The Role of Holmium Laser in Treating Urological Diseases

The Role of Holmium Laser in Treating Urological Diseases

Thanks to major medical advancements, laser beams have become increasingly common in treating urological diseases over the past few years. Patients suffering from benign prostatic hyperplasia (BPH) and urinary tract stones can benefit from laser-based treatments.
Research indicates that many traditional surgical procedures have gradually declined due to the advantages of laser treatment, which is considered safer, more precise, requires shorter hospital stays, and has a lower recurrence rate due to the efficiency of the treatment. Among the most common types of lasers is the holmium laser. Let's take a look at the main applications of the holmium laser in the treatment of urological diseases:

1- Treatment of benign prostatic hyperplasia (BPH) with holmium laser:

The holmium laser effectively treats benign prostatic hyperplasia. This condition causes the prostate gland to enlarge, leading to pressure on the urethra and urinary obstruction. Benign prostatic hyperplasia usually occurs in older men and results in pain, discomfort, and difficulty urinating.
The holmium laser enucleation of the prostate (HoLEP) is one of the most effective methods for treating benign prostatic hyperplasia. This option is less invasive and carries lower risks than traditional surgery. Holmium laser prostatectomy provides rapid relief from symptoms, a short recovery period, and fewer complications after the procedure. 
This procedure uses the laser to remove problematic prostate tissue without any incisions. A scope is inserted through the penis to target the prostate tissue causing urinary obstruction. The holmium laser then cuts and enucleates the enlarged portion, separating it within the bladder. A morcellator is then used to suction, fragment, and remove this tissue. Some of the key benefits of this technique include:
- There is no risk of bleeding, as the holmium laser closes the arteries and veins of the prostate before separating the tissue.
- The urinary catheter can be removed after 12 hours, regardless of the size of the enlargement, allowing for a short hospital stay of no more than 24 hours due to the absence of bleeding risk.
- The patient does not require a blood transfusion.
- A saline solution is used, similar to what anyone receiving intravenous care in the hospital would receive, thus having no negative impact on the heart or brain.
- There is no impact on erectile function, as the procedure does not involve the use of electrical current that could affect the erectile nerves.

2- Treatment of urinary tract stones with holmium laser (Holmium Laser Lithotripsy):

Holmium Laser Lithotripsy is a minimally invasive procedure that does not require incisions. After anesthetizing the patient with general anesthesia, a ureteroscope is inserted into the urethra and bladder to access the ureter and kidneys. Once the stone is identified, laser fibers transmit holmium energy to break down the kidney stones. Dr. Enmar Mohamed Habib removes some fragments through the urethra, and smaller pieces can be passed later during urination. The main features of this procedure include:
- The holmium laser is distinguished from other types of lasers by its ability to fragment large stones and treat all types of stones, crushing them into small pieces.
- Holmium laser treatment is a procedure with no complications, bleeding, or impact on erectile function.
- The patient can be discharged from the hospital after a few hours of monitoring, with no need for an overnight stay.

3- Urethral stricture treatment with the holmium laser (Holmium laser urethrotomy):

The holmium laser is also used to treat cases of urethral stricture. This technique is characterized by the ability to combine multiple procedures at the same time if the situation requires it. For example, if a patient has benign prostatic hyperplasia that has led to the formation of urinary stones, both issues can be treated with the same procedure. Additionally, if the prostate enlargement has caused urethral stricture, the patient can undergo a single holmium laser procedure to address both problems. It is important to note that the effectiveness of the holmium laser largely depends on the urologist's experience.

Dr. Enmar Mohamed Habib, Professor of Urology and Pediatric Urology at Cairo University and Fellow of McGill University, Canada, is an expert in the treatment of benign prostatic hyperplasia and urinary stones using holmium laser. So, do not hesitate to contact him now.