Laser Enucleation Treatment Option for BPH

Laser enucleation can be performed on men of any age with urinary outflow obstruction caused by an enlarged prostate. It is particularly indicated in men with large prostates and men on medications to thin the blood such as warfarin, aspirin or clopidogrel (to name a few). Laser Enucleation of the prostate is a modern alternative to the standard Transurethral Resection of the Prostate (TURP) procedure for bladder outflow obstruction due to BPH. It requires a short period of hospitalization and a catheter is needed for 1-2 days until the urine clears.

What are the advantages of Laser Enucleation?

  • There is no upper size limit of prostate that can be treated - traditionally men with prostates over 100 grams in size needed major open surgery
  • There is often less bleeding than after a traditional TURP
  • The chance of recurrence requiring further surgery is very low
  • The PSA generally drops to very low levels after the procedure
  • Prostate tissue is able to be sent to pathology for review - as is not the case with standard laser prostate surgery

How Does Laser Enucleation Work?

This is done under a general anesthetic with the help of a telescopic camera instrument inserted through the penis. The lobes of the prostate are cored out intact and pushed back into the bladder. This allows for a larger resection of prostate tissue and is particularly useful for men with extremely large prostates. The bulky excised tissue is then removed from the bladder by being morcellated (broken up into smaller pieces) by a special instrument inserted through the instrument. The pieces are then sent to pathology for review. A catheter is placed into the bladder to drain the urine while the raw surfaces heal (for around 24 hours) before being removed on the day of discharge from hospital.

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