Laser surgery in Nigeria: what it really treats for kidney stones, prostate, piles and fibroids

Why the word 'laser' sells

Laser sounds painless, modern and cut-free, so it is a popular word on clinic banners and flyers. In surgery, a laser is a thin fibre that delivers light energy to break, cut or seal tissue, usually passed through a telescope or a needle. What decides your result is the operation it is part of, whether that operation suits your condition, and how often the surgeon does it.

So when you see 'laser surgery', ask: which operation exactly, by name? Is it the recommended treatment for my condition, or one option among several? What are the alternatives and their prices? How many has this surgeon done?

Kidney and ureteric stones: laser is the real, standard thing

In ureteroscopy, the urologist passes a thin telescope up through the urine passage and bladder to the stone, with no cut on the skin, and breaks it with a laser fibre. The fragments are removed or washed out, and a temporary soft tube (a stent) is often left for a short time. The laser used is usually a holmium laser or, increasingly, a thulium fibre laser. A 2024 review of 13 studies with 1,394 patients found the thulium fibre laser cleared stones a little more often and a little faster, with no difference in complications. Either way, the size and position of the stone and the surgeon's experience matter more than the brand of laser.

UK guidance (NICE) notes that for smaller stones in the ureter, shockwave treatment from outside the body is also an option where it is available: ureteroscopy cleared stones slightly more often, while shockwave treatment meant less pain and a shorter stay. Many small stones need no procedure at all and pass with water and pain relief. Our guide 'Kidney stone: will it pass on its own, or does it need to be removed?' explains when to wait.

On Mezo, ureteroscopy and laser stone removal is from ₦1,500,000, with the laser fibre, the stent and its removal included in the all-in rate.

Enlarged prostate: real, but specialist work

'Laser prostate surgery' covers several different operations, and they are not equal. UK guidance (NICE) says that when a man needs an operation for an enlarged prostate, the operations to offer are TURP, a related operation called TUVP, or holmium laser enucleation of the prostate (HoLEP), and that HoLEP should be done at a centre that specialises in it or with mentoring in place. The same guidance says laser vaporisation techniques should only be offered within research trials comparing them with TURP, and that laser coagulation should not be offered as an alternative. You may also see ThuLEP, a similar enucleation using a thulium laser; ask the same questions about it.

Mezo does not offer HoLEP or ThuLEP at present. TURP, the long-established operation, is from ₦1,700,000 on Mezo. Many men with an enlarged prostate do not need an operation at all: our guide 'When does an enlarged prostate need surgery?' covers tablets and when surgery helps.

Piles: laser is newer, and the long-term evidence is thin

Laser haemorrhoidoplasty uses a thin laser fibre to shrink a pile from inside. A 2023 review of nine studies with 661 patients, all with grade II or III piles, found less pain, less bleeding and a quicker return to work in the first weeks compared with standard pile surgery, and similar rates of symptoms returning at 12 months. The authors said larger, better trials are still needed, and it has mainly been studied in moderate piles, not the largest ones.

Most piles never need an operation: softer stools, more fibre and water, and simple treatments in clinic often settle them. Mezo does not offer laser treatment for piles. It prices haemorrhoid surgery from ₦800,000, with rubber band ligation in clinic listed on the same page. Our guide 'Do I need surgery for piles?' explains the steps before surgery.

Fibroids: laser is not an established treatment

UK guidance (NICE) has looked at two laser methods for fibroids: removing fibroids with a laser through keyhole surgery, and shrinking them with laser fibres passed through needles under MRI guidance. For both, NICE found the evidence on safety and effectiveness not adequate for routine use, only with special arrangements for consent and audit or research.

The established treatments are medicines for heavy bleeding, myomectomy (removing the fibroids and keeping the womb), hysterectomy, and for some women uterine artery embolisation, which blocks the fibroids' blood supply. If a clinic offers 'laser fibroid removal without surgery', ask exactly what it is and what evidence supports it. Myomectomy on Mezo is from ₦1,000,000.

Questions to ask when a clinic offers laser

• What is the full name of the operation, and is it a recommended treatment for my condition?
• What are the alternatives, including no operation, and what do they cost?
• How many of these have you done, and what happens if it does not work?
• Is the laser fibre included in the quote, or charged separately?
• Will I need a second procedure, such as stent removal, and is it included?
• Who looks after me if there is a problem after I go home?

Common questions