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Prostate laser surgery is now commonly used to treat benign prostatic hyperplasia (BPH). BPH is a non-cancerous condition that occurs in most men as they age, but though it is not in any way life-threatening, it can lead to very uncomfortable symptoms. They include not being able to pass urine easily, a constant sense of urinary urgency, and the feeling that your bladder has not been emptied completely following urination. 

During prostate laser surgery, excess prostate tissue is melted away or cut off with the use of a beam that delivers concentrated light to precise locations, a beam that is inserted into your body through the urethra. Various types of prostate laser surgery exist. Photoselective vaporization of the prostate (PVP) and Holmium laser ablation of the prostate (HoLAP) vaporize the excess prostate tissue, while Holmium laser enucleation of the prostate (HoLEP) is used to cut the excess tissue off, then to be removed by another instrument. 

Why Prostate Laser Surgery?

Compared to open prostatectomy and transurethral resection of the prostate, prostate laser surgery offers significant advantages to the patient. They include a general lower risk of post-surgery bleeding, a much shorter hospital stay (the procedure can even be performed on an outpatient basis), and a much quicker recovery. Men who undergo prostate laser surgery for BPH will also, in contrast to other procedures, generally notice an improvement in their urinary output and comfort right away. They are highly unlikely to need a urinary catheter for longer than 24 hours, again unlike with other procedures. 

Long-term complications are also much less likely with prostate laser surgery than with more traditional forms of prostate surgery. Though that is good news, laser prostate surgery still carries both short-term and long-term risks, just like practically any other surgery. What are they?

Risks And Complications Of Prostate Laser Surgery

Post-surgery bleeding through the urethra is normal, and it may last a few days to a few weeks. If your bleeding appears to be increasing rather than decreasing, if you notice that you are passing clots, or if the blood you are passing is very thick, you need to follow up with your surgeon. 

Burning sensations and a need to pass urine frequently are also normal after surgery, however, if it continues and you are worried, please ask your healthcare provider about the possibility that you have a urinary tract infection, which needs to be treated with antibiotics. UTIs become more likely in men who had a catheter in place for longer. As your bladder has become used to a situation in which you have difficulty urinating, you may find, after your surgery, that the opposite becomes true and that you need to pee more often. This resolves with time. 

Some men experience a narrowing of the urethra, causing a difficulty in urinating once again, after their surgery. This is due to scar tissue and will require additional treatment. Likewise, there is the possibility that you will need follow-up surgery because your excess prostate tissue was removed inadequately or because it returned over time. 

Retrograde ejaculation, in which the ejaculate enters the bladder rather than exiting through the penis, is another possible complication of prostate laser surgery. This is not dangerous but can lead to infertility. A very small number of men who underwent prostate laser surgery will also find themselves having difficulty achieving and maintaining erections. Erectile dysfunction is much less likely with laser surgery than traditional prostate surgery, however. 

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