This surgery removes prostate tissue that blocks the area that allows urine to flow to the outside of your body. When your prostate grows larger, it blocks the urethra and the flow of urine is lessened. Once the tissue is removed, it is then looked at under a microscope to see if you have any other medical conditions such as prostate cancer. A thulium fiber laser is used at our site.
The prostate is a sexual organ and it is part of and surrounds the urethra. It has to main functions:
- To supply fluid that mixes with sperm and allows for movement and nutrition of the sperm in order to help with reproduction
- To close off the upper part of the urethra, keeping sperm from entering the bladder when you ejaculate
The prostate can be a different size in each man. Up until around 50 the prostate is usually around 20 g (the size of a walnut). However it may grow larger as men get older. If your prostate is enlarged you may notice that you:
- Need to urinate frequently
- Are not able to completely empty your bladder
- Have trouble starting or continuing your stream
- Have a weak or slow stream
- Develop UTIs or stones in the bladder
- Leak urine or notice small amounts of blood in your urine
- Not be able to urinate at all (retention)
A bladder that does not empty well puts you a greater risk of urinary tract infections and potential bladder and/or kidney damage.
What happens during surgery?
If you are on blood thinners you will most likely be asked to stop these medications before your surgery. You will also be asked to send off a urine culture beforehand to ensure you do not have an infection. You may need to be started on antibiotics beforehand as well.
The surgery involves placement of a thin tube through the urethra. A camera and a laser are then used to core out the inner prostate tissue causing the blockage and affecting the flow of your urine. The prostate tissue is then pushed into the bladder were it is made into smaller pieces and removed.
A catheter typically be left overnight. It can sometimes be removed the following day or it will sometimes need to remain in for a few additional days. This is a decision that will be made at the time of surgery.
Risks and side effects
Risks of thulium fiber laser enucleation include:
- Infection
- Bleeding
- Injury to the bladder or urethra
- Blood clots in the veins of your legs or in your lungs
- There is a small risk of new onset erectile dysfunction
What will happen after surgery?
The healing process can take weeks to months. It is common to see blood in your urine in the weeks following the surgery. This can last up to a month. You may also notice some blood clots in your urine. It is important to keep your fluid intake up after surgery.
You may experience some transient leakage of urine for several weeks to several months. This is normal and will gradually improve over time. Certain exercises can help improve this.
You will have retrograde ejaculation after your surgery. This will cause semen to flow back into the bladder. This is permanent. This should not affect your ability to have an erection or achieve orgasm if you were able to do before the surgery.
Avoid heavy lifting after your procedure. Do not lift more than 15 lbs for one week after the procedure. Try to avoid strenuous exercise for one week. Do not use hot tubs for one week. Avoid swimming in pools, ales or bodies of water for one week after your surgery.
Most patients do not require strong pain medication after this procedure. Tylenol is usually enough. You may experience bladder spasms and your physician will be able to counsel you with regards to this should they occur.
Close follow up will be arranged with your surgeon after your procedure.
Source: Mayo Clinic Barbara Woodward Lips Patient Education Center
North Shore Urology 