The advanced prostate Laser treatment known as HoLEP (Holmium Laser enucleation of the prostate) is rapidly becoming the procedure of choice for men to treat their debilitating urinary issues.
This minimally invasive surgical technique provides many advancements over older style treatments resulting in minimal down time and excellent outcomes for men.
Benign Prostatic Hyperplasia (BPH) is the most common cause effecting lower urinary tract symptoms in men. Essentially, ageing men especially those over the age of 50 experience excess prostate tissue growth causing obstruction of urine resulting in increased urge and frequency of urine, incomplete emptying, leakage, increased night time urination and the inability to control urine.
Overtime if these symptoms are ignored permanent damage will be done to the bladder resulting in a long term catheter. Luckily advancements in bladder outlet surgery such as HoLEP have resulted in superior outcomes over older style treatments such as TURP and these new minimally invasive options allow men to regain their quality of life.
Read more about the HoLEP treatment below.
What is the HoLEP procedure
Holmium Laser Enucleation is the advanced minimally invasive treatment for an enlarged and obstructing prostate. The procedure involves the use of a fine powered Laser which follows the anatomical planes within a prostate with ultimate precision allowing complete resection of all adenoma (obstructing tissue) whilst preserving the outer capsule, erectile nerves and urethral sphincter. It is best to think of the prostate like mandarin with the laser peeling away the internal mandarin or obstructing tissue of the prostate to allow an open passage for urine to flow.
A unique feature of HoLEP is the morcellation. This is when the tissue that has been lasered off is processed with a device used to suction out the tissue that was left behind in the bladder.
What are the benefits of the HoLEP surgery over other surgeries like TURP
HoLEP displays a favorable safety and effectiveness profile resulting in significant Qmax improvements (urinary flow rate), short catheterization time and hospital stay, low complications rate as well as durable long term results. HOLEP is widely considered a viable alternative to the conventional surgical techniques such as TURP (Banga-Mouss et al 2022).
The superiority of HOLEP continues to be demonstrated with other benefits such a reduced blood loss and shorter operating time. Another benefit unique to HOLEP is the ability to allow for prostate tissue sampling to look for cancer post enucleation.
In summary, HoLEP’s short and long term outcomes are superior to those associated with TURP and greenlight laser:
· less bleeding
· lower chance of erectile dysfunction or incontinence
· same maximal flow rate and urinary symptom improvement
· minimal reoperation rate
· less catheter time
· Prostate cancer tissue sampling
· Reduced hospital stay
Prostate Surgeon Dr Martin Elmes offers the full range of minimally invasive prostate surgeries for your needs. There are multiple procedures available in his Gold Coast Urologist practice to suit your specific prostate shape and size.
Contact Dr Martin Elmes rooms on 07 5575 7922 to find out more and secure your appointment today.
Banga-Mouss RB, Briffaux R, Damba JJ, Charles T, Puichaud A, Robin H, Angermann E, Pires C, Odzebe AWS & Ouaki C 2022, ‘Holmium Laser enucleation of the prostate: a 3-year single center experience of 173cases’, African Journal of Urology, 22, 47.