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What is HoLEP (Holmium Laser Enucleation of the Prostate)?
The HoLEP method, also known as Holmium Laser Prostate Enucleation, is a type of prostate surgery. The procedure is applied through the urinary canal. For this, a holmium laser is used. Open prostate surgery is not the only method for removing the prostate. With this method, the entire prostate can be removed in a closed manner. For this, spinal anesthesia is usually used in surgery. Thus, prostate treatment with HoLEP surgery is performed more easily than other open prostate surgery methods.
However, with this treatment method, only the prostate is not removed. Benign prostate enlargement can also be prevented with HoLEP treatment. This method is highly preferred today as it is a reliable treatment method used in the treatment of various prostate diseases.
Benign prostate enlargement is one of the most common diseases in men. In some cases, benign prostatic enlargement may be seen more frequently. In particular, men over the age of 60 are at risk in this regard. In fact, benign prostate can be seen in one out of every two men above this age limit. This situation causes many complaints in men. Frequent urination is one of these complaints. This is a situation that greatly reduces the quality of life of people.
If the disease is detected in the early period, it can be treated with the HoLEP method. If detected at an early stage, drug treatment is also possible. However, in case of delay in treatment, it may be necessary to seek help from surgical methods. It is important for patients to be aware that this is not a cancer at this point. However, it should be kept in mind that in some people, both cancer and benign prostate enlargement can coexist. For a correct diagnosis, the patient should be evaluated well.
The HoLEP method is applied in many health centers in Turkey. Urologists in Turkey have experience in prostate treatment with Holep.
How is HoLEP Surgery Performed?
General anesthesia is assisted for the surgery. However, in some cases, anesthetizing from the waist down may be sufficient. In the surgery, a special device with a camera is entered through the urinary canal. Thus, the enlarged prostate tissue is displayed carefully and in detail. This tissue is then separated from the capsule by laser and left into the bladder.
After it is left in the bladder, this tissue is broken up with another instrument and expelled from the body by vacuuming. At the end of the procedure, the catheter is inserted and the operation is terminated. The removed prostate tissue is sent to pathology to investigate whether it is cancerous after the procedure.
How is HoLEP Surgery Performed?
- For the HoLEP method, the size of the prostate does not matter. This procedure can be applied to small-sized prostate as well as to large-sized prostate safely.
- Even if the size of the prostate is very large, it is not necessary to make an incision on the body. This treatment method is an alternative to open surgery and can be performed in a closed manner.
- It can be preferred instead of open surgery when necessary.
- Since the entire prostate is removed in the procedure, the probability of repeating the operation is very low.
- After the procedure, the sexual life of the person will not be damaged. It is recommended to take a break only for the first 1-2 months.
- The probability of bleeding in the surgery is very low and blood transfusion is not required.
- If necessary, even people who use blood thinners can be treated.
- Patients can be discharged in as little as 1-2 days. There is no need for a long stay.
- There is no pain when urinating after the surgery.
Who Is HoLEP Surgery Performed?
This procedure is a suitable surgical method for anyone who needs prostate surgery. It is a method that can be safely preferred, especially in patients for whom open surgical methods cannot be applied. If the prostate is larger than 80 grams, then open surgery is usually recommended. However, prostate size is not important in the HoLEP method. On the contrary, the procedure gives more effective results in large prostates.
If the person has a bladder stone during the surgery, this can also be successfully removed. Likewise, these stones can be broken with a closed laser. Patients with stenosis in the urinary canal can get rid of this stenosis with a laser treatment to be applied during the same procedure.
Especially people with cardiovascular disease, stent in the heart vessel and people who have undergone bypass before can safely benefit from this treatment. Those who have atherosclerosis and therefore use blood thinners can also safely take HoLEP treatment.
What Awaits Patients After HoLEP Surgery?
The catheter is removed shortly after the operation. It is normal to see some changes in urine color after the patient is discharged. Minor bleeding may also occur. These usually appear at the beginning and end of urination.
There is no need to worry as this is a temporary condition. In addition, it is very rare to experience pain and ache while urinating in this method. However, some people may experience these complaints. These complaints are temporary and do not cause a serious problem. They are usually seen in the first weeks and then their effects decrease.
In addition, since the prostate is completely removed during the surgery, some patients may experience dripping and urinary incontinence in the first weeks. However, this situation is more common in patients who wear catheters for a long time and remain immobile. This can also be seen in patients with neurological disease and diabetes.
If the patient’s complaints do not go away on their own in a short time, then exercise and the use of some medications may be needed. Inflammation may occur in people who wear catheters for a long time and have a low immune system. This risk can be reduced by taking a urine culture beforehand.
Patients with prostate enlargement problem and suitable for Holep procedure can be treated in Turkey in a healthy and safe way. Holep surgeries in Turkey are performed by experienced and professional urology specialists in many health institutions.
Is HoLEP Treatment Effective?
HoLEP is an up-to-date and reliable treatment method using laser technology. This method is also preferred today, especially since it requires less recovery time compared to open surgeries. With this treatment method, prostate enlargement can be controlled.
Since it is a current and widely used treatment method today, patients do not need to worry about treatment. The method is done by reaching the prostate using the urinary canal. Thus, it is a similar process to removing the inside of an orange.
In addition, since the prostate is completely removed in this procedure, the probability of recurrence of the disease is almost negligible. Bleeding is almost never seen. In addition, this process is very suitable for people who need to use blood thinners. Patients can return to their normal lives within the first 1-2 days after surgery. The procedure also does not cause any harm to sexual functions.
Frequently Asked Questions About the HoLEP Method
How Many Days Will You Stay in the Hospital After HoLEP Surgery?
After the procedure, patients are discharged in a very short time. Usually, the catheter is removed on the first day after the operation and the patient is discharged if there is no problem. However, this period may be extended for 1 more day in patients with advanced age and additional disease.
How Many Days Does the HoLEP Surgery Heal?
If there is no problem, the patients are coffin for the first 24 hours and their catheters are removed. Thus, they can quickly return to their normal lives. It may be necessary for people not to observe themselves for the first day after the catheter is removed.
Especially people who are elderly and have additional diseases should be careful against any side effects. Hospitalization is usually not required after surgery. However, it should not be forgotten that every surgery has some risks and the body should rest afterward.
When to return to normal life after HoLEP?
It is possible to return to normal life in a very short time after HoLEP surgery. This period can usually vary between 2-3 months. During this period, people can do light exercises, provided that they do not force themselves too much. It is important to pay attention to the foods consumed during this period.
Especially high fiber foods should be preferred, so that the possibility of constipation is minimized. In the first month after the surgery, acidic drinks and spicy foods should not be consumed. For sexual intercourse, we recommend waiting for 1-1.5 months. Light bleeding may occur after the first intercourse. There is no harm in this.
Can Prostate Cancer Develop After HoLEP?
In all prostate surgeries, the inner part that puts pressure on the urinary canal is removed. Thus, only the outer part of the prostate is left behind. It is possible to develop cancer in this remaining part in the future. For this reason, we recommend that especially elderly patients have the necessary check-ups at certain intervals after the surgery.
Does the Prostate Grow Again After HoLEP Surgery?
No, this is not possible. Since the entire prostate is removed in prostate surgery, the disease does not recur and does not grow.
Is Surgery Necessary After HoLEP?
During the operation, the prostate tissue of the person is completely separated from the capsule by laser. Meanwhile, no part of the interior remains. Repeating the procedure is only necessary if prostate tissue is left behind. If no mistakes are made during the surgery, no prostate tissue is left behind. Thus, there is no need to repeat the hoLEP surgery.
Does HoLEP Surgery Harm Sexuality?
After the surgery, the nerves that surround the prostate and serve to harden men can be damaged and adversely affected. However, this is not a common occurrence. The energy used in the procedure can only affect the 0.4 mm depth of the prostate capsule. This means that the energy required to decompose prostate tissue does not adversely affect the nerves that provide erection.
However, sex should not be rushed immediately. It is best to wait 1-1.5 months after the procedure. After this period, sexual intercourse can be tried, provided that it is not forced too much. However, since the prostate tissue is completely cleared, some side effects may occur. For example, during orgasm, semen may escape back. In some cases, minor bleeding may occur. The escaping semen is then excreted from the body with urine.
While these may seem worrisome, they are certainly not harmful to health. Related side effects usually disappear on their own within a short time. However, if the situation does not improve, we recommend that you consult your doctor.
What Should Be Considered After HoLEP Surgery?
After the surgery, people can return to their daily lives in a short time. However, we recommend waiting for activities such as heavy sports. Light sports may be preferred for the first 2-3 months. Drinks and foods that will tire the stomach should not be consumed as much as possible. These are acidic and very spicy foods.
For sexual intercourse, it is best to wait for the first 1-2 months. After the operation, your doctor will inform you about all kinds of side effects and points to be considered.