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HOLEP- LASER PROSTATE SURGERY




What is holmium laser?

Holmium laser is solid state, pulsed laser that emits light at a wavelength of 2.1 microns. It can be transmitted through optical fibres which makes them highly suitable for endoscopic surgeries especially in urology for treatments of stones, BHP, tumours. The laser is highly absorbed by water and has a shallow penetration depth( approx 0.4 mm) which minimizes the collateral damage to sensitive surrounding tissues, also provide better hemostasis.

What is the benefit of this laser surgery?

Laser surgery is the modern way of treatment which provides lesser post operative complications like bleeding, infections etc.


What is the prostate?

Prostate is an accessory male sexual gland that plays an important role in the formation of seminal fluid,its secretion provides nourishment to the sperms. It is situated just below and at the base of the urinary bladder of males. This is important for the reproduction. So after reproductive age group the function of this gland becomes very less.

What is bladder neck obstruction?

The neck of our urinary bladder gives origin to the urethra through which urine passes time to time. So when the bladder neck gets obstructed (by enlarged prostate or spasm),person will experience poor flow or inability to pass urine.


What medicine should I stop before this surgery?

Before HOLEP surgery blood thinning agents like anti platelet drugs( like aspirin, clopidogrel) , anti co agulants(Warfarin, Heparin, Dabigatran) should be stopped, however as there is decreased risk of bleeding in HOLEP surgery, in emergency patient can undergo HOLEP even when the medications are continuing.

In diabetic cases what is the advice?

The patient should be in a normal glycaemic status to undergo any kind of surgery as high blood sugar causes increased risks of infection and delayed healing. So, usually if the patient is on oral anti diabetic drugs, it is stopped after admission and Insulin injection is given after checking the blood sugar levels three times daily. After surgery this injectable regimen may again shifted to oral anti diabetic drugs according to the patients glycaemic status.


What should I bring for the admission day?

You should bring the Doctor’s prescription, all the pre operative reports (if already done before), all the relevant reports regarding previous treatments and investigations. Also bring personal use articles like toothpaste, brush, comb, shaving kit( for male) etc. and the regular medications taken at home. Avoid bringing mobile phones, any gadgets or any valuable things (like ornaments).

What is the pre operation test ?

Usually a complete hemogram (TLC, DLC, Hb, Platelet count), Coagulation profile (PTime, INR, APTT), Serology, USG-KUB, Uroflowmetry.

What is spinal anesthesia?

It is a type of regional anaesthesia where anaesthetic drugs are injected in a space called sub arachnoid space which is surrounding our spinal cord, by this all the sensations as well as activity function is lost for 3-4 hors below our waiste. The injestion is pushed from the back in sitting position.

Will I have permanent back pain after spinal anesthesia?

Not at all,post operatively there may be back pain and headache for few days but it is well controlled by analgesics and hydration( fluid intake).

When will I regain sensation after the anesthesia?

The anaesthetic drug action remains for 3 -4 hours, as the HOLEP surgery takes 2-3 hours, so patient regain sensation 1- 1.5 hours after surgery is over.