Holmium Laser Enucleation of the Prostate Procedure (HoLEP):
The prostate gland is a part of the male reproductive system. Enlargement of prostate or BPH (Benign prostatic hyperplasia) is a common symptom in aging men. Medications are available for the same. Doctors usually prefer small surgical corrections to correct the same. TURP or Transurethral Resection of the Prostate or HOLEP (Holmium Laser Enucleation of the Prostate) are commonly used procedures. HoLEP scores over TURP procedure and most doctors prefer HoLEP due to its inherent advantages.
How is it done ?
HoLEP is a simple procedure and requires short hospitalization for a day or two. The procedure is performed under general anesthesia, a catheter and a telescopic camera is used to aid the process inserted through the penis. During HoLEP procedure, a laser is used to precisely and accurately target and remove the malignant or trouble causing portion of the prostate. An instrument called a morcellator is then used to cut the prostate tissue into easily removable fragments or pieces. The lobes of the prostate are pushed into the bladder and sucked (Morcellated) by an instrument inserted through the telescopic camera.
With HoLEP, surgeons can remove the entire portion or the targeted area of the prostate gland that can block urine flow, which improves urinary symptoms to a great extent and provides a long lasting solution as there is nothing to grow back or revisiting of malignancy following this procedure. HoLEP is an effective and less invasive choice to older and traditional methods of removing prostate obstructions or malignancies. HoLEP helps preserve removed tissue for further microscopic examination.
The pieces are sent for laboratory analysis to check for malignancy. A catheter is used to drain the urine until the portion heals. Sterile saline is irrigated into the bladder through the catheter to dilute any blood in the urine and prevent clots from popping up. It is normal to have some blood passage in the urine after the operation; it is advisable to drink plenty of water for a few days until it clears. Clots are sometimes passed 10-14 days after the operation which is part of the healing process.
 Advantages:
- It takes less time, requires less hospitalization.
- Less bleeding, easier healing.
- PSA levels drop significantly.
Disadvantages:
- The possibility of infections.
- Takes longer time as compared to TURP
- The nephrologists performing the procedures must be well versed.
- The patient may have problems ejaculating normally for the first few months.
Home care after the Procedure:
- The patient must the area is kept dry
- The medications prescribed must be taken regularly
- Uncontrolled bleeding or redness, swelling at the site must be reported
At KIMS, our Nephrologists are well versed in the procedure and many patients have benefited from the same. We are one of the pioneers in introducing laser procedures in Hyderabad for treating malignancies effectively.