Photoselective Vaporization of the Prostate
Photovaporization of the prostate is laser removal of extra prostate (benign prostatic hyperplasia or BPH) tissue that may cause obstructive urinary symptoms (slow stream and difficulty emptying or retention of urine) and irritative symptoms (urinary frequency and urgency).
Before surgery, most patients have in-office cystoscopy and prostate ultrasound, medical imaging (x-rays), urine and blood tests, a physical exam and an electrocardiogram (EKG) if needed.
If you have a foley catheter, you will be asked to have a catheter change about 10 days before surgery for a sterile urine collection. Antibiotics will be started 3 days before surgery based on urine culture results.
If you can, stop taking blood thinning medications 7 days before surgery. You also should stop aspirin and non-steroidal anti-inflammatory (NSAID) medications (ibuprofen, naproxen and prescription NSAIDS). If you take prescription blood thinners such as Warfarin and Plavix, ask your provider if these medications can safely be stopped 5-7 days before surgery. If you can't stop taking your blood thinners, this procedure may still be done. We also ask that you stop vitamins and herbal or nutritional supplements because they may cause you to bleed longer or may interact with your anesthesia.
If you are taking prostate medications, keep taking them until you are told to stop by your urologist.
The night before surgery, do not eat or drink anything after midnight, except for your prescription medications with sips of water.
No bowel prep is necessary. Let us know if you become ill, develop fever, chest pain, heart racing, cough, shortness of breath or wheezing prior to surgery.
The surgery usually takes about 60 minutes, depending on the size of your prostate. A spinal or general anesthesia may be used for this procedure. The anesthesiologist will meet with you before surgery to talk about what type of anesthesia is best for you. The extra prostate tissue is vaporized with a special instrument through a cystoscope which goes in through the urethra and the bladder. There should not have to be any outside cuts. The prostate tissue is removed through laser destruction. It cannot be checked for cancer.
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 not able to urinate after surgery you may have to have a catheter replaced for a longer period of time.
You should plan on resting for 2-3 days after surgery. You may gradually increase activities as you feel better. It is common to have some burning and urgency with urination for up to 3 weeks after surgery. Some men need to be place on a short course of overactive bladder medication. Some times, you may pass bright red blood. If this happens, drink 8 oz of water/hour and rest until it clears up. Pink or light red urine is common for up to 3 weeks after surgery.
Things to Do to Reduce Bleeding
1. Drink when thirsty.
2. Avoid letting your bladder get too full. 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. It is important that
you do not strain with bowel movements. Adding fruits and vegetables as
well as fiber to your diet will help prevent constipation. Your provider may
order a stool softener or a mild laxative.
Restrictions and special Instructions
• 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.
• You may shower.
• You may not take a tub bath if you go home with a catheter in place.
• Your urologist will let you know when you can drive and return to work
(usually around 2 weeks).
Your first follow-up visit will be made for you before you leave the hospital. This will usually be in 2-3 weeks to check your urine flow and bladder emptying.
When to Call the Doctor
• 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
• Temperature is greater than 100.5°F by mouth for 2 readings taken 4 hours
Urology Clinic (608) 263-4757
Nights, weekends, and holidays this will give you 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.
If you live out of the area, please call 1-800-323-8942.
Your urologist is Dr. ______________________________________
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 07/23/2013
Copyright © 07/03/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7521
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