Benign Prostatic Hyperplasia (BPH) is the most frequent pathology of the prostate. It derives from a benign growth of the prostate that causes an obstruction of the urinary tract at the level of the prostatic urethra (at the exit of the bladder). This obstruction generates a symptomatology that significantly alters the patient's quality of life. Symptoms are independent of prostate size, so patients with small prostates may present severe symptoms and patients with large prostates may be completely asymptomatic.
Early diagnosis and treatment is important in order to avoid complications derived from this obstruction of the urinary tract such as acute urinary retention, the appearance of bladder stones or even, in advanced cases, renal failure.
Minimally invasive surgical procedures for BPH
BPH surgery has undergone great advances in recent years. We now have a variety of minimally invasive techniques that allow treatment of both large and small prostates.
It is important to know that the treatment of benign prostatic growth is different from that of prostate cancer, so it is of vital importance to make a correct diagnosis in order to offer the optimal treatment for each patient.
The first therapeutic step consists of a pharmacological treatment that helps to reduce the obstruction by relaxing the prostate musculature or even reducing its volume.
When this treatment fails or is insufficient, the next therapeutic step is surgery for benign prostatic hyperplasia.
The choice of the optimal surgical technique for each case is selected according to the prostate volume and the patient's comorbidities and medical history.
The main surgical options for the treatment of prostate adenoma are prostatic enucleation with Holmium laser and transurethral resection of the prostate with bipolar energy.
Holmium Laser Enucleation of the Prostate (HoLEP)
This endoscopic technique allows complete removal of the prostate adenoma without the need for skin incisions. It is performed through the urethra and replaces conventional open surgery (retropubic adenotomy).
When is it necessary to perform a HoLEP?
It is indicated for medium to large prostates.
Benefits of Holmium laser prostate enucleation
Its main advantages are a lower risk of intraoperative bleeding, less postoperative pain, shorter bladder catheterization time and a shorter hospital stay.
Unlike prostate tissue vaporization techniques, this technique allows us to extract the tissue in order to carry out an anatomopathological study and thus rule out the presence of tumor cells.
Risks of Holmium laser prostate enucleation
In the postoperative period after prostate laser surgery it is important to monitor bleeding and possible infection. All these risks are minimized thanks to the antibiotic prophylaxis used in the operating room and the lavage through the probe with continuous saline.
How long does this laser prostate surgery take?
The duration of prostate enucleation with Holmium laser is about 1 hour. Logically, this duration may vary according to the size of the prostate or the patient's characteristics.
Transurethral resection of the prostate with bipolar energy
This is an endoscopic technique that is indicated in small and medium sized prostates. It uses bipolar energy to resect the prostate adenoma through the urethral duct. It also allows us to extract the tissue in order to carry out an anatomopathological study and thus rule out the presence of tumor cells.
Advantages of transurethral resection of the prostate with bipolar energy
This technique has a very favorable postoperative period in which patients hardly have any pain and the risk of bleeding is low.
What complications or side effects can transurethral resection have?
As in the postoperative period following prostate laser surgery, it is important to monitor for bleeding and possible infection. These are also prevented by using intraoperative antibiotic prophylaxis. intra-operative antibiotic prophylaxis and continuous flushing of the bladder through the bladder catheter. Recovery time is similar to Holmium laser enucleation of the prostate (HoLEP).
Ramirez Urology is a team of professionals specialized in urologywhere the most advanced surgical techniques are applied to provide optimal results, always offering individualized treatment to each patient.