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Dr. Dinesh Kumar TP

Consultant - Urology, Andrology and Kidney transplant Surgeon

Manipal Hospitals, Mysuru

Basics To Know About Holmium Laser Enucleation Of The Prostate (HoLEP)

Posted On: Jan 29, 2024

blogs read 3 Min Read

HoLEP Surgery - Featuers Advantages and DisAdvantages

Benign prostatic hyperplasia (BPH) generally occurs in older men. As you age, your hormone levels change. This leads to non-cancerous growth of the prostate gland. Symptoms of such conditions may include:

  • Frequent urination
  • Hesitancy in urination
  • Nocturia

 

The medical community has developed new treatments for BPH. One such technique is Holmium Laser Enucleation of the Prostate (HoLEP). In this article, we will explore further how urology interventions have improved using this approach.

BPH Indications

When you have BPH, your prostate gland starts to worsen gradually. This affects your urethra and prevents you from urinating normally. Such a condition indicates the need for HoLEP. By being able to remove the tissues precisely, HoLEP can cure this obstruction.

 

Contraindications of HoLEP

Certain health concerns may make HoLEP an unsuitable option for BPH. It is critical to talk to a medical specialist to know if you can avail of this procedure. 

Here, we have enlisted the most common issues. Refrain from HoLEP if your medical history shows any of the following.

  • Active Urinary Tract Infection (UTI): Generally, doctors do not opt for HoLEP if you have an active UTI. It may spread the infection. So, complete treatment of UTI is crucial before proceeding with the treatment plan.

  • Prostate Cancer: HoLEP is not suitable for patients with prostate cancer. A thorough evaluation is necessary to rule out malignancy before considering the procedure.

  • Unfit for Anaesthesia: HoLEP is nothing different than a surgical procedure. So, you need to be fit enough to bear anaesthesia. Doctors will assess your medical conditions thoroughly to make sure you are suitable. 

What Are the Advantages of HoLEP?

There are pretty evident reasons why HoLEP is one of the most popular procedures for treating BPH. Let us check out the advantages of this procedure. 

  • Effective Tissue Removal: This is the primary objective of HoLEP. The precision capacity of this procedure is an effective way of removing prostatic tissue and eliminates the drawbacks of conventional surgical procedures. 

  • Minimal Bleeding: The laser used for HoLEP has a dual action. It can cut and coagulate blood vessels simultaneously. Such a technology reduces intraoperative and postoperative bleeding and also keeps the surgical site clean minimising the chances of infection.

  • Quick Recovery: HoLEP is a minimally invasive surgical procedure. This allows patients to recover faster than traditional methods. This, in turn, will ensure a quick return to your normal lifestyle as well.

  • Reduced Risk of TURP Syndrome: Transurethral Resection of the Prostate (TURP) syndrome is a potential complication in traditional prostate surgeries caused by the absorption of electrolytes into the bloodstream. Since HoLEP procedure causes minimal electrolyte loss, there is a reduced risk of developing TURP.

What Are the Disadvantages of HoLEP?

Everything in this world has both its upsides and downsides. HoLEP is also no different. So, let us check out the disadvantages of this procedure.

  • Learning Curve: HoLEP requires specialised skills. Professionals must have a certain level of technical expertise to handle this procedure. So, urologists may need training to become proficient.

  • Equipment Cost: The initial setup cost for the laser equipment used in HoLEP can be higher compared to traditional methods. Even though it might be a huge investment, its long-term benefits make the expense worth it.

  • Postoperative Irritative Symptoms: Some patients may experience irritative voiding symptoms temporarily after the procedure. The symptoms may include:

    • A feeling of urgency for urination
    • Frequent urination
    • Discomfort during urination.

If you have any doubts related to this procedure, consult an experienced professional at Manipal Hospitals Mysore to ensure you are walking on the right path.

Salient Features of HoLEP

  • Laser Technology: HoLEP utilises a holmium laser for the procedure. This can vaporise the prostate tissue effectively. Such precision makes HoLEP quite popular in the urological field.

  • Enucleation Technique: The traditional method used to remove parts of the prostate. Contrarily, HoLEP involves enucleation. This means it completely removes the obstructive tissue and treats BPH symptoms. 

  • Clear Visualisation: The procedure allows urologists to target the affected area precisely with excellent visibility. They can easily navigate their way through the intricate anatomy of the prostate. Additionally, it does not damage the surrounding structures.

  • Reduced Catheterisation Time: HoLEP is associated with a shorter period of catheterisation. With minimal trauma to your urinary tract, it promotes faster recovery. This quicker healing procedure allows you to resume your normal urinary function more rapidly. 

  • Applicability to Various Prostate Sizes: HoLEP is suitable for any prostate size. This versatility makes the treatment suitable for different degrees of BPH.

For individuals experiencing prostate problems, it is advisable to consult an expert urologist for a thorough evaluation. Only with a thorough check-up can they suggest if HoLEP suits you or not. If not, they will prescribe some other treatment approach.

FAQ's

No, if you have UTI or prostate cancer, your doctor may not recommend HoLEP surgery. Also, if your body is unfit for anaesthesia, this procedure may not suit you.

HoLEP surgery is a minimally invasive procedure that ensures reduced intraoperative and postoperative blood loss. It also promotes faster recovery and catheterisation time. Most importantly, HoLEP is suitable for any prostate size.

The urologist first checks the prostate with the help of an endoscope. Next, they position a thin laser fibre near the prostate tissue. Finally, a holmium laser is used to cut and vaporise the obstructive tissue precisely.

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