Approximately half of men over the age of 50 experience an enlarged prostate, leading to difficulties with urination. Traditionally, treatment for this condition has involved major surgery. However, a new laser procedure that lasts only 30 minutes has shown promise in effectively treating the condition with minimal side-effects. Martin Klein, a 70-year-old semi-retired NHS worker from London, shares his experience as one of the first men in the UK to benefit from this innovative procedure.
Five years ago, I started noticing that I had an increased urge to urinate frequently. When I did go, I experienced difficulty in urinating and my bladder never fully emptied. As a result, I was waking up every hour during the night, which greatly affected my sleep and left me feeling exhausted. I consulted my GP, and after trying different solutions, including medication, that didn’t work, I was referred to a urologist named Dr. Chris Ogden.
I was diagnosed with benign prostatic hyperplasia (BPH), or an enlarged prostate. Dr. Ogden informed me that surgery would be necessary, but he also discussed a new technique where a thin laser could be used to remove excess prostate tissue. This procedure was quick, non-invasive, and carried a lower risk of side-effects compared to other surgeries that could potentially result in incontinence or erectile dysfunction. Intrigued by the advantages, I decided to proceed with the laser procedure.
During the procedure, I experienced no pain, only slight discomfort from the urinary catheter that was inserted immediately afterward. The catheter was removed within a couple of days. I noticed excellent results soon after the procedure; I could urinate properly and fully empty my bladder. Previously, I had been waking up every hour at night to use the bathroom, but now it’s only a couple of times, even with my habit of drinking lots of tea. I’ve experienced no side-effects and am thrilled to be able to enjoy a good night’s sleep once again.
Dr. Chris Ogden, a consultant urologist at Princess Grace Hospital and University College Hospital in London, explains that BPH is a common condition in older men. The prostate gland, approximately the size of a walnut and located under the bladder, wraps around the urethra. As it enlarges, it starts squeezing the bladder and narrowing the urethra, leading to symptoms such as difficulty in initiating urination, frequent urination, and incomplete bladder emptying.
Initially, lifestyle changes are recommended for BPH treatment, such as reducing caffeine intake, which can irritate the bladder and worsen urinary symptoms. Medications like alpha-blockers or 5-alpha reductase inhibitors may also be prescribed if lifestyle changes do not alleviate symptoms. However, around 30% of men with BPH will require surgery to address the condition.
The gold-standard treatment, transurethral resection of the prostate (TURP), involves using a metal tube with a light and loop of wire to cut away excess tissue causing the symptoms. While effective, TURP can result in nerve damage, leading to erectile dysfunction and incontinence. The new Echolaser procedure offers a more minimally invasive approach. Instead of passing instruments through the urethra, the laser is inserted through a small needle in the perineum, between the anus and scrotum. This procedure minimizes damage to the bladder neck tissue and has fewer side-effects.
During the Echolaser procedure, the patient is sedated and given a spinal nerve block for local anesthesia. The needle, approximately one-third of a millimeter in diameter, is guided by an ultrasound probe in the rectum. The laser probe, about a third of a millimeter wide, is passed through the needle into the enlarged prostate. The laser generates heat, vaporizing the excess tissue. As there is no cutting or bleeding involved, patients can usually return home on the same day of the procedure. Improvement in symptoms is typically seen within a few weeks, with the full benefit realized after three months due to the shrinking of the affected tissue.
The initial results of the Echolaser procedure, presented at the British Association of Urological Surgeons conference, show that 80% of patients experienced a doubling of their flow rate three months after treatment, leading to a significant improvement in their quality of life. The cost of the Echolaser treatment ranges from £4,000 to £8,000 for private patients.
Overall, this innovative laser procedure showcases a promising alternative for treating enlarged prostates that is faster, less invasive, and associated with fewer side-effects compared to traditional surgery.
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