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Treatments

Laser Treatment for Enlarged Prostate

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Laser treatment for enlarged prostate uses light energy to reduce the size of the prostate and ease symptoms.

Minimally invasive laser treatment for enlarged prostate gland

Laser treatment for an enlarged prostate is a minimally invasive option that uses high-energy laser to remove excess prostate tissue and improve urine flow. It’s especially helpful for men at higher risk of bleeding. Studies have shown that laser treatments like GreenLight™ and HoLEP are as effective as traditional surgery, with fewer bleeding complications.1-4

Types of laser treatment for enlarged prostate

There are different types of laser therapy used to treat an enlarged prostate, below are only a few examples it is important to discuss with your urologist which treatment is right for you.

Photovaporisation

This therapy uses a high-powered laser to vaporise the enlarged prostate tissue and reduce its overall size. The laser also cauterises the blood vessels as it vaporizes tissue, greatly reducing any bleeding.3,4

Laser enucleation of the prostate

This therapy uses a high-powered laser to cut away excess prostate tissue that is blocking the urethra. There are different kinds of laser laser enucleation treatments, but they all use intense light energy to remove excess prostate cells and reduce its size. These laser-based procedures also seal blood vessels which can facilitate a shorter hospital stay.5

How does Photovaporisation work?

The laser targets haemoglobin in the red blood cells in your prostate. This vaporises the surrounding prostate tissue to open a path in the urethra. Because this method vaporizes instead of cuts tissue, this is a good option if you have bleeding concerns.3,4

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How does HoLEP work?

Holmium laser enucleation of the prostate removes the tissue from the prostate. The intense light energy from the holmium laser cuts away prostate tissue to a precise depth of up to 0.4mm. Laser enucleation is usually recommended for men with a large prostate, typically four times the normal size.

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Benefits of laser treatment for enlarged prostate

Minimally invasive treatment

Laser treatments for enlarged prostate use light energy to remove prostate tissue without making incisions in the abdomen.This is why it has demonstrated shorter hospital stay compared to TURP, usually no more than one day.6-8

Studies show that HoLEP and GreenLight are associated with low complication rates.1,8-10 Side effects could include, but are not limited to, a change in ejaculation, incontinence, and erectile disfunction.

Demonstrated to improve quality of life for more than 5 years

Enlarged prostate symptoms were reduced significantly following treatment and the improvements were maintained for at least five years.1,10-13

Treatment option for men with a higher risk of bleeding

Laser therapy has been demonstrated to be a safe and effective treatment for patients with a higher risk of bleeding because the laser cauterizes blood vessels as it goes.3,4,14

Potential risks of laser treatment for enlarged prostate

Risks and side effects are a normal part of any medical treatment. Although side effects can be temporary, it is possible that some may persist for some patients. Here are some of the common risks associated with laser treatment for enlarged prostate. As with any medical procedure, you should discuss the risks with your physician.

  • Cloudy urine
  • Bleeding
  • Incontinence issues
  • Erectile dysfunction
  • Scar tissue formation
  • Fever, Inflammation, Pain, Infection, Scarring
  • Damage to structures near the surgical area (bladder, ureters, and nerves)

The laser treatment for enlarged prostate procedure

Before

You will be given an anaesthetic to keep you comfortable. You and your urologist should discuss what type of anaesthetic is appropriate for you and your condition before beginning the procedure.

During

Your Urologist will insert a thin device containing the laser called a resectoscope into your urethra. The resectoscope has a camera at the end so your surgeon can clearly see the right areas to target while they perform the treatment.

After

At the end of the surgery, your urologist will place a catheter to help you pass urine. This will likely last only 24 hours, but it may take several days.1

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Do you have further questions about laser therapy treatment? Want to know if laser therapy is the right solution for your enlarged prostate? Find a urologist today.

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Frequently asked questions about laser therapies

It is a minimally invasive treatment and there is no abdominal incision required. Your urologist will give you an anaesthetic to help keep you comfortable during your treatment and may recommend pain management medication afterwards.

Yes. The chances that you will repeat the therapy are very low, but that is an option.9,10,12,15

You will need to wear a catheter after your surgery. In most cases, this lasts about 24 hours, but sometimes it may be required for several days. The laser treatment technique has been shown to result in a shorter hospital stay compared to TURP.6,8,14-16

Some men may experience issues with sexual function after laser treatment for enlarged prostate. The amount of time it takes for sexual function to return to how it was before treatment will depend on which treatment you have and how severe and long-term your symptoms were before your therapy. You may experience retrograde ejaculation, where semen is expelled into the bladder, resulting in little or no ejaculation. Your urologist can talk to you about these risks at your consultation.

References:

  1. Bachmann, A., Tubaro, A., Barber, N., d'Ancona, F., Muir, G., Witzsch, U., . . . Thomas, J. A. (2014, May). 180-W XPS GreenLight laser vaporisation versus transurethral resection of the prostate for the treatment of benign prostatic obstruction: 6-month safety and efficacy results of a European Multicentre Randomised Trial--the GOLIATH study. European Urology, 65(5), 931-42. doi:10.1016/j.eururo.2013.10.040​
  2. Zhong J, Feng Z, Peng Y, et al. A systematic review and meta-analysis of efficacy and safety following holmium laser enucleation of prostate and transurethral resection of prostate for benign prostatic hyperplasia. Urology. 2019 Sep;131:14-20.
  3. Woo H, Reich O, Bachmann A, et al. Outcome of GreenLight HPS 120W laser therapy in specific patient populations: Those in retention, on anticoagulants, and with large prostates (≥ 80 ml). Eur Urol . 2008;7(Suppl):378‐83.
  4. Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA Guideline Part II – surgical evaluation and treatment. J Urol. 2021 Oct;206(4):818–826.
  5. Leavitt, D., Netsch, C., Tayeb, M. E., Borofsky, M., Tiburtius, C., Chughtai, B., . . . Okeke, Z. (2015). Comparison of the different techniques for laser enucleation of the prostatePVEP, HOLEP, THUVEP. Journal of Urology, 193(4S). doi:https://doi.org/10.1016/j.juro.2015.02.1353 ​
  6. Lai S, Peng P, Diao T, et al. Comparison of photoselective green light laser vaporisation versus traditional transurethral resection for benign prostate hyperplasia: an updated systematic review and meta‐analysis of randomised controlled trials and prospective studies. BMJ Open . 2019;9:e028855.
  7. Capitán C, Blázquez C, Martin MD, et al. GreenLight HPS 120‐W laser vaporization versus transurethral resection of the prostate for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia: A randomized clinical trial with 2‐year follow‐up. Eur Urol. 2011 Oct;60(4):734‐9.
  8. Cornu JN, Ahyai S, Bachmann A, et al. A systematic review and metaanalysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: An update. Euro Urol. 2015 Jun;67(6):1066‐96.
  9. Thomas JA, Tubaro A, Barber N, et al. A multicenter randomized noninferiority trial comparing GreenLight‐XPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: two‐yr outcomes of the GOLIATH Study. Eur Ur
  10. Elmansy HM, Kotb A, Elhilali MM. Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of followup. J Urol. 2011 Nov;186(5):1972-6.
  11. Law KW, Tholomier C, Nguyen DD, et al. Global Greenlight Group: largest international Greenlight experience for benign prostatic hyperplasia to assess efficacy and safety. World J Urol. 2021 Mar;39:4398‐95.
  12. Calves J, Thoulouzan M, Perrouin-Verbe MA, et al. Long-term patient-reported clinical outcomes and reoperation rate after photovaporization with the XPS-180W GreenLight laser. Eur Urol Focus. 2019 Jul;5(4):676-80.
  13. Jain, A., Nassour, A-J., Khannani, H., Wines, M. P., Chalasani, V., Katelaris, P., Bergersen, P., Symons, J. L., Baskaranathan, S., & Woo, H. (2023). Australian surgical revision rate for benign prostatic obstruction. Department of Urology, SAN Prostate Centre of Exce
  14. Agarwal DK, Large T, Stoughton CL, et al. Real-World Experience of Holmium Laser Enucleation of the Prostate with Patients on Anticoagulation Therapy. J Endourol. 2021 Jul;35(7):1036-41
  15. Gilfrich C, May M, Fahlenbrach C, Günster C, Jeschke E, Popken G, Stolzenburg JU, Weissbach L, von Zastrow C, Leicht H. Surgical Reintervention Rates after Invasive Treatment for Lower Urinary Tract Symptoms due to Benign Prostatic Syndrome: A Comparative Study of More than 43,000 Patients with Long-Term Followup. J Urol. 2021 Mar;205(3):855-863. doi: 10.1097/JU.0000000000001463. Epub 2020 Oct 26. PMID: 33103943.
  16. Malde S, Lam W, Adwin Z, et al. Pharmacological and interventional treatment of benign prostatic obstruction: An evidence-based comparative review. BJUI. 2021;2(4):238–259.

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