Holmium Laser Enucleation of Prostate Surgery (HOLEP)

One of the most common health problems among men aged 50 and above is prostate enlargement. Prostate enlargement can occur and exhibits symptoms such as problems with urinating, frequent urinating at night, interrupted urinating, and frequent urinating in general, and there are various treatment methods.

The treatment is selected based on the patient’s complaints, and laser prostate surgery (Holmium laser prostatectomy; HOLEP) is one of the most preferred methods. As a blood-free surgical technique, HOLEP, by help of a laser probe removal the enlarged adenoma from the outer capsule of the prostate obtained. Thus, the possibility of relapse is eliminated. This technique is the gold standard as one of the most successful prostate enlargement treatments.

What is Prostate Enlargement?

Benign prostate enlargement, known as benign prostate hypertrophy (BPH),is a common problem among men over 50 years of age. Prostate enlargement can be defined as enlargement of the glands inside the prostate, causing stricture in the urinary tract.

This problem makes it harder to urinate, and the patient must squeeze the bladder to urinate. If BPH that causes urinating problems is left untreated, it can cause different health problems, such as kidney failure. For prostate enlargement, two treatment methods, medication and surgery, are commonly hused. Te selected method is determined based on the patient’s complaints.

If the patient does not respond to medication; if a catheter must be used to empty the bladder; if the patient has too many complaints; if there is residual after urinating; and if the patient has a chronic infection, stone formation, and bleeding, surgical methods are preferred.

The most preferred surgical method in recent years has been holmium laser enucleation of prostate surgery (HOLEP).

What is Holmium Laser Enucleation of Prostate Surgery?

Prostate enlargement, which significantly decreases quality of life, is seen in 40% of men over 60 years of age. Most patients have mild complaints and are treated with medication. However, patients with bladder stones, high urea levels, kidney dilatation, bleeding with urination, and frequent urinary tract infections can undergo surgical treatment. Especially for medium- and large-volume prostates, holmium laser enucleation of prostate surgery (HOLEP) is preferred over open surgery, and HOLEP is effective against all prostate sizes.

HOLEP helps eliminate urinary tract obstructions in patients who experience benign prostate enlargement problems. HOLEP is performed without any incisions or blood. By entering from the urinary tract, HOLEP is a safe method, as it has lower complication rates and more functional results. Laser prostate operations were first performed in 1995 abroad, and this is the most preferred method in our country in recent years.


How is Holmium Laser Enucleation of Prostate Surgery Performed?

holmium laser enucleation of prostate surgery, which is one of the most common methods preferred for men with prostate enlargement problems, is performed in the operating theatre.

The operation rarely needs general anesthesia and mainly used spinal anesthesia (numbing below the waist). An endoscopic device is inserted into the urinary tract, and the enlarged prostate is separated from the prostate and pushed toward to the bladder. Different endoscopic equipment is used after this operation to morcellate the tissue separated from the prostate, and this tissue is removed from the urinary tract without cutting the tissue.

A catheter is inserted after the operation, and in some cases, a catheter might not be required. Patients who undergo laser prostate surgery will be hospitalized for 1 or 2 days and discharged later. After removing the catheter, the urine must appear clear without any blood. Since problematic prostate tissue is removed during surgery, there is no risk of prostate enlargement relapse.

How Long does HOLEP Surgery Last?

The diagnostic methods for BPH in men with prostate enlargement are as follows:

  • Prostate examination,
  • Prostate-specific antigen (PSA) test,
  • Measuring urine after urinating,
  • Urine flow test,
  • Cystoscopy,
  • Ultrasound.

Then, an operation is selected based on the diagnosis following these tests and screening methods. The fastest and most effective solution for men with prostate enlargement problems is laser prostate surgery (HOLEP). This operation is performed by a specialist using special equipment, and the operation is completed in approximately 1 hour. The patient is discharged in a short time, and in some cases, a catheter is not even necessary. Laser prostate surgery does not cause any risks for patients who use anticoagulant medications, and patients feel like they are in their 30s after the operation.

The Recovery Process After Prostate Surgery

Men who have holmium laser enucleation of prostate surgery will regain their health in a short time. Patients who underwent prostate surgery should avoid heavy lifting for 2–3 weeks.

The patient will be called for the first follow-up after 3 weeks. Prostate adenoma tissue is evaluated with pathological assessment, and certain tests are applied to the patient. Uroflow tests and ultrasounds are applied first. The uroflow test monitors the improvement in urine flow, an ultrasound is used to check the residual urine, and a blood PSA test is applied. Whether the patient’s experiences any more complaints is investigated.

If the patient experiences problems with urine control, medication treatments or Kegel (pelvic base) exercises are recommended. Patients should avoid sexual intercourse for 1 month after laser prostate surgery and be careful about nutrient intake. Since constipation can be challenging, individuals should consume food with high fiber in the first month and avoid hot, spicy, or acidic food and beverages.

Laser Prostate Surgery Prices

Laser prostate surgery will significantly help patients who have prostate enlargement problems and who suffer from frequent urination. This surgery uses endoscopic devices and advanced technological equipment. Patients inquire about laser prostate surgery prices before their procedure, and the prices vary across clinics and patients. Laser prostate surgery prices are determined by factors such as prostate size, surgery duration, and hospitalization duration. Therefore, HOLEP prices can be different for each patient. You can contact the health institution that will do the operation to learn more about laser prostate surgery prices.

Hospitals that Perform the HOLEP Surgery Technique

Laser prostate surgery (HOLEP) can be used to treat prostate enlargement, which is very common among men of old age, in a short time. This method has low complication risk, low relapse risk, and a bloodless/painless procedure that sees more demand every day. The number of hospitals that perform HOLEP surgery is increasing as demand increases. The operating team must be experienced and experts to ensure the best results. Patients who want to learn more about hospitals that perform HOLEP surgery should consider hygiene, experience, equipment quality, and patient satisfaction factors.

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Holmium Laser Enucleation of Prostate Surgery (HOLEP)
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