Laser Surgery for Stones and Prostate
Laser surgery is a modern, minimally invasive treatment used to manage both urinary stones and benign enlargement of the prostate (benign prostatic hyperplasia or BPH). By delivering highly concentrated laser energy through specialised endoscopic instruments, surgeons can precisely remove obstructing prostate tissue or break urinary stones into tiny fragments without the need for large incisions. Laser surgery has become a widely used option because it offers excellent outcomes, reduced bleeding, and faster recovery for many patients.
What is Laser Surgery for Stones and Prostate?
Laser surgery is performed using a thin telescope inserted through the urethra to access the urinary tract. Depending on the condition being treated, the laser is used to:
- Break kidney, ureteric or bladder stones into small fragments that can be removed or passed naturally.
- Remove or vaporise enlarged prostate tissue that is obstructing urine flow.
Several types of surgical lasers are used in urology, including the Holmium:YAG laser and the Thulium fibre laser, both of which provide excellent precision while minimising damage to surrounding healthy tissue.
What are the Benefits of Laser Surgery for Stones and Prostate?
Laser surgery offers several advantages over many traditional surgical techniques.
Benefits include:
- No external surgical incisions
- Minimally invasive treatment
- Reduced blood loss during surgery
- Lower risk of bleeding complications
- Shorter hospital stay
- Faster recovery
- Less postoperative discomfort
- Precise removal of obstructing tissue
- Effective treatment of stones of varying sizes
- Lower risk of damage to surrounding structures
- Suitable for many patients taking blood-thinning medication
- Improved urinary flow in patients with enlarged prostate
These benefits make laser surgery an excellent option for many patients requiring urological treatment.
When is Laser Surgery for Stones and Prostate Recommended?
Your urologist may recommend laser surgery in several situations.
Common indications include:
- Kidney stones causing pain or obstruction
- Ureteric stones that are unlikely to pass naturally
- Bladder stones
- Recurrent urinary stones
- Benign prostatic hyperplasia causing troublesome urinary symptoms
- Urinary retention caused by prostate enlargement
- Recurrent urinary tract infections related to bladder obstruction
- Bladder stones resulting from poor bladder emptying
- Blood in the urine caused by an enlarged prostate
- Failure of medication to adequately control prostate symptoms
The choice of treatment depends on the size and location of the stone or the degree of prostate enlargement.
What Does Preparation for Laser Surgery Involve?
Preparation begins with a thorough assessment by your urologist.
This may include:
- Medical history and physical examination
- Blood tests
- Urine testing to exclude infection
- CT scan or ultrasound for urinary stones
- PSA testing where appropriate
- Flexible cystoscopy in selected patients
- Review of current medications, including blood thinners
- Temporary adjustment of certain medications if required
- Fasting before the procedure according to your hospital's instructions
- Discussion of the procedure, expected outcomes, and possible risks
Antibiotics may be prescribed before surgery if there is evidence of infection.
How is Laser Surgery for Stones and Prostate Performed?
Laser surgery is usually performed under general or spinal anaesthetic. No external incisions are required.
For urinary stones, a fine telescope called a ureteroscope or cystoscope is passed through the urethra into the bladder and, if necessary, into the ureter or kidney. A laser fibre is advanced through the telescope to the stone. The laser delivers pulses of energy that fragment the stone into very small pieces. Larger fragments may be removed using tiny baskets, while smaller particles are left to pass naturally in the urine. In some patients, a temporary ureteric stent is placed to promote drainage while the urinary tract heals.
For enlarged prostate treatment, a resectoscope is inserted through the urethra to reach the prostate. The laser precisely removes, vaporises, or enucleates obstructing prostate tissue while sealing blood vessels at the same time. This improves urine flow while minimising bleeding. Depending on the technique used, the removed tissue may be sent for laboratory analysis.
What to Expect During Recovery after Laser Surgery for Stones and Prostate?
Most patients recover quickly following laser surgery. Many are discharged on the same day or after one overnight stay.
During the first few days, it is common to experience:
- Mild burning when passing urine
- Increased urinary frequency
- Small amounts of blood in the urine
- Temporary urgency to urinate
Patients treated for urinary stones may pass small stone fragments for several days or weeks.
Most people can return to light daily activities within a few days, although strenuous exercise and heavy lifting should be avoided for approximately two to four weeks. Drinking plenty of fluids helps flush the urinary tract and supports healing.
What are the Risks and Complications of Laser Surgery for Stones and Prostate?
Although laser surgery is considered very safe, all surgical procedures carry some risk.
Potential complications include:
- Urinary tract infection
- Temporary blood in the urine
- Burning during urination
- Difficulty passing urine immediately after surgery
- Temporary urinary catheter requirement
- Urinary retention
- Incomplete stone clearance requiring further treatment
- Ureteric injury during stone surgery
- Temporary urinary urgency or frequency
- Retrograde ejaculation following prostate surgery
- Recurrence of urinary stones or prostate enlargement over time
- Rare injury to surrounding urinary structures
Your urologist will discuss these risks with you and explain the treatment approach that is most appropriate for your individual condition