What is Laser Treatment of the Prostate (Holep)?
Benign enlargement of the prostate is a health problem that increases with age and causes serious problems in the social life of the patient. It causes complaints such as difficulty in urination, inability to empty the urine completely, frequent urination, and an increase in the frequency of going to the toilet at night. Lifestyle changes and drug treatments are usually sufficient in mild cases of this condition, which is seen in approximately half of the male population over the age of 50. However, surgical treatment may be required for patients who do not benefit from these treatments.
In cases where there is no benefit from drug treatment for benign enlargement of the prostate, recurrent catheterization, urinary tract infection, bleeding in the urine, bladder stones, and development of kidney failure, surgical treatments are performed with the patient's preference.
Especially in large-volume prostates (>80 cc), after operations based on the principle of transurethral resection (scraping the prostate from inside the urinary canal), recurrent urethral (urinary canal) strictures, bleeding, TUR syndrome, infection, urinary incontinence can be seen, and open surgery has a higher bleeding rate. This has led to new searches and the use of laser technologies in prostate surgery due to the prolonged hospitalizations and the slow return to social life.
The process of removing the prostate lobes from the capsule with the help of laser by entering the urinary canal with a camera system is called HOLEP surgery. With this method, the maximum amount of prostate tissue is removed.
The HOLEP technique is preferred because the need for re-surgery is minimal, the bleeding rates are very low, and the improvement in voiding rate is superior to other methods.
Holep Surgical Procedure
The HOLEP method is based on the principle of removing the enlarging lobes of the prostate from the capsule endoscopically with the aid of a laser device. The surgical procedure is performed endoscopically under anesthesia. Bleeding that develops while the lobes of the prostate are stripped are controlled simultaneously.
Lobes thrown into the urine bag are crushed with the help of a special tool and taken out. After the procedure, the urine catheter, which will be kept for 2-3 days, is inserted and the washing water is inserted. Necessary supportive treatments are applied to our patients who are mobilized from the first day after surgery.
After the HOLEP surgery, the patients are mobilized at the scheduled time and return to their daily life in a controlled manner after recovery in our clinic. Our patients who urinate after the catheter is removed are discharged with the recommendations and the drugs they will use. The patients who are discharged on the 3rd day after the operation come to the control with the result of pathology.
More prostate tissue is removed compared to monopolar and bipolar TUR-P.
Compared to the open operation, it provides a very serious advantage in terms of bleeding.
No. It is even possible that there is an increase in sexual desire, sexual satisfaction and erection rates. As in all prostate surgeries, after orgasm, the sperm fluid may not go out of the body (retrograde ejaculation), but towards the bladder.
This can only create problems in conceiving children naturally. However, you can have a sick child with assisted reproductive techniques such as vaccination and in vitro fertilization.
The pathology result results after an average of 1 week.
In this procedure, all parts of the prostate except the capsule are removed.
You will usually be discharged after 2-3 days of hospitalization.
There may be slight burning in the urine in the first 1 week after the operation.
At least 2lt/day of water will be drunk and a watery and vegetable-based diet will be given. Fibrous foods will be consumed.
No, your prostate medications will be discontinued after the procedure.
In the first week, you can take short walks at a light pace. It is recommended that you start normal daily activities after 1 week.
You can have sexual intercourse after 1 week.