Prostate diseases, whose prevalence increases with advancing age, are among the top disorders that reduce the quality of life of men. Benign prostate enlargement, which is a problem that makes it difficult to urinate, can negatively affect patients' physical health as well as their psychology, work, social and sexual life. The HoLEP method has an important place in the treatment of this disease.
What is HoLEP?
HoLEP is a closed prostate surgery method. HoLEP surgery stands for "Holmium Laser Enucleation of Prostate", which means the removal of the enlarged prostate inner tissue (adenoma) from its capsule with the help of laser.
Benign Prostate Enlargement (BPH) is a condition in which the prostate growing with age obstructs the outlet of the bladder (urine bag) and prevents urine flow.
FOR WHICH DISEASES IS THE HOLEP METHOD SURGERY APPLIED?
The HoLEP method is used in the treatment of benign prostate enlargement. This method is used very effectively in the treatment of prostate enlargement of all sizes. Since the efficiency of other closed prostate surgery methods is low, especially in prostates of 80 grams or more, the HoLEP method is more preferred.
WHAT ARE THE ADVANTAGES?
In surgeries performed with the HoLEP method, the structure called the sphincter that provides urine retention remains outside the area of intervention. Since the sphincter structure is preserved during surgery, there is no problem of urinary incontinence after surgery.
Tissue depth affected by the HoLEP laser energy is very small. For this reason, it does not affect the nerves that are outside the prostate and provide erection (hardening), so there are no problems such as postoperative sexual dysfunction.
Bleeding is very rare in the HoLEP method compared to other surgical techniques. While the prostate tissue is removed, the blood vessels feeding it are burned with laser energy, so there is almost no bleeding.
Since all of the prostate tissue outside the capsule is removed, the risk of recurrence of the disease after HoLEP surgery is almost negligible.
After the operation performed with the HoLEP method, the duration of catheter stay and hospitalization time is shorter. Patients can return to their daily lives in the early period by experiencing a comfortable and rapid recovery process.
HOW IS HOLEP SURGERY APPLIED?
With the HoLEP method, prostate surgery is performed by entering through the urinary canal through an endoscope without any incision. The prostate tissue separated from its capsule with the help of laser is then separated into very small pieces in the bladder and taken out.
FREQUENTLY ASKED QUESTIONS ABOUT THE HOLEP METHOD
How long the catheter stays after surgery?
Although the duration of catheter after HoLEP surgery for the treatment of the prostate is shorter than TUR surgery, it is between 1-2 days on average.
What are the highlights of HoLEP?
This procedure is actually performed according to the principles similar to open prostate surgery. However, unlike open prostate surgery, it is performed completely closed without any incision. Compared to open prostate surgery, the amount of bleeding is much less, and the duration of catheter stay and hospital stay is shorter. Patients can return to their daily lives in the early period by experiencing a much more comfortable and rapid recovery process compared to open surgery. Since it is performed under wide and direct vision, there is no tissue left inside, so better results are obtained compared to open prostate surgery.
Other than HoLEP, what other closed surgery methods are performed with laser?
It is among the questions that are wondered which of the "state of the art technology in prostate surgeries" methods are. With each passing day, new methods of prostate treatment are emerging. Prostate surgery can be performed with TUR and Greenlight laser methods other than HoLEP.
How is HoLEP different from closed techniques?
In operations performed with closed methods such as TUR and Greenlight, the prostate tissue cannot be completely removed. The prostate tissue remaining in these surgeries can grow over time and cause similar complaints again after a while. In the HoLEP method, the risk of recurrence of the disease is almost negligible.
Does the patient's having chronic diseases affect HoLEP surgery?
Since HoLEP surgery is performed under anesthesia like other surgeries, it includes risk factors for anesthesia. However, it is safer than other techniques in people with chronic diseases due to the shorter operation time and less bleeding.
What should the patient pay attention to after the operation?
Patients can return to their daily work within a few days after surgery. HoLEP is a surgical technique that has a very fast and comfortable recovery process. However, a waiting period of 2-4 weeks is required, as in all surgeries, to be able to do in heavy work and to participate in sports activities.
What is benign prostate enlargement?
Benign Prostate Enlargement (BPH) is a condition in which the prostate growing with age obstructs the outlet of the bladder (urine bag) and prevents urine flow.
At what ages prostate enlargement is observed the most?
Benign growth in the prostate causes problems with urination in about half of men in their 50s and 60s, and in 90 percent of men in the older age group. BPH is thought to be related to hormonal changes in men with aging.
What are the symptoms of benign growth in the prostate?
Poor urine flow, intermittent urination, feeling of incomplete voiding, frequent urination, waking up at night, sudden urgency and blood in the urine are among the main symptoms of prostate enlargement.
What problems does the delay of the surgery cause?
In cases of advanced prostate enlargement that are delayed in the intervention, serious problems such as kidney failure may occur as well as deterioration of the patient's life comfort.
What methods are used to diagnose the disease?
While the examination of the prostate is important in the diagnosis of BPH, according to the patient's condition, tests and imaging methods such as Prostate Specific Antigen (PSA) test, urine flow test, post-voiding urine residual amount measurement, ultrasonography and cystoscopy are used.
Which treatments are applied in benign prostate enlargement?
Benign prostatic enlargement treatment methods are determined by the specialist physician according to the patient's condition. Depending on the severity of the patient's complaints, there are follow-up, drug therapies, interventional and surgical treatments that can be applied. If the patient has mild symptoms of BPH, they are followed up, if they are seen at a moderate level, medication and interventional methods are used, if they are seen at an advanced level, open surgery and closed prostate laser surgery methods are used.
Prepared by Memorial Medical Editorial Board.
11 October 2023
11 May 2021
