HoLEP treatment for BPH Enlarged Prostate

HoLEP treatment

HoLEP (Holmium Laser Enucleation of the Prostate) treatments are available to patients diagnosed with BHP; they are used to improve or resolve urinary issues such as urine retention. HoLEP treatments are safe, minimally invasive and are typically performed under general anaesthetic (although a spinal block or spinal anaesthetic could also be used).

The HoLEP treatment procedure

HoLEP treatments are non-surgical BPH procedures. After an assessment of the bladder is performed, a tiny scope is inserted into the urethra, which then accommodates the HoLEP laser and facilitates direct treatment of the prostate. The laser removes large pieces of prostate tissue (using the same tiny scope) while sealing exposed blood vessels and relieving the prostate of restriction.

HoLEP treatment for BPH
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HoLEP effectively unblocks urine flow by targeting and removing parts of the prostate that are impacting the patient’s urinary system. Tissue removed during the procedure is forced into the bladder, before being extracted with a specific tool. Following the HoLEP procedure, one in ten patients may have difficulty urinating and need short-term use of a catheter.

Advantages¹

HoLEP is exclusively recognised as being the correct endoscopic procedure for prostates of 100cc or more in volume, although HoLEP treatments are appropriate for all sizes of prostate; this notably includes those up to 600cc in volume (30cc is typical for those in their fifties or older). The HoLEP laser also seals blood vessels throughout the procedure, so any bleeding is minimal.

With less than a one percent chance of obstructions being removed from the prostate and growing back within a decade, HoLEP treatments offer patients safe, long-term relief. The ability to urinate normally is also usually restored in all but one percent of catheter-dependent patients, making HoLEP one of the more effective treatments available. Another advantage is cancer detection.

High-risk cancer requiring urgent treatment is seldom found during HoLEP procedures, but low-risk cancer (that can be monitored and go untreated safely) has been incidentally identified in eight percent of patients. With a full painless recovery usually lasting a fortnight, patients typically spend just one night in hospital, before walking should resume (driving one day later).

Disadvantages¹

Patients can experience urinary issues, severe infections, urethral scarring and/or erectile dysfunction. For five percent of patients, full recovery from urinary incontinence can take up to four weeks; further surgery may be required if urinary symptoms are severe, but just as with hospital readmission (due to severe infection), this occurs in far fewer than one percent of cases.

Although erection strength can also diminish for two percent of patients, improvement is twice as likely; nine in ten patients experience reverse ejaculation, but precise and specific ejaculation-sparing HoLEP treatments typically reduce this risk to just one in five. Four percent of patients will usually require further corrective treatment for urethral stricture or scarring.

¹ Prostate Matters, BPH Turp Treatment Details, 17th March 2021

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