HoLEP

HoLEP Prostate Surgery

HoLEP surgery is the process of removing the enlarged prostate tissue from its capsule endoscopically using holmium laser energy. “HoLEP Surgery”, which is the most up-to-date surgical method used in the treatment of prostate enlargement and has become popular in Europe and America in a short time due to its superiority over other treatment methods, has taken its place as the gold standard treatment method in Urology Guidelines.

What is Benign Prostate Enlargement?

Benign Prostate Hyperplasia (BPH) is a condition where the prostate growing with age blocks the outlet of the bladder (urine drainage bag) around it and prevents urination. This situation causes problems with urination in about 50% of men in their 50s and 60s, and in 90% in the older age group.

Complaints such as weak urine flow, intermittent urination, feeling of incomplete voiding, frequent urination, waking up at night, sudden need to urinate, blood in the urine are the main symptoms. In advanced and delayed cases, it is an important health problem that causes serious problems up to kidney failure as well as impairing the comfort of life of the patient.

What is HoLEP Surgery?

HoLEP Surgery stands for “Holmium Laser Enucleation of Prostate”, which means the removal of the enlarged prostate inner tissue (adenoma) from the capsule with the help of laser. This is done 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.

What is the Advantage to Open Prostate Surgery?

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. The amount of bleeding is much less compared to open prostate surgery, the duration of catheter stay and hospitalization time 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 vision by seeing directly with the eye, there is no tissue left inside, so better results are obtained compared to open prostate surgery.

What Advantages Does It Provide Over Other endoscopic Techniques?

This technique has significant advantages over other endoscopic prostate surgeries (such as TUR and Greenlight). Since all of the prostate tissue outside the capsule is removed in HoLEP surgery, the risk of recurrence of the disease is almost negligible.

Since the prostate tissue cannot be completely removed in operations performed with endoscopic methods such as TUR and Greenlight, the results are not as satisfying as HoLEP, especially in large prostates. Prostate tissue remaining in these surgeries can grow over time and cause similar complaints again after a while.

Does it cause urinary incontinence and sexual dysfunction?

Tissue depth affected by the laser used in HoLEP surgery 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. Since the structure we call the sphincter that allows us to keep urine is outside of the area we intervene in this surgery and is protected, problems such as urinary incontinence are not observed after the procedure.