RisksBy Mayo Clinic staff
Serious long-term complications are less likely with prostate laser surgery than with traditional surgery. Risks of laser surgery can 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 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 (retrograde ejaculation). Any prostate 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 procedures to treat an enlarged prostate.
- Erectile dysfunction. There is a small risk that ablative procedures could cause erectile dysfunction — the inability to maintain an erection firm enough to have sex. This is generally less of a risk with laser surgery compared with traditional surgery.
- Need for retreatment. Some men require follow-up treatment after laser ablative surgery because not all of the tissue is removed or it may grow back over time. This is not the case with enucleation. Men who have HoLEP generally don't require re-treatment, because the entire part of the prostate that can block urine flow is removed.
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