Laser surgery of the prostate is a minimally invasive procedure used to treat symptoms of benign prostatic hyperplasia (BPH), a condition of enlargement of the prostate gland. This treatment achieves speedy relief from symptoms, quick recovery as well as reduces postoperative complications.
Laser surgery for enlarged prostate is done by passing special viewing fiber-optic device and instruments transurethrally (through the tip of penis) and does not involve any incisions. The two basic techniques used are:
- Laser ablation: In this technique, the prostate tissues that cause obstruction are burnt away in order to enlarge the urinary channel (urethra)
- Laser enucleation: In this technique, all the obstructive tissues are removed as done in open prostatectomy, but more safe compared to an open procedure.
The procedures for laser ablation include:
- Photosensitive vaporization of the prostate: Photosensitive vaporization (PVP) of the prostate is also known as Greenlight laser therapy or KTP laser vaporization. This procedure uses extremely hot laser energy to dissolve the enlarged prostate. The recovery time is short and has less risk of bleeding
- Holmium laser ablation of the prostate (HoLAP): Holmium laser ablation of the prostate (HoLAP) uses a similar technique as PVP however the source of laser energy differs. The laser energy used for this procedure can be absorbed by water and therefore avoids deeper penetration of the energy into tissues
Laser enucleation surgery is usually recommended for larger prostates that would require an open surgery. The procedures include:
- Holmium laser resection of the prostate (HoLRP): Holmium laser resection of the prostate (HoLRP) involves the insertion of a laser through the tip of the penis to cut the enlarged prostate tissue into smaller pieces that are removed with the help of a surgical scope called resectoscope
- Holmium laser enucleation of the prostate (HoLEP): Holmium laser enucleation of the prostate (HoLEP) procedure resembles HoLRP, but an instrument called tissue morcellator is used to grind the tissue into easily removable fragments. This allows complete and easy removal of tissue