Holep And Thulep

Laser enucleation of the prostate (also called Holmium laser enucleation of the prostate or HoLEP)

Laser enucleation is generally suitable for men who have an enlarged prostate over a certain size (usually 80 mL, approximately 4 times the size of a healthy prostate). The procedure involves a surgeon passing a thin device called a resectoscope through the urethra. The resectoscope has a high pulse laser at the end of it which removes the prostate gland and a camera that allows the surgeon to see a high-quality image on a video monitor. The prostate is cut into very small pieces and removed using a surgical tool passed through the urethra.

The procedure is done under a general anaesthetic or spinal anaesthetic so you will not feel anything.

At the end of the operation, a catheter is placed in your bladder to help drain urine while you recover from the surgery.

The catheter tube is inserted via the urinary opening in the penis. It is passed down the length of the penis, up the urethra and into the bladder. The catheter is inserted at the end of your surgery, so you will not feel any discomfort as you will still be asleep or numb (depending on the type of anaesthetic you have) when the catheter is placed.

You will not need to use the toilet to urinate while a catheter is in place as it drains urine out of the bladder, down the catheter tube and into a urine bag that your medical team will empty for you, as needed.

As well as draining urine from the bladder, the catheter also allows your doctor to flush your bladder and urethra with a sterile solution to help prevent blood clots.

The catheter will be removed once you can urinate on your own. Removing the catheter is usually done by a nurse and is very straightforward, with little discomfort.

You will usually be advised to avoid sexual activity for 2-3 weeks and it is not uncommon when you do to experience retrograde ejaculation. Sometimes called a dry orgasm, retrograde ejaculation is a condition where semen goes into the bladder, rather than through your urethra and out of your penis during an orgasm. It isn’t harmful and the semen will pass through the bladder when you pee, but it can cause fertility issues.

If you have undergone laser enucleation surgery and are producing little to no semen when you climax, have cloudy urine after sex, or your female partner is struggling to get pregnant, then you may wish to talk to your doctor about a test for retrograde ejaculation.

general anaesthetic is a controlled way of forcing you to fall asleep, so you are unaware of the procedure being done.

spinal anaesthetic is injected through a small needle in your lower back to numb the nerves from the waist down. Generally, it lasts 2-3 hours. You will be aware of what is happening around you but won’t feel any pain or discomfort.

A catheter is a thin flexible tube that is inserted into your bladder, allowing your urine to drain freely.

 A resectoscope is inserted through the urethra

The resectoscope removes the enlarged prostatic tissue

 

Laser vaporisation of the prostate

A thin device called a resectoscope is inserted through the urethra. The resectoscope has a laser at the end of it which uses heat to destroy part of the prostate tissue, and a camera that allows the surgeon to see a high-quality image on a video monitor. The procedure is done under a general anaesthetic or spinal anaesthetic so you will not feel anything.

At the end of the operation, a catheter is placed in your bladder to help drain urine while you recover from the surgery.

The catheter tube is inserted via the urinary opening in the penis. It is passed down the length of the penis, up the urethra and into the bladder. The catheter is inserted at the end of your surgery, so you will not feel any discomfort as you will still be asleep or numb (depending on the type of anaesthetic you have) when the catheter is placed.

You will not need to use the toilet to urinate while a catheter is in place as it drains urine out of the bladder, down the catheter tube and into a urine bag that your medical team will empty for you, as needed.

The catheter will be removed once you can urinate on your own. Removing the catheter is usually done by a nurse and is very straightforward, with little discomfort.

You will usually be advised to avoid sexual activity for 2-3 weeks and it is not uncommon when you do to experience retrograde ejaculation. Sometimes called a dry orgasm, retrograde ejaculation is a condition where semen goes into the bladder, rather than through your urethra and out of your penis during an orgasm. It isn’t harmful and the semen will pass through the bladder when you pee, but it can cause fertility issues.

If you have had laser vaporisation and are producing little to no semen when you climax, have cloudy urine after sex, or your female partner is struggling to get pregnant, then you may wish to talk to your doctor about a test for retrograde ejaculation.

general anaesthetic is a controlled way of forcing you to fall asleep, so you are unaware of the procedure being done.

spinal anaesthetic is injected through a small needle in your lower back to numb the nerves from the waist down. Generally, it lasts 2-3 hours. You will be aware of what is happening around you but won’t feel any pain or discomfort.

A catheter is a thin flexible tube that is inserted into your bladder, allowing your urine to drain freely.

 A resectoscope is inserted through the urethra

The resectoscope destroys part of the prostate