Why holmium laser surgery to correct prostate enlargement is better

If you know anyone who needs to go for a prostate surgery better discuss this option with your doctor.

By: Debjani Arora | | Updated: December 4, 2017 10:59 am

An annual screening for prostate cancer can help in early detection. © Shutterstock

The prostate is a gland located just beneath the bladder of every man. Urethra, the tube that carries urine from the bladder to exterior passes through the prostate. With age, there are various changes that happen in the man’s body and many organs start to function differently. The prostate is no different. For men in their fifties, enlargement of the prostate gland is a common occurrence, though most of the time it is harmless. Here are four facts about prostate cancer that every man should know.

Enlarged prostate, or a benign prostatic hyperplasia (BPH), is a non-cancerous growth of prostate that affects a substantial number of men usually after 50 years, in which the enlarged prostate blocks the urethra and leads to difficulty in passing urine. This leads to weak urine stream, straining during urination, interrupted stream, increased frequency of urination, urgency, leaking of urine and passing blood in urine. Here are eight signs of prostate cancer that every guy should know.

In the initial stages, certain lifestyle changes and medicines can help in alleviating minor symptoms. However, patients with severe symptoms need endoscopic surgery using conventional methods such as TURP or transurethral resection of the prostate (TURP). This surgical procedure involves cutting away a section of the prostate for smooth functioning.

But in the past decade laser surgery for prostate enlargement has become a norm. Since the surgery with a laser is absolute bloodless, it is safe in patients who have to undergo bypass or angioplasty, cardiac patients with weak heart and renal or liver failure patients. Moreover, recovery is extremely smooth and fast, so the patients can go home in less than 24 hours.

Patients who have undergone bypass surgery or angioplasty are usually on blood thinners. It is quite hazardous to stop these drugs even for a day. With the option of HoLEP laser surgery, patients need not stop these drugs at all. However, in conventional TURP, these drugs need to be stopped at least for three to five days. Here is everything you need to know about enlarged prostate treatments.

However, when it comes to laser surgery there are many options that can be selected for laser prostatectomy. But Dr Rohit Joshi, Urologist, Chairman and Director for Aarna Super speciality hospital, Ahmedabad suggests that Holmium is better than Thullium and KTP laser. Holmium Pulse 100H is FDA approved for prostate surgery. Of the other lasers the KTP laser has a significant disadvantage as it does not yield tissue for biopsy and hence hidden cancer can be missed. While in Thulium laser patients generally have prolonged burning urination after the procedure.

Here are few reasons he cites why HoLEP ( Holmium Laser Enucleation of Prostate) is better:

HoLEP ( Holmium Laser Enucleation of Prostate) is safe for elderly patients who have associated heart or kidney problems at their age and most importantly, it can be done in patients taking blood thinner drugs like aspirin.
This technique offers a complete treatment and hence the recurrence rates are significantly less.
This technique is size independent which means a prostate of any size (as big as 360 gm of prostatic tissue) can be enucleated safely and effectively.
The blood loss with this technique is negligible and hence transfusion of blood is not needed at all and it is rare to see any bleeding related complications like clot retention, secondary haemorrhage and need for re-cystoscopy and clot evacuation, which are typically seen with the older modality (TURP).
The catheter can be removed as early as 23rd hour and the patient can be discharged the very next day allowing them to resume their normal life quickly which was not the case with TURP.
The low depth of penetration of the holmium lasers causes little damage to healthy tissue, leading to better preservation of sexual function.
This technique has fewer complications in terms of stricture urethra and bladder neck contracture.

Image source: Shutterstock

Published: November 28, 2017 11:36 am | Updated:December 4, 2017 10:59 am

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