Lasers have become well established in Urology, particularly in treating urological disorders such as bladder tumors & BPH .
Lasers have become well established in Urology, particularly in treating urological disorders such as:
- Benign Prostatic Hyperplasia (BPH)
- Partial Kidney Resection
- Removal of Kidney Stones
- Bladder tumors
Laser treatments in urology are growing in popularity & offer many benefits as compared to the traditional surgeries
- Greater Precision & Accuracy
- Less Invasive
- Less bleeding, swelling, pain or scarring
- Shorter Hospitalisation Time
- Quicker Recovery
- Fewer post surgical side effects
Further, laser treatments are an excellent alternative inc are of patients with co-morbidities who are unsuitable for open surgical procedures.
Types of Lasers Used In Urology:
The most commonly used lasers in urological treatments include:
- Nd: YAG
- KTP:YAG (Potassium Titanyl Phosphate)
- LBO:YAG (Lithium Borate)
- Diode Lasers
- Holmium (Ho): YAG
- Thulium (Tm):YAG
LASER TREATMENTS FOR BPH
Lasers have been used as a treatment option for Benign Prostatic Hyperplasia since the 80s. Today, the holmium laser & the latest generation thulium laser are considered to be the most advanced technology & highly used tools for endoscopic prostatectomy procedures.
Earlier the Ho: YAG laser was used as an effective tool for vaporisation of the prostate. This was done through Holmium Laser Ablation of the Prostate (HoLAP). While HoLAP was an easy to learn ablation procedure, its results were not effective in case of large prostates.
Eventually an enucleation technique known as Holmium Laser Enucleation of the Prostate (HoLEP) was developed. HoLEP is a highly successful laser treatment for BPH, regardless of the size of the adenomas. After holmium, a new laser source - Thulium Laser Enucleation of the Prostate (ThuLEP) has gained popularity.
Laser treatments using Ho:Yag or Thulium are less prone to recurrences or complications. They also require much shorter periods of cathertization & hospitalisation. With their excellent homeostatic effect, they are considered for surgery in cardiopathuc patients or those with coagulation problems.
Laser Treatments for Stones in the Urinary System
As compared to the traditional lithotripsy techniques, Holmium lasers offer a safer & minimally invasive alternative for surgical treatment of stones in the urinary tract.
Holmium systems with fibre sets have been developed for laser endoscopic lithotripsy to support surgery for a wide range of urological diseases.
The type of lithotripsy technique to be used depends on:
- Shape of the stone
- Size of the stone
- Chemical composition of the stone
- Anatomical location of the stone
- Patient's symptoms
- Patient's overall health condition
Ho:YAG laser sources offer the advantage of high efficiency for all types of stones & low percentage of migration & propulsion of fragments treated.
For certain types of stones, Ureteroscopy (URS) may be a suitable option. In such cases, Retrograde Intra-Renal Surgery may be considered as it is a latest evolution of the URS.
For kidney stones which are unusually large or are of harder consistency, Percutaneous nephrolithotomy is the most commonly used procedure.
Laser Treatments for Urethral Strictures
Thulium or Holmium laser urethrotomy can effectively treat the fibrotic urethral strictures resulting from spongiofibrosis. Lasers have been effectively used for short strictures of the urethra as well as the more significant ones. They are also useful in treating urethral atresia. The risk of lateral thermal damage is reduced as the laser allows ablation of the damaged tissue with a clean cut, without penetrating too deeply.
Laser Treatments for Tumors
In case of tumours of the urethra, bladder, ureter or the kidneys, Thulium lasers are the most effective. The wavelengths transmitted through fibre optics enhance its effectiveness. Precise control of cutting & ablation can be achieved by adjusting the parameters. It also offers excellent hemostatic effect with minimal damage to nearby tissues.
Lasers are a safe & effective alternative to traditional surgical techniques.
Cysts are fluid filled sacs which may develop in different parts of the body. They are non-cancerous & are usually not harmful. However, cysts in the kidneys are a cause of concern.
If you or your loved one is diagnosed with cysts in your kidneys, consult a urologist to understand how to cut down the risk of complications.
Understanding Renal Cysts
Renal cysts are of two types
• Simple Cysts :
These are individual cysts with thin walls containing water-like fluid. These do not cause damage to the kidneys or affect their function in any way.
• Polycystic Kidney Disease:
Polycystic kidney disease is a genetic disorder resulting in formation of multiple cysts on the kidneys. They tend to cause severe kidney damage as they grow.
In most cases, cysts do not cause any symptoms & cannot be found until a person gets a scan done for some other reason. These cysts may vary from being too tiny to be visible without a microscope to being as large as a tennis ball. Growing cysts put pressure on nearby organs causing pain.
While most cysts do not cause any symptoms, as they get infected or grow larger there may be a few noticeable signs:
- Need to urinate more often than usual
- Bloody or dark urine
- Dull pain in the back
- Pain and/or swelling in the upper abdomen
Polycystic kidney disease may cause symptoms like
- Pain in the back or side
- High Blood Pressure
- Blood in urine
The exact cause of cysts remains unknown. However, studies indicate that cysts may occur when the tiny tubules of the kidney (which collect urine) swell up, get filled with fluid or get blocked.
Cysts are more likely to occur in older adults and men are at a greater risk of developing them when compared to women.
Generally cysts are harmless, but in some cases may lead to severe complications such as:
- Infection in the cyst
- Burst cyst
- Blockage of urine out of the kidney
- Elevated blood pressure levels
Polycystic kidney disease can damage kidneys in the long run.
A blood & urine sample may be required to understand the functioning of the kidney. Certain imaging tests such as the following may also be recommended.
- CT Scan
If the cysts is tiny & doesn't cause any symptoms, treatment may not be necessary. However, frequent imaging tests (usually once every 6 months) have to be done make sure the cyst has not enlarged.
If the cyst is large, treatment may involve sclerotherapy or surgery. Sclerotherapy refers to puncturing & draining the cyst and then filling it with alcohol solution to prevent it from forming again. A large cyst may be removed with a laparoscopic surgery making several small incisions. The surgeon first drains the cyst and then cut & burn the walls of the cyst.