Holmium Laser Technology
Holmium Laser Enucleation of Prostate (HoLEP) is also known as Holmium Laser Prostatectomy. HoLEP is aimed to remove the central part of prostate gland which enlarges due to ageing and causes pressure on urethra (urine passage). The surgical procedure is performed with a special endoscope passed through the urethra.
The High Power Holmium Laser separates the central part of prostate from the surrounding fibrous covering (capsule) and this procedure is nearly bloodless as the laser beam when cuts the gland also seals the blood vessels. The separated part of the prostate is then pushed into urinary bladder and is cut by a special machine (Morcellator) into smaller pieces and then sucked out of the body. The smaller pieces of the prostate are sent for biopsy to detect prostate cancer.
Advantages of HoLEP (Holmium Laser) vs. TURP (Endoscopy)
| HoLEP | TURP | |
|---|---|---|
| Size of Gland | Any size | Not greater than 80 grams |
| Hospitalisation | 1 - 2 days | 3 - 4 days |
| Catheter | Less than 24 hours | 48-72 hours |
| Irrigation | Not needed | Usually needed |
| Blood Loss | 1 in 10,000 | 10-15 in 100 |
| Patients on anticoagulants, aspirin and with heart valves and coronary stents | Safe | High Risk |
| Recovery | Very soon | Few weeks |
| Risk of stricture, bladder neck contracture & impotence | Insignificant | High Risk |
Advantages of HoLEP (Holmium Laser) vs. Other Lasers
| HoLEP | Other Lasers (Greenlight PVP, Thulium, etc.) |
|
|---|---|---|
| Biopsy to detect Prostate Cancer | Possible | Not possible |
| Published Laser RCT | 8 | 2 (Greenlight); 0 (Thulium) |
| Amount of Enlarged Prostate Removed | 82 - 91% | 32 - 51 % |
| Treatment Cost | Economical | Expensive |