Differences between Holmium laser and GreenLight laser

• Laser technology replaces more conventional surgery to treat prostate conditions such as Benign Prostatic Hyperplasia (BPH) and the presence of kidney stones in the urinary system.
• GreenLight laser removes benign prostate tissue with vaporisation, as does the Holmium laser. However, the most common Holmium technique is enucleation, which can also be used to treat bladder stones.
• In prostate surgery, the GreenLight Laser is recommended for medium and small prostates and the Holmium Laser for any type of prostate, regardless of its size.

Before discussing the differences between these lasers, it is important to know what they are used for. GreenLight laser and the Holmium laser treat conditions in the prostate, such as an enlarged prostate. 

Holmium laser also treats stones in the kidney, bladder or ureter so that they can be passed in the urine, in the form of grit.

An enlarged prostate is also known as benign prostatic hyperplasia (BPH) and is a condition that obstructs the outflow of urine through the bladder, resulting in a loss of quality voiding function in men. An enlarged prostate can cause difficulty in initiating urination, the sensation of not being completely emptied or the need to urinate, often at night.

On the other hand, kidney stones can affect any part of the urinary tract, from the kidneys to the bladder. In any case, the presence of these stones in the urinary system can result in symptoms such as pain in the abdomen, a burning sensation when urinating, or even blood in the urine. However, there are times when stones do not present any symptoms until they start to move through the kidney or pass through the ureter.

Laser treatment comes to urology with the aim of avoiding conventional surgery and its associated risks such as surgical wounds, heavy bleeding and the frequent need for blood transfusion. In addition, with the laser technique, the hospital stay is shorter, as is the duration of the surgery.

Here we tell you all about the differences between one laser and the other, as well as the advantages of each of them for benign prostatic hyperplasia.

The main reason for prostate surgery is prostate enlargement, i.e. benign hyperplasia, or the presence of kidney stones in the urinary system. In either case, the symptoms are very bothersome and reduce the quality of urination.

The laser has landed in the urological specialty to treat this type of condition in a faster, more effective and safer way. In this way, the disadvantages associated with more traditional techniques are avoided but the good results are maintained.

Both green and Holmium lasers are suitable for treating Benign Prostatic Hyperplasia. However, the size of the prostate adenoma will determine which laser is the perfect one to solve the problem. 

In addition, the versatility and characteristics of the Holmium laser make it possible to treat other types of conditions such as kidney and bladder stones.

GreenLight laser is a minimally invasive technique for treating benign prostatic hyperplasia (BPH). The technique involves inserting a small fibre through the urinary tract, i.e. the urethra. 

High-powered laser energy is transmitted through this fibre, which evaporates the tissue compressing the urethra and photo coagulates the blood vessels, preventing the possibility of bleeding.

GreenLight laser allows the urological sector to forget about open surgery to treat BPH obstruction.

With the green laser technique (GreenLight XPS), the same results are obtained as with traditional surgery but with fewer complications. In addition, it does not cause irritating symptoms unlike TURP of the prostate. 

GreenLight laser prostate vaporisation is usually performed under general, spinal or epidural anaesthesia or sedation.

Before laser technology reached the medical sector, open surgery was reserved for patients with very large prostates and transurethral surgery for medium and small prostates. Today, the GreenLight laser can operate on prostates of 60 - 80 cc.

This system for treating Benign Prostatic Hyperplasia (BPH) is one of the most important advances that has been developed in the last 25 years to provide a solution to this pathology that affects millions of men between 50 and 60 years of age.

Holmium laser is a minimally invasive treatment compared to open surgery or transurethral resection. The Holmium laser is the treatment indicated for prostates larger than 60 cc (even larger than 100 cc), in which the entire part of the prostate that can obstruct the flow of urine is removed without making incisions.

Holmium laser can be performed on prostates of any size.

Enucleation, a Holmium Laser technique for treating benign prostatic hyperplasia, consists of inserting a lubricated cystoscope to access the prostate. Once inside, the area is enucleated, separating the prostate adenoma from the prostate capsule.

A simile to help you understand the technique: if we compare it to an orange, what the Holmium laser does is separate the segments, i.e. the adenoma, from the skin of the orange, which would be the prostate capsule.

Broadly speaking, enucleation works just as you have read. However, you can find more detailed information by clicking here: Holmium Laser Prostate Surgery.

In addition to Benign Prostatic Hyperplasia, the Holmium Laser can be used to treat other conditions, such as kidney stones.

Holmium laser makes it possible to remove kidney stones from any part of the urinary system without making any incisions in the patient. 

In addition, unlike non-laser, i.e. extracorporeal, lithotripsy, with the Holmium laser, most of the debris can be removed during the procedure itself.

Holmium laser is the recommended technique for lithotripsy, as it ensures 95% success.

Laser technology has reached the urology sector to intervene in prostate conditions such as Benign Prostatic Hyperplasia, i.e. prostate enlargement, and thus avoid open surgery and discard the disadvantages associated with it such as: the surgical wound, slow recovery, the frequent need for transfusion, etc.

Laser intervention is a minimally invasive surgery to treat Benign Prostatic Hyperplasia in which the adenomatous tissue that has grown throughout life is removed. 

Just as open surgery was reserved for large prostates and Transurethral Resection (TURP) for small or medium sized prostates, the laser has arrived to replace these two more conventional surgical techniques.

GreenLight laser uses a photovaporisation system to treat an enlarged prostate. It is a very effective and safe technique that improves symptoms caused by benign prostate enlargement. 

On the other hand, the Holmium laser uses the enucleation technique to remove the prostate adenoma, whatever its size.

Below you can read the most important differences between the Holmium laser and the GreenLight laser:

• The GreenLight laser technique is simpler and is therefore more widespread in the medical sector and more accessible to patients.
• The Holmium laser technique is more difficult to learn and requires more experience than with other lasers. However, hospitals that perform prostate surgery with the Holmium have a group of professionals who are experts in the technique.
• With the GreenLight laser, the vaporisation technique is used to remove prostate tissue.
• The Holmium laser can remove the prostate adenoma with vaporisation or enucleation, the latter being the most common Holmium technique.
• The GreenLight laser is the recommended technique for patients with medium and small prostates.
• The Holmium laser is the appropriate technique for patients with prostates larger than 60 grams. However, the Holmium laser can operate on prostates of any size.
• The GreenLight laser completely vaporises the tissue, making histopathological analysis impossible to check for alterations in the structure or to determine the cause of the hyperplasia.
• The Holmium laser allows a sample of the prostate tissue to be taken for later analysis.

Laser treatment for prostate surgery reduces postoperative complications to 0 - 1 %.

Although the laser technique involves a specific patient profile and circumstances to recommend one laser or the other, it will be the doctor who determines the suitability of the greenlight laser or the Holmium laser.

The greenlight laser has a vaporisation system that is ideal for treating benign hyperplasia. 

This technique selectively vaporises and photo coagulates tissue and blood vessels, respectively. It is an effective, fast and safe procedure with the following advantages:

• It improves symptoms quickly.
• It does not affect sexual function and does not cause incontinence.
• The postoperative catheterisation lasts less than 24 hours.
• Likewise, it is not necessary to stay in hospital for more than one day.
• Minimal bleeding.
• GreenLight laser vaporisation is a technique recommended for patients taking anticoagulants and has a high risk compared to surgery.

Holmium laser is a surgery performed through the urethra where the surgeon looks for the boundary between the prostate and the adenomatous tissue to laser cut and coagulate the surface. In this way, he achieves precision and minimal bleeding, which is not achieved with other surgical techniques.

In addition to this, Holmium laser has a number of advantages:

• Any size prostate can be operated on.
• No incision is made in the abdomen.
• No surgical bleeding.
• The catheter is removed quickly.
• Minimal hospital stay.
• Bladder stones can be treated, i.e. kidney stones can be removed.
• Short and long-term results.
• Low reoperation rate.

Operarme has the collaboration of several hospitals throughout the country, with a high level of experience in laser technique, in which both prostate surgery and lithotripsy are carried out.

If you would like to request a surgical assessment consultation so that the specialist in charge can check the surgical necessity and determine your suitability as a patient, we remind you that Operarme offers you a first appointment free of charge, immediately and without obligation.

To book your free surgical assessment consultation you can call us on +34 91 141 33 56 or fill in the contact form. 

After the request, a member of Operarme’s Patient Service team will contact you to arrange the consultation and/or answer any questions you may have.

If you wish, you can also request this free consultation by clicking on the following image: