HoLEP is a modern and completely safe surgery used to cure BPH (benign prostatic hyperplasia).
The surgery allows the removal of adenomatous nodes quickly and safely without causing impotence, urinary incontinence, urethral strictures, retrograde ejaculation and other complications typical of more traumatic surgical interventions.
Features of the innovative equipment for holmium enucleation of the prostate HoLEP
This is absolutely so. Urological clinics and departments that offer such operation should have special technical equipment. Prefix "Ho" in the name HoLEP means that the enlarged prostate gland is removed with the help of a special holmium laser.
Radiation of a holmium laser accurately destroys the layer of connective tissue between the enlarged prostate gland and its capsule. Accuracy of exposure is 0.4 mm – healthy tissues are no longer exposed to the thermal effect of the laser outside this zone. Special properties of radiation make it possible to preserve the structure of prostate capsule and avoid blood loss.
Holmium laser has several power modes and is used to remove the prostate gland of any volume. At the same time, the original structure of prostate cells is preserved, which allows performing comprehensive histological study and excluding the oncological process.
Who needs HoLEP surgery?
Patients suffering from BPH undergo HoLEP surgery. BPH is a disease accompanied by an increase in the prostate size. This pathology is peculiar in 50% of males after the age of 50 and the risk of its occurence throughout the lifespan reaches 85%. Therefore, BPH can be named the most widely spread urologic illness among males.
Increased prostate can compress the nearby located organs in certain cases. The biggest danger is the compression of urethra, as it causes an acute retention of urine. The person will not be able to empty the bladder. The only way out of this situation is a partial removal of the prostate gland.
There are several types of surgeries that are used in such cases. Usually it is a transurethral resection of the prostate (TURP) or an open adenomectomy. These surgeries are available in most clinics, including developing countries. However, they have a number of shortcomings. The TURP surgery can be performed only with a small prostate volume. Open prostatectomy is very traumatic and carries high risks of complications as well as a painful and prolonged postoperative period.
Hence, HoLEP gains wide reaching popularity as the most modern BPH surgery of today. HoLEP presupposes removal of the "extra" prostate tissues through the urethra. This surgery is effective for any volume of the prostate gland in comparison with TURP.
Procedure of HoLEP surgery
HoLEP surgery is performed under general anesthesia. First, the endoscope is inserted into the bladder through the urethra. Then a cut is made on the neck of the bladder. It passes through the entire tissue of the enlarged prostate gland, down to its capsule. The incision gradually widens.
After this, the doctor separates the average proportion of the prostate with blunt dissection and pushes it into the bladder with the help of the endoscope beak. At the next stage of the operation, lateral lobes of the prostate gland are removed alternately.
The areas of the prostate that are already in the bladder are too large to be extracted through the urethra. Therefore, they are crushed by means of the morcellator. Morcellator is a tube with rotating blades inside. The tube sucks in removed prostate tissues like a vacuum cleaner and grinds them, making it possible to take them out through the urethra.
- Low risk of complications that is 2 times lower in comparison with TURP and 5 times lower in comparison with open prostatectomy
- Ability to perform surgery for large volume of prostate gland. While TURP is performed at a prostate volume of up to 90 cm3, HoLEP can be performed at a volume exceeding 200 cm3
- High efficiency - the probability of recurrence after HoLEP does not exceed 2%
- Preservation of the patient’s erectile functions, because during the operation peripheral nerves are not damaged
- Rapid recovery - the rehabilitation time is 2-3 times shorter compared to other surgical interventions. Catheter is removed after 1-2 days from the urethra, while after TURP it takes 4 days
- Less pronounced postoperative pain and lower need for painkillers
- There is no risk of bleeding, because the laser coagulates the vessels during the surgical procedure
- Due to absence of large blood loss, HoLEP is not contraindicated for patients who receive antiaggregants or anticoagulants
Where to undergo HoLEP?
Surgical interventions are performed under the trained hand of Professor, M.D. Horst Schuldes. He has a great experience in conducting such surgical interventions.
Booking Health can arrange your trip for treatment to Germany. We are going to going to help you to:
- Agree on the possibility of surgery with the hospital administration
- Lower your expenses for medical services
- Shorten the waiting time for surgery
- Solve the problem of accommodation of any accompanying people in the hospital or at a nearby located hotel
We also offer the full service package including booking tickets, visa issue, paperwork translation, transfer from the airport to DRK Altenkirchen-Hachenburg Hospital and then back.
Choose treatment abroad and you will for sure get the best results!
Author: Dr. Nadezhda Ivanisova