LASER TREATMENT FOR ENLARGED PROSTATE - Quanta System

UROLOGIE
LASER TREATMENT FOR
ENLARGED PROSTATE
Introduction
Research has shown that your enlarged prostate and causes urinary symptoms.
You and your doctor discussed that your prostate will be treated with a laser.
The laser will again create space in your prostate. This will better support you urinate.
the prostate
The word "prostate" comes from the Greek 'prostateis', or' he who comes first. Only
men have this gland. The prostate is located below the bladder and above the sphincter
of the bladder. The urethra runs through the prostate. Urine runs through the urethra
and is removed from the bladder .
The prostate gland develops in the male during puberty under the influence of
hormones. The male prostate produces fluid that - along with moisture from the
seminal vesicles – forms the sperm. The size of a normal prostate is about 10
to 15 cc.
Benign prostate enlargement
With increasing age, the prostate enlarges. The opening of the urethra
near the prostate becomes smaller. This may urinary symptoms
occur. For most men, the prostate grows, but not all men have
symptoms.
Benign prostatic hyperplasia is also known as
BPH (Benign Prostate Hyperplasia).
For aging men, it is often less easy to relax the sphincter between the
bladder and prostate (bladder neck). This also can cause urinary symptoms.
This information is written for patients with the utmost care.
It concerns general information. This information is not legally
binding.© 2005 Jeroen Bosch hospital www.jeroenboschziekenhuis.nl
(URO-093,uitgave juni 2011)

Symptoms of enlarged prostate
The symptoms may include:
• a less powerful stream of urine and / or an interrupted flow;
• difficulty with the beginning of urination;
• more urgency and frequent urination;
• dripping;
• unwanted loss of urine (incontinence);
• at night, increased urination;
• a feeling that the bladder is not empty.
The combination of these symptoms is also called LUTS (Lower Urinary Tract
Symtoms).
Benefits of the treatment
Together with your doctor, it was decided to treat your enlarged prostate with an
laser. The hospital uses the Cyber TM, one of the newest
and most advanced lasers for prostate surgery.
The advantages of laser treatment of the prostate compared to the standard
treatment, called TURP include:
• less postoperative (after surgery) problems.
• a shorter hospital stay
• less blood loss after surgery
• The bladder catheter stays in for a short time.
The advantage over other lasers is that the the Cyber TM enables the urologist
in precise targeting laser energy to remove prostate tissue.
Higher precision means more safety and fewer complications. In addition,
the urologist is able to remove tissue with the laser Cyber TM in order to have this
tissue investigated by the pathologist for (eg cancer)
The results of tissue examination after your discharge will be discussed with you at
the clinic.
How do you prepare for?
The hospitalization usually begins on the day of the surgery. You must be sober from
24.00 hours at night the day before the surgery. This means that from that time you
are no longer allowed to eat
drink or smoke.
On the ward you will receive a conversation with the nurse and
blood will be taken.
Do you use blood thinning medication? Than it is sometimes necessary to stop the
medication.This is in consultation with your doctor.
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The course of the operation
Laser treatment of the prostate occurs under anesthesia with an spinal
or under general anesthesia.
The urologist brings an instrument through your urethra, a cystoscope. This allows the
prostate examined. Through the cystoscope, a laser fiber is inserted.
Excess tissue from the prostate is excised and evaporated by the laser piece by
piece. This technique is called vapo-resection. The effect is similar to the
hollowing of an apple with an apple drill.
The wall (the capsule) of the prostate remains. The cut pieces are
flushed out with a washing liquid, which runs through the cystoscope into the
bladder.
There is only an internal wound. Any blood vessels can be coagulated with the laser,
to prevent bloodloss.
After surgery, a bladder catheter is inserted.
When using a laser everyone in the operating room must wear protective goggles.
After the operation
The bladder catheter is removed the day after surgery when the urine is clear in color
is. Next, you must be able to urinate spontaneously (pee yourself). The nurse will after
urination with an ultrasound device examine if your bladder is empty. If urinating is no
longer a problem you may go home.
After surgery, you may temporarily experience problems with urination. Sometimes it
may be a difficult to hold your urine. It is also possible that there is some blood in the
urine, this is only temporarily do not be alarmed. Please
adequate rest and drink lots until the blood disappears.
What are the risks?
After surgery, bleeding can occur from the prostate. Usually this bleeding
stops spontaneously . The urine still remain several days in succession bloody or
clots arise and there is a urination problem, please contact us.
There may be a urinary tract infection and / or an action associated with epididymitis
fever. Usually such an infection can properly be treated with antibiotics.
It may take some time before you can hold your urine perfectly again. This
is because the sphincter (the "downstream" where the prostate is located) needs time
to get used to the powerful stream. After a Cyber TM laser treatment of the prostate, it
often happens that after an
orgasm the sperm enters the bladder and not out of the penis.
The semen is as it were in the wrong direction.
The locking mechanism that normally prevents the laser is - together with the excess
prostate tissue - removed. There is called a "dry" ejaculation. This is not dangerous
to your health. Erectile dysfunction does not occurre after surgery.
There is a very small chance that after some time a narrowing of the urethra occurs.
This is due to the formation of scar tissue. Sometimes a new (surgical) treatment is
necessary.
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Precepts and advice
Most patients can pick up their normal activities within a few days. A good recovery is
dependent on that the first four weeks you:
• are moderate with alcohol.
• no heavy physical work.
• Heavy lifting, heavy housework and sports are activities that are best
avoided.
• do not ride.your bicycle.
• No intercourse or masturbating.
• minimize pressur on the bowel. Avoid constipation by drinking lots and eat highfiber
food.
If you have questions about your activities? Talk to the nurse or
urologist.
If you used blood-thinning medicines before the surgery, you may resume using after a
few days as the urine is clear.
We advise you the first week at least to drink two litters of fluid per day. (Unless you are
otherwise not allowed to drink a lot). This fact contributes to a good recovery and
healing of internal wounds. Especially if there is some blood in the urine. It is important
to follow this advice. Thus the bladder is flushed in natural way and the urine will
become lighter of color again.
Questions or problems after discharge?
Please contact the hospital. During office hours please call the clinic
Urology, outside office hours please call the Urology ward, The nurse will attempt to
answer your question whether contact the urologist on duty.
After your first check at the urology outpatient clinic please contact your general
practitioner when problems might occur. (unless your urologist made some other
arrangements) .
Contact the hospital or the doctor if you:
• keep having blood in the urine continuously for several days, it is not geting less, and
your urine keeps (dark) red in color.
• except blood, large blood clots in the urine..
• much straining to urinate, you feel that your bladder does not empty completely.
• fever above 38.5°C
• have pain that does not disappear after taking painkillers.
Control
There is an check-up appointment with your urologist. This appointment is
usually six weeks after surgery. First then the effect of
operation is examined. You will arrive with a full bladder to the clinic, so the strength of
the urine flow (flowmetrie) can be measured. with an ultrasound they examine if there is
still urine in the bladder after urination. You will also be asked questions
about your urinary symptoms.
.
More information
For more information on the Department of Urology, Jeroen Bosch Hospital
for urological examinations and treatments, please visit: www.jeroenboschziekenhuis.nl/urologie
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