Benign Prostate Hyperplasia (BPH) is the most frequent pathology at the prostate level. It is derived from a benign growth of the same that causes an obstruction of the urinary tract at the level of the prostatic urethra (at the outlet of the bladder). This obstruction generates symptoms that significantly alter the patient's quality of life. The symptoms are independent of the size of the prostate, 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 said urinary tract obstruction such as acute urinary retention, the appearance of bladder stones or even, in advanced cases, kidney failure.
Minimally invasive surgical procedures for BPH
BPH surgery has seen great advances in recent years. Currently we have a variety of minimally invasive techniques that allow the 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, therefore it is vitally important to make a correct diagnosis to offer the optimal treatment for each patient.
The first therapeutic step consists of a pharmacological treatment that helps reduce the obstruction, relaxing the prostate muscles or even reducing its volume.
When this treatment fails or is insufficient, we advance to the next therapeutic step, which consists of surgery for Benign Prostate Hyperplasia.
The choice of the optimal surgical technique for each case is selected based on the volume of the prostate and the patient's comorbidities and medical history.
The main surgical options for the treatment of prostate adenoma They 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 the complete removal of the prostate adenoma without the need for skin incisions. It is performed through the urethra and replaces conventional open surgery (retropubic adenomectomy).
When is it necessary to perform a HoLEP?
It is indicated for medium or large prostates.
Benefits of prostate enucleation with Holmium laser
Its main advantages are the lower risk of intraoperative bleeding, less postoperative pain, less urinary catheter time and a shorter hospital stay.
Unlike the prostate tissue vaporization techniques, this technique allows us to extract the tissue to perform an anatomopathological study and thus rule out the presence of tumor cells.
Risks of prostate enucleation with Holmium laser
In the postoperative period after prostate laser surgery, it is important to monitor bleeding and possible signs of infection. All these risks are minimized thanks to the antibiotic prophylaxis used in the operating room and the washing through the probe with continuous serum.
How long does this laser prostate surgery last?
The Duration of prostate enucleation with Holmium laser It is around 1 hour. Logically, this duration can vary depending on the size of the prostate or the characteristics of the patient.
Transurethral resection of the prostate with bipolar energy
It is a endoscopic technique that is indicated in small and medium-sized prostates. It uses bipolar energy to resect the prostate adenoma through the urethral canal. It also allows us to extract the tissue to perform 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 experience any pain and the risk of bleeding is low.
What complications or side effects can transurethral resection have?
As in the postoperative period of prostate laser surgery, it is important to monitor bleeding and possible signs of infection. These are also prevented by using a intraoperative antibiotic prophylaxis and continuous lavage of the bladder through the urinary catheter. Recovery time is similar to Holmium Laser Prostatic Enucleation (HoLEP).
Ramírez Urology is a team of professionals specialized in urology, where the most advanced surgical techniques are applied to provide optimal results, always offering individualized treatment to each patient.