Laser Prostate Surgery

• HoLEP Laser Technology advantages over TURP
• Powerful, efficient, high precision Holmium laser for treatment of prostate enlargement able to resect (enucleate) prostatic tissue

HoLEP (Holmium Laser Enucleation of the Prostate) is the state of the art surgical treatment for an enlarged and obstructing prostate and with increasing literature confirming it is the gold standard treatment for patients with an enlarged prostate (BPH) suffering from lower urinary tract symptoms.

It is minimally invasive and follows the exact anatomical planes within a prostate with ultimate precision allowing complete resection of adenoma (obstructing tissue) whilst preserving the outer capsule, erectile nerves and urethral sphincter.

Advantages of HOLEP over the older style TURP (“rebore”) is less bleeding, decreased catheter time and reduced hospital stay. This is possible because of a more efficient control over bleeding by the laser and the technique of enucleation whereby the tissue is cut only once as compared to repeated cuts in a TURP. Numerous articles such as below supports the benefits and superiority of HoLEP and over TURP.

Reference: Westhofen T, Schott M, Keller P, Tamalunas A, Stief CG &Magistro G, 2020, ‘Superiority of HoLEP over TURP in a matched-pair analysis of bleeding complications under various antithrombotic regimens’, Journal of Endourology, pp1-19.

The laser device used by A/Professor Louie-Johnsun is the CyberHo 100 – the revolution in HoLEP surgery.

The CyberHo Holmium laser brings outstanding innovation for the treatment of BPH (Benign Prostatic Hyperplasia), with high effectiveness, safety and durability.

Key features include;

• FAST CUTTING - The limited depth of penetration, together with the fast tissue incision, results in precise cut without affecting surrounding tissues
• RELIABILITY– clinical outcomes of HoLEP have been widely investigated, with many clinical studies demonstrating its safety and effectiveness also in the long run
• SIZE INDEPENDENT– HoLEP overcome the limitations affecting other BPH techniques regarding prostate size
• EFFECTIVE HEMOSTASIS– the Holmium radiation is highly absorbed by water, allowing quick coagulation of bleeding and minimising time off blood thinners which often don’t need to be stopped
• HIGH POWER– Up to 105 W output, for fast quick incision, cutting down treatment time

Further information and videos from Quanta System are provided below.

Prostate Enlargement (BPH) &
Urination Problems

If you are referred to Dr Louie-Johnsun for an assessment of BPH / LUTs, at your appointment you can expect to:

• Fill out a symptom score sheet (IPSS) and discuss the severity of your symptoms
• An assessment with a urinary flow rate followed by a bladder ultrasound scan to assess your ability to empty your bladder
• Prostate cancer risk assessment based on a PSA blood test result and a rectal examination of the prostate (DRE)
• Dr Louie-Johnsun will then discuss treatment options such as lifestyle modification, medications and surgery (including transurethral resection of the prostate (TURP) and Holmium laser enucleation of the prostate- HoLEP).

HoLEP (Holmium Laser Enucleation of the Prostate)

HoLEP is the state of the art surgical treatment for an enlarged and obstructing prostate and with increasing literature confirming it is the gold standard treatment for patients with an enlarged prostate (BPH) suffering from lower urinary tract symptoms.

It is minimally invasive and follows the exact anatomical planes within a prostate with ultimate precision allowing complete resection of adenoma (obstructing tissue) whilst preserving the outer capsule, erectile nerves and urethral sphincter.

Advantages of HOLEP over the older style TURP (“rebore”) is less bleeding, decreased catheter time and reduced hospital stay.  This is possible because of a more efficient control over bleeding by the laser and the technique of enucleation whereby the tissue is cut only once as compared to repeated cuts in a TURP. Numerous articles such as below supports the benefits and superiority of HoLEP and over TURP.

Reference: Westhofen T, Schott M, Keller P, Tamalunas A, Stief CG &Magistro G, 2020, ‘Superiority of HoLEP over TURP in a matched-pair analysis of bleeding complications under various antithrombotic regimens’, Journal of Endourology, pp1-19.

The laser device used by A/Professor Louie-Johnsun is the CyberHo 100 – the revolution in HoLEP surgery.

The CyberHo Holmium laser brings outstanding innovation for the treatment of BPH (Benign Prostatic Hyperplasia), with high effectiveness, safety and durability.

Key features include;

• FAST CUTTING - The limited depth of penetration, together with the fast tissue incision, results in precise cut without affecting surrounding tissues
• RELIABILITY– clinical outcomes of HoLEP have been widely investigated, with many clinical studies demonstrating its safety and effectiveness also in the long run
• SIZE INDEPENDENT– HoLEP overcome the limitations affecting other BPH techniques regarding prostate size
• EFFECTIVE HEMOSTASIS– the Holmium radiation is highly absorbed by water, allowing quick coagulation of bleeding and minimising time off blood thinners which often don’t need to be stopped
• HIGH POWER– Up to 105 W output, for fast quick incision, cutting down treatment time

• Dr Louie-Johnsun is also performing the UroLift® System treatment. This is a minimally invasive approach to treating prostate enlargement and symptoms by lifting the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.
• Clinical data has shown that the UroLift System treatment is safe and effective in relieving lower urinary tract symptoms due to prostatic enlargement without compromising sexual function. The goal of UroLift is to relieve symptoms so you can get back to your life and resume your daily activities earlier (please note this treatment is NOT suitable for every patient)