In this guide
TECHNOLOGY, EXPLAINED VISUALLY
Equipment & illustrations
Enlarge ↗MOSES 2.0 / Pulse 120H
A holmium laser platform. In HoLEP, laser energy separates obstructing prostate tissue before it is removed from the bladder.
Image: Boston Scientific ↗
Enlarge ↗SOLTIVE
A thulium fibre laser platform for urological surgery. The specific prostate technique and available equipment are discussed with the surgeon.
Image: Olympus ↗
Enlarge ↗GreenLight XPS
GreenLight laser energy vaporises obstructing prostate tissue to create a more open channel for urine flow.
Image: Boston Scientific ↗START WITH THE MECHANISM
What happens to the obstructing tissue?
“Minimally invasive” describes a broad range of procedures. The treatment name alone does not tell you how much tissue is removed, how quickly symptoms improve or how long the benefit may last.
Enucleate or vaporise
Laser surgery separates and removes tissue, or vaporises it, to create a more open channel.
HoLEP · ThuLEP · GreenLightTreat with water vapour
Rezūm delivers steam into tissue. Improvement develops as the treated tissue shrinks.
RezūmOpen the passage
UroLift holds tissue apart with implants. iTind temporarily reshapes the outlet.
UroLift · iTindLaser procedures: two main approaches.
HoLEP & ThuLEP
Holmium or thulium laser energy helps separate the enlarged inner tissue from the outer prostate. The tissue is removed through the urinary passage, with material available for pathology.
Discuss the gland’s anatomy, expected catheter use, bleeding, temporary leakage and the likelihood of changes to ejaculation.
GreenLight
Laser energy vaporises obstructing tissue to improve the channel. It generally does not produce a substantial tissue specimen for laboratory examination.
Ask how your prostate size, medicines and priorities affect the choice between vaporisation and other approaches.
Ejaculation and erections are different functions. A change in ejaculation does not automatically mean erectile dysfunction. Discuss both explicitly.
MIST: less intervention, careful selection.
Rezūm water-vapour therapy
Steam is delivered into selected prostate tissue. Symptoms may temporarily worsen from swelling before improving. A catheter may be needed during early recovery. Ask about the expected pace of improvement and the possibility of further treatment.
UroLift prostatic urethral lift
Small permanent implants hold obstructing tissue away from the urethra. Prostate shape and size affect eligibility. Discuss implant-related considerations, expected relief, ejaculation and the possibility of needing another procedure later.
iTind temporary implant
A temporary device is placed to remodel the outlet and removed after a short period. It is not a permanent implant. Ask about appropriate anatomy, current evidence and local availability.
These procedures are options for selected patients, not a promise that every technique is available or appropriate at every centre.
How the decision is made.
- Confirm the causeConnect symptoms with urinary flow, bladder emptying, prostate anatomy and relevant tests.
- Identify complicationsRetention, repeated infection, bleeding, stones or impaired kidney drainage may change the recommendation.
- Discuss your prioritiesSymptom relief, ejaculation, anaesthesia, catheter use, recovery and durability all matter.
- Compare alternativesMedicines, TURP, Aquablation, simple prostatectomy or embolisation may also enter the discussion.
A clear recovery plan before you leave.
Clarify medicines, anaesthesia, catheter expectations and transport home.
Follow instructions for catheter care, fluids, activity and warning symptoms.
Review symptoms, flow, residual urine and any sexual or urinary side effects.
Inability to pass urine, fever with chills, heavy bleeding or painful clot retention needs urgent assessment.
Four questions worth asking.
- Why does this procedure suit my prostate and bladder?
- What changes in ejaculation or urinary control should I expect?
- How likely is further treatment, and what would the next option be?
- What is included in the recovery and follow-up plan?
Further reading: NIDDK: enlarged prostate · EAU: male urinary symptom treatment · Mayo Clinic: BPH treatments
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