Holmium Laser Surgery for Prostate Enlargement

(A modern, safe, and effective alternative)

What is prostate enlargement?

Benign prostate enlargement, medically known as Benign Prostatic Hyperplasia, is a very common condition in men over 40–50 years old. It involves an increase in the size of the prostate, which can compress the urethra and make urination difficult.

Most common symptoms:

• Difficulty starting urination
• Weak urinary stream
• Feeling of incomplete bladder emptying
• Increased frequency of urination (especially at night)
• Urinary urgency

When these symptoms significantly affect quality of life and do not improve with medication, surgical treatment is considered.

What is holmium laser surgery?

Holmium laser surgery, known as Holmium Laser Enucleation of the Prostate, is a minimally invasive technique used to treat prostate enlargement.

It uses a specialized laser (Holmium Laser) to remove the prostate tissue that is blocking urine flow.

How is the procedure performed?

• An endoscope is inserted through the urethra (no external incisions).
• The laser separates and cuts the enlarged prostate tissue.
• The tissue is fragmented and removed from the bladder.

The entire procedure is performed under anesthesia and usually lasts between 1 and 2 hours, depending on prostate size.

Advantages of holmium laser surgery

This technique has gained popularity due to several benefits compared to traditional procedures such as TURP:

1. High effectiveness

It completely removes obstructive tissue, reducing the need for reoperation.

2. Less bleeding

Ideal for patients taking anticoagulants or with higher surgical risk.

3. Faster recovery

• Shorter hospital stay
• Earlier catheter removal

4. Suitable for large prostates

Unlike other techniques, it can be used even in very large prostates.

Risks and possible side effects

Although it is a safe procedure, some effects may occur:

• Burning sensation during urination (temporary)
• Mild urinary incontinence (usually temporary)
• Retrograde ejaculation (common)
• Urinary tract infection

Most of these effects are temporary and improve over time.

Who are candidates?

This procedure is indicated for patients with:

• Moderate to severe symptoms of prostate enlargement
• Poor response to medical treatment
• Urinary retention
• Recurrent urinary tract infections
• Bladder or kidney damage due to obstruction

Recovery

After surgery:

• Patients can go home within 24–48 hours
• It is recommended to avoid intense physical activity for 2–3 weeks
• Improvement in urinary flow is usually immediate