Laser Treatment in Urology

Laser Treatment in Urology


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).

All lasers use concentrated light to generate precise and intense heat. Prostrate Laser surgery removes excess prostate tissue by:

Ablation. The laser melts away excess tissue. Example: KTP Greenlight laser

Enucleation. The laser cuts away excess prostate tissue. Example: HoLEP

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.


Prostate (HoLEP)

Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive treatment for BPH. The surgeon uses the laser to enucleate the prostate gland tissue, leaving just the capsule in place. HoLEP is performed transurethrally, using a holmium laser to separate the plane between the prostate gland tissue and the prostate capsule. This prostate laser surgery allows complete resection of all adenomatous tissue, minimizing the need for future re-treatment.


HoLEP Offers Some Distinct Advantages:

  • Treatment of any size prostate gland.
  • Prostate laser surgery completes excision of the obstructing prostate tissue down to the prostate’s encapsulating structures, resulting in a re-treatment rate of less than 2 percent.
  • Early, immediate symptom relief and fast return to normal activity. Same-day or next-day hospital discharge is possible when the procedure is performed in a 23-hour observation setting.
  • Tissue preservation for pathologic examination. Because adenomatous tissue is excised rather than ablated, surgeons can examine specimens for prostate cancer or other abnormalities.
  • Fewer potential complications. The low depth of penetration of the holmium laser causes little damage to healthy tissue. Hence, under prostate laser surgery the risk of excessive bleeding associated with traditional surgical approaches is reduced.

When To Choose Surgery ?

  • Your symptoms are moderate to severe
  • Medication hasn’t relieved your symptoms
  • You have a urinary tract obstruction, bladder stones, blood in your urine or kidney problems, recurrent infections
  • You prefer definitive treatment

Kidney Stones

Kidney stones (renal lithiasis, nephrolithiasis) are small, hard mineral deposits that form inside your kidneys. The stones are made of mineral and acid salts.

Facts about kidney stones

  • Stones are common: about 1 in 10 people will form a stone at some point.
  • You have a 5 to 10% chance of forming a stone during your life.
  • Men form stones more often than women, with a ratio of 3 to 1. This difference is now becoming smaller, perhaps due to the changes in lifestyle and diet.
  • You are most likely to form a stone between the age of 30 and 50.
  • Stone patients often form stones more than once in their life.

RIRS (Retrograde Intrarenal Surgery):

Retrograde intrarenal surgery (RIRS) is a procedure for doing surgery within the kidney using a viewing tube called a fiberoptic endoscope.

In RIRS the scope is placed through the urethra (the urinary opening) into the bladder and then through the ureter into the urine-collecting part of the kidney. The scope thus is moved retrograde (up the urinary tract system) to within the kidney (intrarenal).

RIRS may be done to remove a stone. The stone is seen through the scope and can then be manipulated or evaporated by a laser probe or grabbed by small forceps, etc.

The new Holmium: YAG laser delivers very short, intense pulses of infrared light that can break down any form of stone, no matter what kind, into tiny fragments that can be flushed out or excreted in urine. It’s less invasive than surgery, meaning patients recover more quickly and are less likely to experience complications.


Percutaneous Nephrolithotomy(PCNL)

Percutaneous nephrolithotomy is a procedure used to remove kidney stones from the body when they cannot pass on their own. This procedure uses small telescopes and instruments inserted through a small incision in your back to remove the kidney stones.

Percutaneous nephrolithotomy is used most often for larger stones or when other procedures, such as extracorporeal shock wave lithotripsy or ureteroscopy, are unsuccessful or not possible.