RisksBy Mayo Clinic staff
Serious long-term complications are less likely with prostate laser surgery than with traditional surgery. Risks of laser surgery include:
- Temporary difficulty urinating. You may have trouble urinating for a few days after the procedure. Until you can urinate on your own, you will need to have a tube (catheter) inserted into your penis to carry urine out of your bladder.
- Urinary tract infection. Urinary tract infections are a possible complication after any enlarged prostate procedure. An infection is increasingly likely to occur the longer you have a catheter in place, and may require antibiotics or other treatment.
- Narrowing (stricture) of the urethra. Just as you can form scars on the outside of your body, you can form scars on the inside after prostate surgery. These scars can block urine flow, requiring additional treatment.
- Dry orgasm. Laser surgery can cause retrograde ejaculation, which means semen released during sexual climax (ejaculation) enters your bladder rather than exiting the penis. Retrograde ejaculation isn't harmful, and generally doesn't affect sexual pleasure. But it can interfere with your ability to father a child. This is a common long-term side effect of enlarged prostate procedures.
- Need for re-treatment. Some men who have laser surgery later require more treatment. When laser surgery doesn't provide symptom relief, or symptoms return over time, transurethral resection of the prostate (TURP), open prostatectomy or HoLEP may be needed to reopen the urinary channel. The need for re-treatment is most common with laser procedures that only remove part of the prostate (ablative procedures). Men who have HoLEP generally don't require re-treatment, because the entire part of the prostate that can block urine flow is removed and can't grow back.
- Erection problems. There is a small risk that laser surgery could cause erectile dysfunction — the inability to maintain an erection firm enough to have sex. This is generally less of a risk than it is with traditional surgery. It occurs less often with HoLEP than with other laser procedures.
- AUA guideline on the management of benign prostatic hyperplasia: Diagnosis and treatment recommendations. Baltimore, Md.: American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/bph-management/chapt_1_appendix.pdf. Accessed March 12, 2009.
- Humphreys, MR (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2011.
- Fitzpatrick JM, et al. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/125743340-3/0/1445/91.html?tocnode=54305416&fromURL=91.html. Accessed April 14, 2011.
- Lee J, et al. Advances in laser technology in urology. Urology Clinics of North America. 2009;36:189.
- Rieken M, et al. Complications of laser prostatectomy: A review of recent data. World Journal of Urology. 2010;28:53.
- Ahyai SA, et al. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. European Urology. 2010;58:384.
- Gnessin E, et al. An update on holmium laser enucleation of the prostate and why it has stood the test of time. Current Opinion in Urology. 2011;21:31.
- Prostate enlargement: Benign prostatic hyperplasia. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement. Accessed May 23, 2011.