Benign prostatic hyperplasia (BPH) — also called prostate gland enlargement — is a very common complication as men get older. Prostate gland enlargement may cause painful or uncomfortable urinary symptoms, such as obstructing the urine flow out of the bladder or pain during urination. It can also create bladder, urinary tract or kidney problems.
The severity of symptoms in people who have prostate gland enlargement may vary, but the symptoms tend to slowly and progressively get worse over time. Common signs and symptoms of BPH include:
- Recurrent need to urinate
- Higher frequency of urination at night (nocturia)
- Difficulty in starting urination
- Weak urine flow that stops and starts without any control
- Dripping at the end of urination
- Failure to wholly empty the urinary bladder
The prostate gland is located underneath the bladder and the urethra passes through the center of the prostate. When prostate gland enlargement occurs, it starts to block urine flow. Although, it isn’t entirely clear what causes prostate gland enlargement or BPH, till date. However, it might be due to changes in the balance of sex hormones as men grow older.
There are more than a few effective treatments for prostate gland enlargement, including medications, minimally invasive therapies and surgery. To select the best option, the doctor will consider various factors like the symptoms, the size of prostate and other health conditions.
Holmium Laser Enucleation of the prostate (HoLEP) is a contemporary alternative to the conventional Transurethral Resection of the Prostate (TURP) procedure for bladder outflow obstruction due to prostate gland enlargement (BPH).
HoLEP can be executed on patients of any age with urinary outflow blockade caused by prostate gland enlargement. It is mainly indicated in men with prostate gland enlargement (over 60mls in size) and men on medications to thin the blood such as warfarin, aspirin etc.
The major advantages of HoLEP as identified are-
- There is no upper size limit of prostate that can be dis-obstructed
- There is often less blood loss than after a conventional TURP
- Recovery is often faster than after TURP
- The chance of recurrence, requiring more surgery is very low
- The PSA normally drops to very low levels after HoLEP operations