Focal Laser Ablation for BPH
What is Focal Laser Ablation for BPH?
Focal Laser Ablation (FLA) (also known as Laser Focal Therapy) is a minimally invasive treatment method that uses precisely targeted laser energy to ablate, or destroy, specific areas of tissue. While it has been utilized in the treatment of various medical conditions such as certain cancers, it can also be used in the treatment of Benign Prostatic Hyperplasia (BPH).
In the context of BPH, laser therapy works by delivering precise amounts of laser energy to the enlarged prostate tissue, destroying excess tissue without causing significant damage to the surrounding areas. Laser treatment for enlarged prostate can help to alleviate the urinary symptoms caused by BPH.
Laser treatments are known for their precision. This means that laser treatment for BPH can target the enlarged prostate tissue while minimizing damage to the surrounding tissues. This can lead to fewer side effects and complications.
Studies have shown that laser BPH treatments can effectively improve the symptoms of BPH. This includes symptoms like frequent urination, difficulty starting and stopping urination, and the inability to completely empty the bladder.
The FLA procedure for BPH is done as an outpatient procedure, meaning patients go home on the same day of the treatment. This is more convenient for many patients as compared to procedures that require a hospital stay.
About Focal Laser Ablation for BPH
To minimize the risks of BPH treatment, Prostate Laser Center uses an FDA-cleared laser system to insert a 1.85-mm laser fiber through your rectum into your prostate under MRI guidance. Monitoring the laser energy in two different planes in real time helps the physician avoid the neurovascular bundles responsible for erectile function and ejaculatory ducts to minimize the risk harming them.
This laser system is so precise that it’s most commonly used in the brain. There are no guarantees in medicine, but this system minimizes the risks to your neurovascular bundles, internal urinary sphincter, and prostatic urethra. With this treatment option, retrograde ejaculation risk is about 15%, and the risk of erectile dysfunction is less than 5%.
Due to swelling in the prostate from the procedure, urinary symptoms get worse before they improve. Most men get back to their baseline function approximately three weeks after the procedure and see noticeable improvement around three months after the procedure (plus or minus a month).
Advantages of Focal Laser Ablation
An ambulatory outpatient procedure – usually 2-to-4 hours in length
No General AnesthesiaWe utilize conscious sedation for the patient’s comfort
Approximately 85% of men have improved urination after the procedure
Decreased Risk of Side Effects
Lower risk of side effects such as urinary incontinence and impotence compared to traditional procedures
No LimitationsFocal laser therapy does not limit the option to treat with other treatments if needed in the future
Frequently Asked Questions
Private insurance will sometimes cover a significant portion of the procedure, minus copays and deductibles. You can call your insurance with these codes to ask about your coverage: The CPT code is 52647 and the ICD code is N40.1.
Medicare generally does not cover the procedure.
The “Blue Laser” is a marketing term. The laser system that is most commonly used is the Visualase laser system which has two available laser fiber optics: a smaller one with a blue plastic cover and a slightly larger one with an orange plastic cover.
In order to create wider ablation zones for better margins (for cancer) and larger tissue destruction (for BPH), we use the slightly larger fiber optic.
When the prostate grows so much that it is under a lot of pressure, it tries to expand in a direction with relatively less pressure. Sometimes, this is the direction of the bladder, and a median lobe can grow into the bladder. These can be difficult to treat with certain procedures, but with MRI guidance, a laser can be placed directly into the median lobe for treatment.
Over 200 cc!