Holmium Laser Prostatectomy is a procedure which uses laser energy to treat an enlarged prostate or benign prostatic hyperplasia (BPH)
Benign (non-cancerous) enlargement of the prostate gland, also known as Benign Prostatic Hyperplasia (BPH for short), almost every man will experience some symptoms of BPH in their lifetime. As the prostate enlarges it cuts off the flow of urine down the urethra and results in varying symptoms. BPH is not usually life threatening but you may have found it to be embarrassing, inconvenient and uncomfortable.
Symptoms of BPH include the need to urinate often, the need to urinate suddenly, difficulty emptying your bladder completely, and difficulty sleeping due to frequent urination.
The prostate is a walnut-shaped gland that is part of the male reproductive system. It is located below the bladder and surrounds the urethra. The urethra is the tube that transports urine from the bladder out of the body. The main function of the prostate is to supply nutrients to the fluid that carries semen.
While TURP has been proven effective, some complications exist. The hospital stay is 1-3 days and you may have to return home with a catheter in place. The catheter may be attached to a leg bag and removed several days later. Blood thinning medications may need to be stopped prior to the operation and this can lead to a small increased risk of heart attack and stroke.TURP complications include blood loss and transfusion, impotence, incontinence, infection and retrograde ejaculation (dry climax). Typical recovery time is 4 – 6 weeks.
Holmium laser procedures use laser energy to alleviate BPH symptoms with fewer complications than invasive surgery by ablating or removing enlarged prostate tissue with high-powered laser energy. Holmium laser procedures are generally performed under spinal, epidural or general anesthesia. After receiving anesthesia, your urologist will pass a camera through a tube placed in your urethra, enabling him or her to view the bladder and prostate. The Holmium laser fiber (small flexible tube) is also passed through the same tube.
The prostate is then either ablated or large pieces of prostate are cut out using a very high degree of precision. The prostate pieces are then cut into smaller pieces and then flushed out of the bladder. A catheter is placed and then removed the next day. There is very little if any bleeding during the procedure and the patient experiences very rapid symptom relief.
Carefully designed clinical trials have shown that Holmium Laser Prostatectomy is as effective as TURP in improving symptoms. Holmium Laser Prostatectomy removes more obstructing tissue, is associated with less bleeding and has a shorter catheterisation time and hospitalization than TURP. Because saline is used as an irrigant there is almost no risk of dangerous fluid absorption with Holmium Laser Prostatectomy.
In patients who have large prostates (>100g), there is a greater risk of stress urinary incontinence after surgery because more tissue is removed. However in almost all cases this completely resolves by 6 weeks postoperatively.
The other common type of Laser Prostatectomy is known as a ‘Greenlight’ Laser Prostatectomy. Click here for more information about Greenlight laser surgery.