Laser Prostate Surgery

Laser prostate surgery, especially HoLEP (Holmium Laser Enucleation) and ThuFLEP (Thulium Fiber Laser Enucleation), are minimally invasive surgical options that completely remove obstructing prostate tissue, providing long‑term relief.

What is laser prostate surgery?

Laser prostate surgery is the endoscopic removal or vaporization of the prostate tissue that causes obstruction at the bladder neck using a high‑energy laser. This improves urinary flow and shortens the need for a catheter and hospital stay.

For whom is laser prostate surgery suitable?

The procedure may be appropriate for:

• Individuals with moderate‑to‑severe BPH symptoms
• Patients who do not achieve relief with medication or experience side effects
• Those who develop complications such as recurrent urinary tract infections, bladder stones, or kidney damage
• Patients on anticoagulants with a high bleeding risk (due to the laser’s coagulation advantage)

How is laser prostate surgery performed?

The surgeon inserts a cystoscope through the urethra, strips the prostate tissue layer by layer with a holmium or thulium laser, and removes the fragments from the bladder. The procedure is performed under general or spinal anesthesia and is usually completed in a single session.

Which laser is more advantageous in prostate enlargement?

HoLEP with a holmium laser enables deep dissection; repeat rates in large prostates are below 7% in the long term. ThuFLEP with a thulium fiber laser offers finer, nearly bloodless cuts. Satisfaction rates are similar, while transfusion needs are lower. The decision is individualized based on prostate volume, comorbidities, and surgeon experience.

Latest technologies in prostate surgery

Laser techniques that optimize energy distribution and preserve ejaculation shorten operative time while delivering more effective results.

How long does laser prostate surgery take?

A standard HoLEP or ThuFLEP operation is completed in 45–90 minutes.

What is ThuFLEP?

Thulium fiber laser (ThuFLEP) uses continuous light at a 1‑µm wavelength to cut tissue without a blade. With power up to 200 W and shallow penetration depth, it keeps bleeding to a minimum.

What is HoLEP?

Pulsed holmium laser (HoLEP) operates at a 2.1‑µm wavelength; thanks to high water absorption, it can completely separate prostate lobes along the anatomical plane.

Postoperative period

Patients usually stay in the hospital for one night. Pink‑red urine on the first day is normal. Regular walking, adequate fluid intake, and avoiding heavy exercise for 2–3 weeks are advised.

When is the catheter removed after surgery?

After HoLEP, the catheter is removed in most patients within 1–3 days and in selected cases on the same day. In ThuFLEP it is usually removed within 24 hours.

Does the prostate grow back after laser surgery?

After HoLEP, the need for re‑operation within five years is about 6.6%. ThuFLEP outcomes are similar.

Side effects of laser prostate surgery

• Early stress urinary incontinence (usually < 8 weeks). Most patients regain full continence in 3–6 weeks; pelvic‑floor exercises can speed recovery.
• Retrograde ejaculation (30–70%)
• Rarely, temporary erectile dysfunction or urethral stricture
• Bleeding and transfusion needs are lower than with classic TURP.

Does laser prostate surgery affect sexuality?

New ejaculation‑preserving techniques increase early continence while reducing semen backflow. Orgasm and erection are generally preserved.

What happens if prostate surgery is delayed?

Untreated benign prostatic enlargement can lead to bladder wall hypertrophy, kidney function impairment, and frequent urinary tract infections.

When can sexual intercourse be resumed after ThuFLEP?

Sexual activity is typically allowed 4–6 weeks post‑operation, provided urinary flow is regular and there is no pain. The exact timing should follow the surgeon’s advice.

HoLEP & ThuFLEP prostate surgery prices

The fee varies depending on hospital class, equipment, prostate volume, and insurance coverage. For an exact quote, please contact our hospital.

Frequently Asked Questions About Laser Prostate Surgery

1- Does laser prostate surgery hurt?

The operation is performed under anesthesia; afterwards mild burning may occur, and pain is usually controlled with paracetamol.

2- How long is the recovery time?

Most patients return to daily activities within 1–2 weeks; complete tissue healing takes 6–8 weeks.

3- Is bloody urine normal after surgery?

Pink‑red urine is expected for the first 1–3 days; consult your doctor if you notice clots or dark blood.

4- When can I do sports or lift heavy objects?

Avoid heavy exercise and cycling for 3–4 weeks; walking is encouraged.

5- Is ThuFLEP effective in large prostates?

It can be safely applied to prostates up to 250 mL in volume.

6- Is retrograde ejaculation permanent after HoLEP?

It is permanent in most men. Rates are decreasing with new techniques.

7- Is burning during urination after catheter removal normal?

Mild burning for the first few days is normal. If symptoms persist, a urine culture may be required.

8- What is the chance of needing repeat surgery?

The likelihood is below 7% within five years. The more tissue removed by laser, the lower this rate.