One of these delivers laser energy through a fiber in the urethra, and prisms are used to deflect the laser beams sideways toward the prostate. Another device employs a tip that comes into direct contact with the gland. A third, called an interstitial laser, heats the prostate with probes placed inside the gland. Different procedures are used to provide different degrees of thermal cell destruction that range from coagulation to complete vaporization. It can take weeks to months, however, for the dead tissue to slough off and for maximum improvement in symptoms to occur.
Vaporization is effective right away.
It should be noted that these are all new procedures and patients should be sure their physician has experience with them. They can be performed even on men who are taking anti-clotting medications, such as coumadin or aspirin. Most studies report improvements in symptoms after coagulation and vaporization procedures equal to those resulting from TURP, although urinary flow rate is less improved. In fact, after these procedures, especially laser coagulation, the prostate temporarily enlarges and causes obstruction and irritation, which can be severe. Most men require a temporary catheter to drain urine afterward.