Prostate laser surgery is used to relieve moderate to severe urinary symptoms caused by an enlarged prostate — a condition known as benign prostatic hyperplasia (BPH).
During prostate laser surgery, your doctor inserts a scope through the tip of your penis into the tube that carries urine from your bladder (urethra). The prostate surrounds the urethra, and if the prostate is enlarged, it restricts urine flow from the bladder. A laser passed through the scope delivers energy that shrinks or removes excess tissue from the prostate that is preventing urine flow.
Lasers use concentrated light to generate precise and intense heat. There are several different types of prostate laser surgery, including:
- Photoselective vaporization of the prostate (PVP). A laser is used to melt away (vaporize) excess prostate tissue and enlarge the urinary channel. This procedure is generally used to treat prostates that are mild to moderately enlarged.
- Holmium laser ablation of the prostate (HoLAP). This procedure is similar to PVP but uses a different type of laser.
- Holmium laser enucleation of the prostate (HoLEP). A laser is used to cut and remove the excess prostate tissue that is blocking the urethra. Another instrument is then used to cut the prostate tissue into small pieces that are easily removed. HoLEP can be an option for men who have a severely enlarged prostate.
The type of laser surgery your doctor recommends will depend on several factors, including:
- The size of your prostate
- Your health
- The type of laser equipment available
- Your doctor’s training
Why it’s done
Prostate laser surgery helps reduce urinary symptoms caused by BPH, including:
- Frequent, urgent need to urinate
- Difficulty starting urination
- Slow (prolonged) urination
- Increased frequency of urination at night
- Stopping and starting again while urinating
- The feeling you can’t completely empty your bladder
- Urinary tract infections
Laser surgery might also be done to treat or prevent complications due to blocked urine flow, such as:
- Recurring urinary tract infections
- Kidney or bladder damage
- Inability to control urination or an inability to urinate at all
- Bladder stones
- Blood in your urine
Laser surgery can offer several advantages over other methods of treating BPH. It can take several weeks to months to see noticeable improvement with medications. Improvements in urinary symptoms from laser surgery are noticeable right away. The advantages over traditional surgery, such as transurethral resection of the prostate (TURP) and open prostatectomy, can include:
- Lower risk of bleeding. Laser surgery can be a good option for men who take medication to thin their blood or who have a bleeding disorder that doesn’t allow their blood to clot normally.
- Shorter or no hospital stay. Laser surgery can be done on an outpatient basis or with just an overnight hospital stay.
- Quicker recovery. Recovery from laser surgery generally takes less time than recovery from TURP or open surgery.
- Less need for a catheter. Procedures to treat an enlarged prostate generally require use of a tube (catheter) to drain urine from the bladder after surgery. With laser surgery, a catheter is generally needed for less than 24 hours.
