What is HoLEP, and what does it help treat?
Written in association with:In this article below, highly regarded consultant urologist, Mr Tev Aho, discusses the main benefits of HoLEP, whilst also telling you how this procedure is performed and what conditions it can help treat.
What is HoLEP, and what does it help treat?
HoLEP is a minimally invasive surgical procedure used to treat benign prostatic hyperplasia (BPH), a common condition in middle-aged and older men characterised by enlargement of the inner core of the prostate gland. BPH can lead to bothersome urinary symptoms, such as difficulty initiating urination, weak urine flow, frequent and urgent urination, which can significantly impact quality of life if left untreated. HoLEP can also be used to treat the complications of BPH which include: recurrent urinary tract infections, bleeding from the prostate, bladder stones and complete urinary retention requiring the placement of a urinary catheter.
What happens during a HoLEP procedure?
During a HoLEP procedure, a small telescope-like instrument called a cystoscope is inserted into the urethra, allowing the surgeon to visualise the prostate gland. A holmium laser is then used to precisely peel away and remove the entire enlarged inner core of the prostate (the adenoma) which, when it grows inwards, obstructs the urethra interfering with urine flow and the ability of the bladder to empty, and puts pressure on the bladder causing frequency and urgency of urination. Once peeled away, the adenoma is mechanically chewed up and suctioned out of the body through the cystoscope using a small instrument called a tissue morcellator.
What makes the HoLEP technique so advantageous?
One of the key advantages of HoLEP is its ability to completely remove obstructive prostate adenoma, regardless of the size and shape of the prostate gland. Unlike traditional transurethral resection of the prostate (TURP) surgery, which involves shaving off portions of the adenoma, HoLEP allows for its complete removal resulting in better relief of urinary symptoms and a higher chance (99%) of allowing successful catheter removal in men with catheter-dependent urinary retention.
HoLEP is the most durable minimally invasive prostate procedure with a less than a one percent chance of the prostate regrowing to the point of requiring further surgery. BPH medications can be permanently stopped after HoLEP and PSA (prostate blood test) results are expected to reduce to less than 2 after HoLEP regardless of how high they were prior to surgery.
Is HoLEP suitable for everyone?
Whilst HoLEP is highly effective in relieving symptoms and complications of BPH in virtually any man, it may not be suitable for all patients. The presence of certain medical conditions, and patient preferences should be considered when determining candidacy for HoLEP. Patients considering HoLEP should undergo a thorough evaluation by a urologist with expertise in the procedure to determine the most appropriate treatment plan for their individual needs and goals.
