Laser Prostatectomy is a surgery in which the surgeon passes a thin telescope down the urethra and then slides a very fine end-firing laser fibre, measuring 550-um in diameter down the telescope. This fibre delivers the laser energy at a power setting of 2.0 joules at 50 hertz (100 watts) and is used to carefully remove the excess prostate tissue that is causing obstruction of the urethra. This tissue is carefully dissected from within the prostate capsule by a process called enucleation and removes as much prostate tissue possible.
The procedure is also known as Holmium Laser Enucleation of the Prostate (HoLEP). The residual fragments or lobes of the prostate are passed in to the bladder. The residue is further cut in to smaller fragments by morcellator and then extracted.
When the surgeon has finished lasering your excess prostate tissue a catheter will again be inserted. Depending on the time of your surgery the catheter will be removed on the evening of surgery or early in the morning. Most people are able to be discharged catheter free within 24 hours of the HoLEP procedure.
In this procedure, the capsule of the prostate remains intact, and at the end of the operation the inner surface of the capsule is raw, which heals over the next month or so.
The procedure can be carried out under a general or spinal anesthetic (where you are awake but numb from the waist down). Your anesthetist will help you to decide which type is most appropriate for you.
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