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Laser enucleation is usually recommended for men with a large prostate, typically four times the normal size. During the procedure, a surgeon inserts a thin tool with a laser and camera called a resectoscope, through the urethra.
The laser removes the extra prostate tissue, which is then broken into small pieces and taken out through the same tool.
You’ll be given either general or spinal anaesthesia, so you won’t feel any pain during the procedure.
A general anaesthetic is a controlled way of forcing you to fall asleep, so you are unaware of the procedure being done.
A 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.
At the end of the surgery, a thin, flexible tube called a catheter will be gently placed in your bladder to help drain urine as your body heals.
The catheter is inserted through the opening in the penis, down the urethra, and into the bladder. Since you’ll still be asleep or numb when the catheter is placed, you won’t feel discomfort.
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 bag that your medical team will empty for you, as needed. The catheter also helps flush the bladder and urethra to prevent blood clots.
The catheter will be taken out soon after surgery, once you're able to urinate on your own. The nurse will remove it, and it’s a simple process with little discomfort.
You’ll likely be advised to avoid sexual activity for 2–3 weeks after the procedure. When you do resume, it’s common to experience something called "retrograde ejaculation". This means that during orgasm, semen flows backward into the bladder instead of out through the penis. This is sometimes called a dry orgasm. It’s not harmful, and the semen will leave your body when you urinate, but it can affect fertility.
If you’ve had laser enucleation and notice little or no semen during orgasm, have cloudy urine after sex, or if your female partner is having trouble getting pregnant, it might be helpful to talk to your doctor about testing for retrograde ejaculation. This is when semen enters the bladder instead of coming out through the penis. This is something you should discuss with your doctor to understand the risks.
This chapter provides general information about laser enucleation of the prostate to treat BPE. It is not a replacement for professional medical advice or treatment. Always consult your doctor or healthcare provider for guidance on your individual medical situation.
Last updated: May 2025