Holmium laser

What is the Holmium Laser and How Does it Work?

1. Type of Laser: The Holmium laser is a solid-state laser operating at a wavelength of 2,100 nanometers. This specific wavelength is highly absorbed by water and biological tissues, making it effective for use in human tissue.
2. Mechanism of Action: The laser produces energy transmitted via an optical fiber. When this laser energy contacts tissue, it produces several effects:
   • Ablation: The removal of diseased or unwanted tissue.
   • Cutting and Excision: It allows for precise tissue cutting with minimal damage to surrounding tissues.
   • Coagulation: Helps control bleeding, as the heat generated by the laser can seal blood vessels.
3. Use in Benign Prostatic Hyperplasia (BPH): In the case of BPH, the Holmium laser is used for prostate enucleation. This procedure involves using the laser to precisely cut and remove the enlarged prostate tissue that is blocking urine flow. The removed tissue is then fragmented and extracted from the body.
4. Advantages:
   • Reduced Bleeding: Compared to more invasive techniques, the Holmium laser produces less bleeding.
   • Precision: Allows for the removal of tissue with high precision, avoiding damage to surrounding healthy tissues.
   • Faster Recovery: Patients generally experience a quicker recovery and fewer postoperative complications.
5. Diverse Applications: In addition to its use in BPH, the Holmium laser is used in the fragmentation of kidney and ureteral stones, and in other urological procedures.

The Holmium laser allows access through the urethra, replicating the same procedure as in open surgery but in a safer manner. Thanks to the laser, it is possible to enucleate the prostatic adenoma, introduce it into the bladder, and extract it through the urethra. This entire process is conducted without causing incisions or wounds in the patient.

Advantages of Prostate Surgery with Holmium Laser

According to the results published with this surgical technique, the Clinical Practice Guidelines issued by the European Association of Urology (which are reviews of works published in top scientific journals by experts in the field) recognize only one surgical procedure as optimal for the treatment of any prostate size with the same functional results as open surgery, but with far fewer complications: Holmium laser prostate enucleation (Holmium).

Less Pain and Symptoms

In line with this, and according to research published in the journal PLoS One, the use of the Holmium laser results, on one hand, in lower rates of pain in the genitourinary area, and on the other, reduces the aforementioned symptoms of the lower urinary tract (incontinence, urinary urgency, nocturnal enuresis). This is a significant advantage when compared with other surgical procedures used in the treatment of benign prostatic hyperplasia.

Does Not Affect Erectile Function

One of the aspects that most concerns patients after surgery is the side effects on their sexual life. Therefore, it is important to highlight that Holmium laser prostate enucleation does not affect sexual function or the ability to have an erection. However, it does affect ejaculatory function.

This circumstance can occur in patients who have undergone surgery to resolve their benign prostatic hyperplasia.

The procedure of Holmium laser prostate enucleation is straightforward, requiring only epidural anesthesia, and its less invasive nature means that patients with benign prostatic hyperplasia develop fewer side effects.

Patients with this condition generally present with a weak urine stream, difficulty in urination, the need to urinate at night, high daytime urinary frequency, and urgency to urinate.

Furthermore, prostate hyperplasia can eventually lead to complications such as bleeding, infection, formation of bladder stones, deterioration of kidney function, or even the inability to urinate, necessitating the use of a urinary catheter.