HF 7521

Photoselective Vaporization of the Prostate

Photo vaporization of the prostate involves using a laser to remove extra prostate tissue called benign prostatic hyperplasia (BPH). This extra tissue may make it harder to urinate. It can cause a slow urine stream and make it harder to empty or retain urine. These problems may cause irritation and make you urinate more often.

Getting Ready for Surgery

Clinic Visit/Tests

Before surgery, most patients have an in-office visit. This visit may include:

  • Cystoscopy

  • Prostate ultrasound

  • Imaging (x-rays)

  • Urine and blood tests

  • Physical exam

  • Electrocardiogram (EKG)

Catheter Change

If you have a foley catheter, you will need to have it changed about 10 days before surgery so we can collect a sterile urine sample. You will start antibiotics 3 days before surgery based on urine test results.

Medicines

Blood thinners: If you can, stop taking blood thinning medicines 7 days before surgery. These include:

  • Aspirin and non-steroidal anti-inflammatory (NSAID) medicines (ibuprofen, naproxen, and prescription NSAIDS).

  • Warfarin and Plavix are prescription blood thinners. Ask your provider if you can safely stop these 5-7 days before surgery. If you can't stop taking your blood thinners, this procedure may still be done.

  • Vitamins and supplements: Stop taking these because they may cause you to bleed longer or may interact with your anesthesia.

Prostate medicines: If you are taking prostate medicines, keep taking them unless you are told to stop by your urologist.

Diet

Stop all food and drink at midnight (12 am) the morning of surgery. Take any required prescription medicines with a sip of water.

Bowel Prep

You do not need to do a bowel prep before this surgery.

Illness

Call us if you become ill, get a fever, chest pain, heart racing, cough, shortness of breath or wheezing before surgery.

Day of Surgery

Anesthesia

You will meet with the anesthesiologist before surgery to talk about your best anesthesia option. You may have spinal or general anesthesia.

The Procedure

The surgeon will insert a cystoscope through the urethra and into the bladder. Then, the surgeon will vaporize the extra prostate tissue with a special tool. There should not have to be any outside cuts. The prostate tissue is destroyed by the laser. It cannot be checked for cancer. The surgery takes about 60 minutes. It depends on the size of your prostate.

After Surgery

Most patients go home the same day. You may need to stay overnight if there are other medical problems, if you live far away, or if the surgery is late in the day. The catheter will be kept in overnight and taken out the next day. If you can’t urinate after surgery, you may need a catheter for a longer time.

Activity

You should plan on resting for 2-3 days after surgery. You may slowly increase activities as you feel better. It is common to have some burning and urgency when you urinate for up to 3 weeks after surgery. You may need to take a short course of overactive bladder medicine.

Bleeding

Sometimes, you may notice bright red blood in your urine. If this happens, drink 8 oz of water each hour and rest until it clears up. Pink or light red urine is common for up to 3 weeks after surgery.

To reduce bleeding:

  1. Drink when thirsty.

  2. Avoid letting your bladder get too full as this can press on your prostate. Urinate at least every 4 to 5 hours or sooner if you feel the need. You can expect to pass ½ cup to 2 cups (150-450 ml.) of urine at one time.

  3. Avoid constipation. Straining can cause extra bleeding. Do not strain with bowel movements. Adding fruits and vegetables and fiber to your diet will help prevent constipation. Your provider may order a stool softener or a mild laxative.

Restrictions

  • Do not have sex or ejaculate for 2 weeks after surgery.

  • Do not lift over 10 pounds.

  • Do not do tiring exercise.

  • No sitting for long periods of time for 2 weeks after surgery.

  • No driving until approved by your urologist.

Bathing

You may shower, but no tub baths if you go home with a catheter in place.

Work

Your urologist will let you know when you can return to work (around 2 weeks).

Follow-Up Care

Your first follow-up visit will be made for you before you leave the hospital. This will be in about 2-3 weeks to check your urine flow and bladder emptying.

When to Call

  • You cannot pass urine

  • Your urine remains bloody and you cannot see through it (it is OK if urine is clear like cranberry juice)

  • You pass large blood clots

  • You have a fever over 100.5°F by mouth for 2 readings taken 4 hours apart

Who to Call

UW Health Urology

608-263-4757

UW Health East Madison Hospital Urology

608-440-6464

UW Health One South Park Medical Center Urology

608-287-2900

After hours, nights, weekends, and holidays, the clinic number is answered by the paging operator. Ask for the Urology doctor on call. Leave your name and phone number with the area code. The doctor will call you back.

The toll-free number is: 1-844-607-4800.