What is HoLEP Treatment?

In some men, after age 40-50, a new tissue begins to grow around the urethra that passes through the prostate. It compresses the urinary tract passing through it. This tissue that grows later is called "adenoma"; it is not cancer. The adenoma pushes the patient's original prostate outward, making it a capsule. Complaints such as weak urination, waking up to urinate at night, frequent urination, intermittent urination, waiting to urinate, and inability to empty the urine are seen.

With today's scientific research and developing technology, significant progress has been made in the diagnosis and treatment methods used in health. In particular, newly defined surgical intervention methods have provided advantages such as high treatment success, rapid recovery, shorter hospitalization, and fewer complications after treatment. In this sense, a new surgical procedure, which is applied for prostate problems that are common in elderly male patients and which has been increasingly preferred in recent years, is the method called HoLEP treatment. It has been widely used in all European countries and America in the last ten years and is seen as the new gold standard in prostate treatment.

What is HoLEP Treatment?

HoLEP method: It is an abbreviation of the treatment method expressed as "Holmium Laser Enucleation of the Prostate" in English. This method aims to eliminate the problem of urinary tract obstruction of the prostate tissue, which occurs as a result of benign prostatic hyperplasia (BPH), which is one of the most common health problems in older men that laser surgeryThe most crucial advantage of HoLEP treatment is that it provides a practical and fast healing treatment with closed surgery without the need for any incision in the patient.
In the current clinical approach, in severe cases that do not respond to drug treatment, TUR-P (Transurethral resection of the prostate), which is the method in which the prostate gland is removed by entering the urethra with the closed surgery method, is a more effective and less risky method compared to the methods in which the prostate gland is removed by open surgery. It has become the preferred method.

Who is HoLEP Treatment Applied to?

It is inevitable to resort to surgical treatment in cases where drug therapy is insufficient, and prostate size increases. The HoLEP method can be applied with a high success rate in cases where prostate enlargement of any size is seen, obstructing as a result of prostate enlargement in the urinary tract.

How is HoLEP Treatment Applied?

Before applying HoLEP treatment, a detailed physical examination is performed by taking the patient's clear disease history. Various blood and urine tests may be required to determine that the patient has no additional health problems that may prevent the operation. Appropriate precautions and procedures are applied before surgery to prepare patients with other chronic conditions for surgery. The surgery is performed under spinal or general anesthesia.

HOLEP surgery is performed by entering through the closed canal where the patient urinates. With the Holmium Laser, the enlarged adenoma is removed from the patient's prostate, which has taken the form of a capsule. No adenoma tissue is left in the patient, the tissue that subsequently grows and compresses the urinary tract.

Therefore, there is no need to make any incisions outside the body during the surgery.

The catheter is withdrawn 24-48 hours after the surgery. And he is discharged. The patient can start eating and drinking the same day after the surgery.

What are the Advantages of HoLEP Treatment?

The HoLEP method has some advantages compared to other interventions used in prostate surgery since it is a method that is applied with the closed surgery method without the need for any incision or additional intervention.

• It is done closed with Holmium Laser; it is a less bleeding surgery.
• It can also be applied to those who use blood thinners.
• It is the preferred surgery in patients with heart and lung problems.
• It does not damage the nerves associated with erection (hardening).
• The entire adenoma is removed. The removed tissues are sent for analysis.
• Most patients can go home the next day. The probe time is short.
• The patient urinates very quickly.
• It can be performed on prostates of any size.
• Since the enlarged part of the prostate (Adenoma) has been completely removed, it is rare for it to grow again in the following years.

What Risks Does HoLEP Treatment Involve?

Although HoLEP treatment is a very successful method in prostate-related diseases, it also brings some risks and complications, as in any surgical treatment method. In this sense, the complications that can be seen in the patient after the application of HoLEP treatment are as follows:

• After the surgery, a temporary burning sensation and light bleeding may occur while urinating.
• Among prostate surgeries, HOLEP surgery best protects the urinary sphincter muscles. These muscles are prominent, unapproachable, and well-protected. However, if the urinary-holding sphincter has become sluggish before surgery, some patients may rarely experience temporary urinary drips after catheter removal. These drips resolve with medication and exercise, sometimes within a few days or weeks. Permanent urinary incontinence is not seen.
• As in all kinds of surgeries, namely TUR, Plasmakinetic, or Greenlight surgeries, since the semen and bladder neck are open, they go to the urinary bladder and are then excreted with urine. This is called retrograde ejaculation and has no harm to affect the patient's health.
• The depth of the Holmium Laser in the tissue is 0.4 mm. This laser can't pass through the 6-7 mm thick capsule and damage the masculine nerves, so it has no harmful effect on erection.
• Various complications such as injury to the organs and tissues of the urinary tract, obstruction in the urinary tract, severe bleeding, and urinary tract infection are infrequent due to the development of scar tissue in the urinary tract after surgery.