The use of lasers in urology is not new, but research suggests lasers will become more routine to treat urological conditions as the year’s progress. Many traditional operations have been phased out in favour of laser methods.
Laser procedures are less invasive than major surgeries. They are considered to be safer, more precise and require less hospitalisation for patients. Due to their efficiency, fewer reoperations occur after laser treatment. Among the most common types of lasers are holmium, diode and thulium lasers. Let’s take a look at some of the ways lasers are being used to treat urological conditions.
Laser surgery of the prostate can effectively treat symptoms of benign prostatic hyperplasia (BPH). This condition causes an enlargement of the prostate gland, resulting in compression of the urethra and the blockage of urine. BPH commonly occurs in older men and leads to pain, discomfort and difficulty urinating.
Holmium Laser Enucleation (HoLEP)
One of the most efficient ways to treat an enlarged prostate is through holmium laser enucleation (HoLEP). This option is minimally invasive, with less risk than the current standard surgery known as transurethral resection of the prostate (TURP). Holmium laser enucleation achieves quick relief from symptoms, fast recovery and fewer postoperative complications. This procedure uses a laser to remove problematic prostate tissue without any incisions. An instrument (resectoscope) is inserted into the eye of the penis and through the urethra to target the prostate tissue, causing urine blockage. A holmium laser then cuts away from this obtrusive tissue.
Bladder stones refer to the hard mass of minerals that can form in the bladder when the bladder can’t completely drain. They can be very painful and often indicate other urological conditions such as BPH, kidney stones, or a damaged urethra. Bladder stones have symptoms such as pain, difficulty urinating or blood in the urine. The most common and least invasive method to remove bladder stones is through a laser-based procedure known as a transurethral cystolitholapaxy.
During a transurethral cystolitholapaxy procedure, a small instrument (cystoscope) is inserted into the urethra to get a visual of the bladder stone. Lasers can then break down the stone into tiny fragments, which are removed from the body. This is conducted under regional or general anaesthetic. It is minimally invasive with a quick recovery time.]
Kidney stones are hard mineral deposits formed in the kidneys. They are formed from the salt of urine and can lead to a urine blockage. Kidney stones also cause pain, fever, infection or more serious complications. While some kidney stones can be passed without medical assistance, larger stones may require surgery for removal. Lasers can be used to remove kidney stones through a procedure known as a ureteroscopy.
A ureteroscopy is most commonly used to treat kidney stones or ureteric stones. It may also be used to inspect and treat cysts, tumours, or abnormal tissues in the urinary system. No incisions are made during this procedure. Instead, an instrument (ureteroscope) is inserted through the urinary passage to get a visual of the stone. A laser fibre then breaks up the stone into small fragments. Some stones are fragmented into dust, and other fragments will be removed using forceps or a basket-shaped instrument. A ureteroscopy is minimally invasive and offers a quick recovery time for patients.
Prostate cancer is the most common cancer found in Australian men. Advancements in the medical realm have made treating different types of cancer with lasers a real-world possibility. In clinical trials, doctors are using lasers to treat prostate cancer, among other illnesses.
Focal Laser Therapy
The use of lasers as the primary treatment for prostate cancer is still a developing area of medicine. One emerging technique is known as focal laser therapy. The theory is that men with prostate cancer confined to a single area will benefit from this laser therapy as it’s less risky than removing the entire prostate gland. It is also said to avoid complications associated with prostatectomy and radiotherapy.
Focal laser therapy works by locating and destroying a small area of cancerous cells with laser-induced interstitial thermotherapy (LITT). As this procedure is still in the early stages of development, many believe it’s too early to recommend routinely. In addition, research is still being conducted into the side effects and safety of focal laser therapy. One key concern is the potential to miss cancerous cells by only targeting a small area.
Dr Arianayagam is an experienced urologist and specialist urological surgeon based in Sydney. He works from his urology clinic in Bella Vista and at public and private hospitals across Sydney and treats all kinds of prostate conditions.
If you have any further questions or would like to book an appointment, please feel free to call.
In the meantime, here are some tips for your urologic health:
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