on the size of pathological growth . This method can be used to remove even large adenomas (to reduce the risk of complications, enucleation of large hyperplasias requires 2-3 sessions).
• Preventing blood loss . Under the influence of a laser beam, damaged vessels are sealed and do not bleed. This feature of the intervention makes it possible to eliminate adenoma in men suffering from bleeding disorders. Laser therapy is considered to be a bloodless surgical technique.
• TUR syndrome does not occur . This complication accompanies most interventions on the prostate gland and is associated with the entry of a small amount of rinsing water or cooling hardware fluid into the bloodstream through open injured vessels.
• Short postoperative period . Depending on the speed of prostate contraction, the patient’s hospital stay after laser surgery ranges from 24 to 72 hours.
• Sustained therapeutic effect . After laser exposure, re-pathological tissue growth rarely occurs. Remission after enucleation is observed in patients no earlier than 20 years later.
• Minimum complications . A burning sensation in the urethra, a small amount of blood in the urine and erectile dysfunction disappear a few days after laser exposure. If blood appears or erectile dysfunction occurs, patients are advised to abstain from sexual activity for a while.

Conditional disadvantages

• Technical complexity . It is necessary to influence tissue with a laser with extreme precision, and not all clinics have specialists of this level.
• Duration of the procedure . The elimination of pathological hyperplasia occurs on average 1 g per minute, and the elimination of large formations takes a lot of time.
• Great cost . Expensive equipment and highly qualified specialists are not available in all public medical institutions, and in private clinics the cost of the procedure will be about 50 thousand rubles.

But the disadvantages of the technique are not related to the effect of laser removal on the male body, but to the problems of organizing the treatment process. The only minor drawback of the treatment method is the inability to perform tissue cytology . Wash waters contain laser-deformed cells, and it is not always possible to perform a cytological analysis to exclude the possibility of a malignant neoplasm.

Laser enucleation of prostate adenoma is well tolerated, minimizes the risk of side effects and has a short recovery period.

Need for further therapy

Successful surgery does not guarantee a complete cure. To prevent possible complications, the following is carried out:

• Anti-inflammatory treatment . The use of anti-inflammatory drugs will reduce the risk of postoperative infection and improve the condition of the prostate.
• Massage . Massaging the prostate in the early recovery period is not recommended, but vacuum cups can be used. Cupping is prescribed for adenoma to improve blood circulation in the pelvis, but they can also be placed 2-3 days after vaporization to prevent blood stagnation, which can occur due to vascular damage. Indirect vacuum massage will help prevent the development of congestion in the pelvis.

It is immediately worth noting that only benign tumors can be eliminated using a laser. If a man has prostatitis (adenoma is almost always a complication of this disease), then it is necessary to continue to take medications, as well as follow medical recommendations regarding diet and lifestyle.

Laser vaporization will help eliminate benign neoplasms with minimal risk of injury to the male reproductive system. If there is no suspicion of a malignant neoplasm, I can perform this procedure not only for medical reasons, but also at the request of the patient.

By undergoing the necessary examinations and paying for the operation, a man can get rid of problems of the genitourinary system that have arisen due to the development of an adenoma.

Source: http://viva-man.ru/adenoma-prostaty/lazernaya-vaporizatsiya-adenomyi-prostatyi/