HOLEP – An Efficient procedure to Treat Enlarged Prostate:
Benign prostate Hyperplasia (BPH) is a common condition in the elderly. Several techniques under laser prostatectomy have evolved since 1980s to treat BPH. Among such techniques the more efficient and improved laser application is Holmium laser enucleation of the prostate (HOLEP). When compared to traditional trans-urethral resection of the prostate (TURP) – hospital stay and blood loss is significantly lower in the HOLEP procedure. Let us understand why HOLEP is a very efficient procedure.
What is the Prostate?
The prostate, a part of the male re-productive system, is about the same size and shape as a walnut and weighs about an ounce. It is located below the bladder and in front of the rectum and surrounds the urethra – a tube – like structure that carries urine out from the bladder through the penis.
What is BHP/BEP?
BHP (Benign Prostate Hyperplasia) or Benign Enlargement of the Prostate (BEP) is non-cancerous enlargement of the prostate and is a common cause of bladder outlet obstruction and lower urinary tract symptoms in men over 40 years of age. It is prevalent in men over 50 years of age to such an extent that two out of ten males will eventually require an operation to relieve the symptoms of BHP.
What are the common symptoms of Enlargement of Prostate (BEP/BPH)?
Since the prostate surrounds the urethra just below the bladder, its enlargement can result in symptoms that irritate to obstruct the bladder.
A common symptom is the need to frequently empty the bladder, especially at night. Other symptoms include difficulty in starting the urine flow or dribbling after urination ends. And also, the size and strength of the urine stream may decrease.
Is BPH a rare condition?
No, it is very common. It affects approximately 50% of men between 51 and 60-year-old and up to 90% of men over age 80.
Does BPH lead to Prostate Cancer?
No, BPH is not cancer and cannot lead to cancer. Still, both problems can happen at the same time. There may not be any symptoms during the early stages of prostate cancer. So, whether your prostate is enlarged or not, you should talk to your urologist whether the prostate cancer screening is right for you.
What are Treatment options for Prostate Enlargement?
BPH can be managed medically or surgically. The standard surgical treatment of BHP is transurethral resection of the prostate (TURP). However, relatively high morbidity associated with TURP has led to the development of minimally invasive techniques like HOLEP that use holmium laser.
What are the applications of lasers in Urology?
Lasers have a wide range of applications inn urology ranging from treatment of prostate enlargement, kidney stones, strictures (narrowing of urinary pipe) to urinary cancers. With the availability of 100 Watts Holmium lasers, stones of any size, any composition and any location within the kidney can be pulverized into dust.
What is HOLEP?
Holmium laser enucleation of the prostate (HOLEP) is a treatment for an enlarged prostate (BPH). During holep procedure, a laser is used to precisely remove the obstructive portion of the prostate, similar to open surgery without the need for incisions. During the procedure, surgeons remove the entire portion of the prostate gland that blocks urine flow. HOLEP improves urinary symptoms and provides a lasting solution as there is nothing to grow back following this procedure. HOLEP is an effective and less invasive alternative to older, more traditional methods of removing prostate obstructions. In addition, HOLEP preserves removed tissue for microscopic examination.
What if I deny the surgery indicated for me?
A syndrome of bladder decompensation will eventually develop if the symptoms persist for long. This can manifest as an accumulation of residual urine, which can lead to re-current urinary tract infections and the formation of bladder calculi. In severe cases, acute urinary retention can occur and obstructive nephropathy can develop if high voiding pressures are transmitted back to the kidneys.
What are the advantages of holep over conventional TURP?
- Significantly less bleeding compared to TURP
- Discharge is often quicker (within 1-2 days) than after TURP
- No upper size limit of prostate that can be removed
- The chance of recurrence requiring further surgery is very low
- The PSA (Prostate Specific Antigen) generally drops to very low levels after HOLEP operation
What is the effect of removal of the Prostate Tissue?
When the obstructing tissue is removed there will be an immediate improvement in your urine flow and as the prostate cavity heals, urinary symptoms will improve further.
With this right treatment approach, which is less invasive and effective you can get back to normal life. And therefore, to ensure that your treatment is comprehensive and consistent with your medical history, schedule an appointment with a urologist.
-Source: THE HINDU (News Paper)