Here at the Sydney Prostate Centre, we are passionate about Holmium Laser treatment for BPH (Benign Prostatic Hypertrophy).
I believe that it offers significant advantages to a standard prostate resection1.
What we do is we put a telescope in through the eye of the penis.
We have a laser fibre that is inserted through the resectoscope.
The laser then works on the prostate and it cuts and seals at the same time.
It also uses saline for irrigation, the same thing we put in a drip, so if that absorbs into the system, there's no issue as opposed to a standard TURP (Transurethral Resection of the Prostate)2.
The Holmium Laser also cuts at the plane between the adenoma – the abnormal growing, central part of the prostate – and the capsule, so we get a wide clearance when we resect this.
This tissue is then removed piecemeal through the bladder and through the urethra, so there's no incision.
I've been doing the Holmium Laser now for over fifteen years, and I've been extremely happy with the clinical outcomes, which is consistent with a large prospective registry-based patient cohort study in 20243.
There is less bleeding, quicker recovery, shorter catheterisation and fewer complications.3
I believe this is now the platinum standard for BPH4, and this technique will be increasingly used throughout the world and Australia.
The main stumbling block is a steep learning curve5, and the cost of the laser.
Holmium Laser Information
HoLEP Information from British Association of Urological Surgeons
HoLEP Patient Brochure