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 urethra is surrounded by the prostate. A laser is passed through the scope. The laser delivers energy that is used to shrink or to remove the excess tissue that is blocking the urethra and preventing urine flow.
All lasers use concentrated light to generate precise and intense heat. Laser surgery removes excess prostate tissue by:
- Ablation. The laser melts away excess tissue.
- Enucleation. The laser cuts away excess prostate tissue.
There are different types of prostate laser surgery, such as:
- Photoselective vaporization of the prostate (PVP). A laser is used to melt away (vaporize) excess prostate tissue to enlarge the urinary channel.
- Holmium laser ablation of the prostate (HoLAP). This is a similar procedure to PVP, except that a different type of laser is used to melt away (vaporize) the excess prostate tissue.
- Holmium laser enucleation of the prostate (HoLEP). The laser is used to cut and remove the excess tissue that is blocking the urethra. Another instrument, called a morcellator, is then used to chop the prostate tissue into small pieces that are easily removed.
The type of laser surgery your doctor will perform depends on several factors, including the size of your prostate, your health, the type of laser equipment available and your doctor's training.
July 23, 2013
- Management of benign prostatic hyperplasia (BPH). American Urological Association. http://www.auanet.org/education/clinical-practice-guidelines.cfm. Accessed April 16, 2013.
- Gravas S, et al. Critical review of lasers in benign prostatic hyperplasia (BPH). BJU International. 2011;107:1030.
- Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-6/0/1445/0.html. Accessed April 16, 2013.
- Lee J, et al. Advances in laser technology in urology. Urology Clinics of North America. 2009;36:189.
- Rieken M, et al. Complications of laser prostatectomy: A review of recent data. World Journal of Urology. 2010;28:53.
- Ahyai SA, et al. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. European Urology. 2010;58:384.
- Gnessin E, et al. An update on holmium laser enucleation of the prostate and why it has stood the test of time. Current Opinion in Urology. 2011;21:31.
- Prostate enlargement: Benign prostatic hyperplasia. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement. Accessed April 16, 2013.
- McVary KT, et al. Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia. Journal of Urology. 2011;185:1793.
- Cunningham GR, et al. Surgical and other invasive therapies of benign prostatic hyperplasia. http://www.uptodate.com/home. Accessed April 16, 2013.
- Preparing for your operation and recover. American College of Surgeons. http://www.facs.org/patienteducation/surgery.html. Accessed April 16, 2013.
- Humphreys MR (expert opinion). Mayo Clinic, Phoenix, Ariz. May 22, 2013.