LASER PROSTATE SURGERY

What is it?

We perform laser (using a Holmium:YAG) removal of the obstructive prostate tissue via a telescope (cystoscope) placed through the penis opening under a general anaesthetic. This technique is also known as Holmium Laser Enucleation of the Prostate (HoLEP)

A nice channel (tunnel) will be opened up in the central part of your prostate gland which will enable you to pass urine more easily.

Once the resected prostate tissue has been removed and good haemostasis has been achieved, a catheter (IDC) will be placed for ~24-48hrs after the surgery. The IDC will be  removed once the urine is clear/rosé, & the nurses will check you that you are passing urine well before you are able to safely go home.

What are the main benefits of Laser prostate surgery?

HoLEP in used in many different parts of the world, & it has been shown to be a safe and effective procedure. 

Although there are many types of BPH surgeries available, HoLEP offers the unique advantage in being able to remove a large amount of tissue without any incisions on the body, even in very large prostates, while decreasing the risk of bleeding and providing tissue for pathology analysis (to look for cancer). 

HoLEP decreases the need for blood transfusions during surgery, minimizes the time of stay in the hospital to one or two days, and reduces the risk of needing repeat surgery.

What are the common side effects after Laser prostate surgery?

  • Temporary burning and bleeding during urination. Some blood may be seen in the urine for weeks after surgery. This is usually not an indication of anything serious, only that the healing process is not yet finished.
  • Urinary incontinence (inability to control urine flow) can occur in a small number of patients immediately after surgery and they may need to wear pads for the first few days/weeks. This typically improves over several weeks. Performing pelvic floor muscle strengthening  exercises can help decrease leakage from stress actions such as coughing, sneezing, or lifting. The rate of long term leakage is very low. Patients may also have leakage related to urgency & this may require treatment with anticholinergic medication (such as Vesicare/Betmiga/Ditropan). 
  • Retrograde ejaculation or “dry ejaculation.” In ~75% of cases, the patient will not see any fluid post ejaculation during sexual activity after surgery
  • Erectile function is generally not significantly affected. A small percentage of patients have reported improved erectile function while a small percentage have reported decreased erectile function.

BEFORE laser prostate surgery:

AFTER Laser prostate surgery: