Before surgery you will be given either general anesthesia — which means you'll be unconscious during the procedure — or spinal anesthesia, which means you'll remain conscious. Exactly what you can expect during and after prostate laser surgery varies depending on the particular type of laser and technique used.
During the procedure
A narrow fiber-optic scope is inserted through the tip of your penis into the urethra. The laser inserted through the scope is used to destroy, vaporize or cut out the prostate tissue blocking urine flow. Depending on the procedure, your doctor might also use instruments to remove cut pieces of prostate tissue from the bladder.
After the procedure
You'll likely have a urinary catheter in place because of swelling that blocks urine flow. If you're unable to urinate after the tube is removed, your doctor might reinsert the catheter to allow you to heal or give you catheters that you can insert on your own a few times a day until swelling goes down and you can urinate normally.
You might also notice:
- Blood in your urine. It's normal to see blood for a few days to weeks after the procedure. Call your doctor if the blood in your urine is thick like ketchup, bleeding appears to be worsening or blood clots block your urine flow.
- Irritating urinary symptoms. You might feel an urgent or frequent need to urinate, or you might have to get up more often during the night to urinate. Most men experience burning, especially at the tip of their penis and near the end of urination. With some types of laser surgery, these symptoms can last for weeks or even months depending on how you heal and the size of your prostate.
- Difficulty holding urine. Incontinence can occur because your bladder is used to having to push urine through a urethra narrowed by enlarged prostate tissue. For most men, this issue improves with time.
Depending on the type of prostate laser surgery you have, you might go home afterwards or need to stay in the hospital overnight.
Your doctor is likely to recommend that you:
- Take it easy. Avoid strenuous activity, such as heavy lifting, until your doctor approves it. You might need to wait up to two weeks after HoLEP, but as little as a few days with procedures such as PVP.
- Hold off on sex. Your doctor might recommend waiting a week or two after the procedure. Ejaculating too soon can cause pain and bleeding.
- Take medication as prescribed. If your doctor prescribes antibiotics, take the full course.
Jan. 25, 2017
- Cunningham GR, et al. Transurethral procedures for treating benign prostatic hyperplasia. http://www.uptodate.com/home. Accessed May 11, 2016.
- Wein AJ, et al., eds. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed May 11, 2016.
- Nair SM, et al. A review of laser treatment for symptomatic BPH (benign prostatic hyperplasia). Current Urology Reports. 2016;17:45.
- Brunkhorst O, et al. Evaluation of the learning curve for holmium laser enucleation of the prostate using multiple outcome measures. Urology. 2015;86:824.
- Abdul-Muhsin H, et al. Analysis of benign prostatic hyperplasia patients' perspective through a third-party administered survey. Urology. 2016;88:155.
- Jaeger CD, et al. Holmium laser enucleation (HoLEP) and photoselective vaporization of the prostate (PVP) for patients with benign prostatic hyperplasia (BPH) and chronic urinary retention. BJU International. 2015;115:295.
- Laser removal of prostate tissue (HoLEP). Mayo Foundation for Medical Education and Research; 2014.
- Photo Selective selective vaporization of the prostate (PVP). Mayo Foundation for Medical Education and Research; 2015.