HoLEP (Holmium Laser Enucleation of the Prostate)

Holmium Laser Enucleation of the Prostate - HoLEP Surgery

What is Holmium Laser Enucleation of the Prostate (HoLEP)?

Holmium laser enucleation of the prostate (HoLEP) is a form of laser surgery. It is used to treat obstruction (blockage) of urine flow brought on by Benign Prostatic Hyperplasia (BPH). The prostate gland is not malignant but has become larger in BPH-afflicted males. Numerous urinary tract symptoms, including frequent urination, inability to pee, trouble commencing urination, or lack of bladder control, can be brought on by an enlarged prostate. The procedure offers a long-lasting cure for benign prostatic hyperplasia, a disorder marked by an enlarged prostate. HoLEP surgery also retains excised tissue to be analyzed in a lab for further disorders, such as prostate cancer.

HoLEP Procedure Details

Steps and Preparations before Holmium Laser Enucleation of the Prostate (HoLEP Procedure)

Before a HoLEP procedure, the patient will typically go through the following steps:

• Consultation with a urologist: The patient will have a consultation to discuss the procedure and determine if it is the best treatment option for their specific condition.
• Pre-operative tests: The patient will have a physical examination and may undergo tests such as a urine flow test, a prostate-specific antigen (PSA) test, and a digital rectal examination (DRE) to assess the size and condition of the prostate.
• Medications: The patient will be given instructions on which medications to take or not take before the procedure, such as blood thinners.
• Pre-operative instructions: The patient will be given instructions on how to prepare for the procedure, such as fasting for a certain period of time before the procedure.
• Anaesthesia: The patient will be given an option of general or spinal anaesthesia, depending on the preference of the patient and the surgeon.
• Review of the plan: The patient will be able to review and understand the plan of the surgery and ask questions to the surgeon if any.
• Imaging studies: The patient may need to undergo imaging studies such as an ultrasound or MRI of the prostate to help the surgeon plan the procedure and identify any potential complications.
• Lab work: The patient may be required to have lab work done such as a complete blood count (CBC) and coagulation tests to ensure they are healthy enough for the procedure.
• Urine culture: The patient may be asked to provide a urine sample for culture to ensure they do not have any urinary tract infections
• Informed consent: The patient will be asked to sign a consent form indicating that they understand the risks and benefits of the procedure and that they agree to proceed with the surgery.

It is important to note that the specific steps and requirements before a HoLEP procedure may vary depending on the patient’s individual health and circumstances, as well as the specific protocols of the surgeon and facility.

Procedure details during HoLEP (Holmium Laser Enucleation of the Prostate)

During a HoLEP procedure, the following steps typically take place:

• Anaesthesia: The patient will be given general or spinal anaesthesia to ensure they do not feel any pain during the procedure.
• Insertion of the scope: A scope will be inserted through the urethra and into the prostate. The scope has a camera and a laser attached to it.
• Visualization of the prostate: The surgeon will use the camera on the scope to visualize the prostate and identify the areas of enlargement.
• Resection of the prostate: The laser will be used to vaporize and remove the enlarged prostate tissue. The laser energy will be directed at the prostate tissue in a precise manner to avoid damage to the surrounding healthy tissue.
• Removal of the tissue: The resected tissue will be removed from the body through the scope.
• Closure of the urethra: The urethra will be closed with a small stitch to prevent bleeding.
• Monitoring of the patient: The patient will be monitored for any complications or bleeding during and after the procedure.
• Recovery: After the procedure, the patient will be taken to a recovery room where the anaesthesia will be reversed and their vital signs will be monitored.

It is important to note that the specific steps and duration of a HoLEP procedure may vary depending on the patient’s individual health and circumstances, as well as the specific protocols of the surgeon and facility.

Recovery and Follow-up after HoLEP Surgery(Holmium Laser Enucleation of the Prostate)

• Patients may experience discomfort, swelling, and bleeding in the urinary tract after a HoLEP procedure.
• Rest is recommended for the first 24 hours and avoid strenuous activity for several days afterwards.
• A catheter will be inserted to help the urinary tract heal and prevent complications and typically be removed within a week.
• Antibiotics will be prescribed to prevent infection, and pain medication may be given to manage discomfort.
• Some temporary symptoms such as urinary incontinence and urgency may be experienced, but they usually improve over time.
• Follow-up appointments with the surgeon may be required to check for any potential complications and the progress of recovery.
• The effectiveness of the procedure may take several weeks or months to be noticed.
• Certain foods and drinks that may irritate the urinary tract may be advised to be avoided.

Advantages of holmium laser enucleation of the prostate (HoLEP)

• HoLEP surgery is a minimally invasive procedure, it requires only a few small incisions. This reduces the risk of infection and other complications associated with traditional open surgery.
• Rapid recovery; the majority of patients are able to go home the same day. In comparison to typical open surgery, patients can resume their daily activities significantly sooner.
• Improve urinary function by removing the enlarged prostate tissue that is blocking the urethra. This can help to reduce the symptoms of urinary obstruction, such as difficulty urinating and frequent urination.

Recovery And Follow Up

What occurs after prostate enucleation with a holmium laser (HoLEP)?

• Surgery-related tissue will be examined in the lab for any abnormal results.
• Post-surgery, the patient will be examined by the surgeon to assess healing and to repeat tests such as the urine flow rate, bladder scan, and symptom score. These tests evaluate the surgical procedure’s efficacy. Patients are typically examined six weeks and six months following surgery.
• Urinary incontinence issues can be helped by starting pelvic floor exercises (commonly known as Kegel exercises) as soon as feasible.

How long is the healing process?

Most patients need to recover at home for at least one to two weeks before they can go back to work. Before returning to work, some patients may need three to four weeks to heal, especially if the position requires hard labour. During the healing process, patients shouldn’t try any hard lifting, but they should walk and engage in other modest activities.

When to Call the Doctor?

Consult your doctor if-:

• You notice an increase in the frequency of urination, soreness, or sudden difficulty passing pee.
• You are severely bleeding or have clots in your blood flowing.
• Your fever is more than 101 degrees.

For the Holmium Laser Enucleation of Prostate treatment in Delhi, book an appointment with Dr Ashish Saini, an extremely skilled and experienced urologist in Delhi. Book an appointment right now for prostate cancer treatment.