When it comes to treating benign prostatic hyperplasia (BPH), among the tools we use at our clinic is a new laser method, one that is directed primarily at middle-aged patients for whom it is important to retain a full ejaculation even after treatment for their prostate disorder. This demands an extremely accurate and precise treatment of the prostate by laser, one that has now been made possible thanks to the so-called Evolve Laser method developed by the German company Biolitec based in Jena.
Evolve is a minimal-invasive procedure. Laser energy is used to remove obstructive prostate tissue from around the urethra that causes the symptoms usually associated with BPH.
The laser operates in the infrared range, and in this method uses two wavelengths of 1470 and 980 nanometers (nm) running in parallel. This has the advantage that an optimal absorption is achieved in water and hemoglobin, which in turn means a high rate of ablation in combination with a good hemostatic (blood-staunching) effect. In plain text: the proliferative prostate tissue is swiftly and effectively ablated and the free off-flow of retained urine is completely restored.
The Evolve Laser also ensures that the internal structures of the prostate gland that enable ejaculation are spared. Thus, for the very first time there is now a method available that enables so-called retrograde ejaculation to be prevented. In particular middle-aged men between 40 and 50 years of age who may still have the wish to sire children can draw new hope even if they are suffering from BPH.
The excellent hemostatic profile has a positive impact on the healing process: there is virtually no loss of blood, and the surrounding tissue is spared. The patient experiences relief directly following the treatment and no longer feels the constant and uncomfortable urge to urinate.
The invisible infrared laser beam is led through a specially shaped glass-fiber light conductor directly to where it is needed. Here the smoothed tip of the instrument comes into contact with the tissue and hence achieves an extremely high degree of ablation compared with conventional laser methods.
The new treatment method is also suited for high-risk patients, since there is no longer any need for strong anesthesis, and any anticoagulation medication that these patients are often obliged to take can be recontinued a short time after the treatment.
It may be necessary to insert a bladder catheter after the treatment. In most cases, this is removed again 24 to 48 hours later. Most patients experience relief of their symptoms and a substantial improvement in their ability to pass urine very soon after the treatment.
For about one week you may experience slight complaints when passing urine, detect minute traces of blood in your urine, or still have a slightly raised urge to urinate. These symptoms will, however, soon recede again, since your bladder will require a little time to "accustom" itself to the fact that the obstruction in your urethra is no longer there.
Most men are discharged from the clinic very soon, in most cases the following day.
In theory, every surgical intervention involving the prostate can result in an impairment of sexual function. If, however, you have been sexually active prior to the procedure, it is highly probable that your sexual activity will not be impaired following the treatment. At this point it should be mentioned that of all the treatment methods involving the ablation of prostate tissue, laser vaporization is the one associated with the lowest rate of sexual function impairments.
Most patients experience relief of their symptoms and a substantial improvement in their ability to pass urine very soon after the treatment - in most cases within the space of 24 hours. Certain factors, such as other health disorders in the patient's medical history and his current state of health, may, however, have an effect on the treatment and reconvalescence.
Your physician will decide which form of therapy is best in your particular case. In most cases, however, patients can stop taking their other BPH medication a few weeks after the treatment.
As a rule, activities involving relatively little physical exertion, such as e.g. office work or driving a car can be resumed after just a few days. Physically demanding work and sexual activities can normally be resumed after two to three weeks.