Laser Prostate Surgery (HoLEP) is fast becoming gold standard treatment for enlarged prostate requiring surgery. Recently we operated on a 70 year old patient with prostate weighing about 200 grams. Single stage laser surgery was carried out (HoLEP). No blood transfusion was required and patient was discharged the next day.
Laser surgery offers several advantages over traditional methods, particularly for very large prostates (>100 grams):
- Efficiency in Tissue Removal
- HoLEP removes the prostate tissue in entirety, regardless of size, making it highly effective for large glands.
- It offers a shorter surgical time compared to open procedures.
- Minimized Bleeding
- The laser’s coagulation properties significantly reduce blood loss, crucial for patients with bleeding disorders or on anticoagulants.
- The laser’s coagulation properties significantly reduce blood loss, crucial for patients with bleeding disorders or on anticoagulants.
- Quicker Recovery
- Most patients experience shorter hospital stays and quicker return to normal activities.
- Most patients experience shorter hospital stays and quicker return to normal activities.
- Durable Results
- Studies show that HoLEP provides long-term symptom relief and low retreatment rates, even for very large prostates.
Procedure Overview
HoLEP involves the use of a high-powered holmium laser to precisely enucleate the enlarged prostate tissue. The tissue is then morcellated and removed. This technique ensures complete removal while preserving the surrounding structures, reducing the risk of complications like incontinence or erectile dysfunction.
Current Trends and Research
- Comparative Studies: Research shows HoLEP outperforms TURP and open prostatectomy in safety and efficacy for large prostates.
- Patient Outcomes: A 2023 meta-analysis reported improved urinary flow and reduced post-operative complications with HoLEP.
- Adoption Rates: Increasing global adoption due to advancements in laser technology and surgeon training.
Conclusion
Laser surgery, particularly HoLEP, is transforming the management of very large prostate glands. Its minimally invasive nature, effectiveness, and safety profile make it an excellent option for patients seeking relief from severe BPH symptoms.
For men with very large prostates, laser surgery is no longer just an alternative—it’s a leading choice in modern urology and we at Institute of Urology, Jaipur make sure you get the best of urology under a single roof.
