It is now possible to safely eliminate the symptoms of benign prostatic hyperplasia (BPH) using Holmium Laser Enucleation of the Prostate (HoLEP), a precisely targeted laser therapy.
Benign prostatic hyperplasia (BPH) is a common condition that affects most men as they age due to the natural enlargement of the prostate gland in response to hormonal changes. According to studies, half of men will experience symptoms of prostate enlargement by the age of 50. These symptoms may include urinary obstruction, difficulty in urine flow, pain during urination, or nocturia that disrupts sleep. Such symptoms can affect the quality of life, prompting patients to seek treatment. So, how is prostate enlargement treated?
Holmium laser therapy is one of the modern methods used to alleviate or even treat prostate enlargement in Turkey. It directs laser beams to remove the overgrown prostate tissue without affecting the surrounding organs. This treatment offers excellent results comparable to transurethral resection of the prostate (TURP). So, What is the cost of HoLEP treatment in Turkey, and what are prostate laser surgery side effects?
What is Holep treatment for prostate enlargement?
Holmium Laser Enucleation of the Prostate (HoLEP) is a minimally invasive procedure used to treat urinary obstruction in men without subjecting the patient to the risks of surgery. Additionally, this procedure effectively removes a significant portion of the prostate tissue by separating the outer layer of the prostate gland from the inner layer. It is important to note that removing a more substantial portion of the prostate gland provides better relief from symptoms.
The Holmium laser device uses a light beam to ablate the prostate tissue surrounding the urethra and obstructing the urine outlet. Depending on the size of the prostate, the laser treatment for prostate takes about 3 hours. As a precaution, the patient stays in the hospital for one night to ensure no potential complications.
Green light laser prostate surgery surpasses other treatment methods in terms of safety and effectiveness. Moreover, the low cost of laser treatment for prostate enlargement in Turkey compared to surgical prostate removal is noteworthy.
Causes of prostate enlargement at an early age
Contributing Factors:
- Age: The risk of prostate enlargement increases with age but can also occur at an early age.
- Family History: A family history of prostate enlargement increases the risk of developing the condition.
- Race: Certain races, such as Black men, are more prone to prostate enlargement compared to others.
- Medical Conditions: Some medical conditions, such as diabetes and heart disease, may increase the risk of prostate enlargement.
- Lifestyle Factors: There are lifestyle factors that may increase the risk of prostate enlargement, such as:
- Obesity: Obesity is linked to an increased risk of prostate enlargement.
- Diet: A deficiency in specific nutrients, such as Vitamin D and zinc, may increase the risk of prostate enlargement.
- Lack of Physical Activity: A sedentary lifestyle may increase the risk of prostate enlargement.
- Hormonal Factors: Hormonal changes associated with aging also play a role in prostate enlargement.
Unconfirmed Causes:
- Prostatitis: Some researchers believe that prostatitis (inflammation of the prostate) may play a role in the development of prostate enlargement.
- Medications: Certain medications, such as those used to treat hair loss, may increase the risk of prostate enlargement.
- Environmental Factors: Some environmental factors may increase the risk of prostate enlargement, but further research is needed.
Who is laser prostatectomy performed for?
Benign prostatic hyperplasia (BPH) occurs in more than 50% of men over the age of 60 and is a major cause of urinary difficulty symptoms in this population. As age advances, the symptoms of this condition can worsen.
Although many cases of urinary tract obstruction due to BPH can be treated without surgery, some patients who do not benefit from these medical treatments may eventually require surgery or laser therapy to avoid long-term problems such as urinary retention, urinary tract infections, and bladder stones.
Typically, candidates for laser prostate treatment are those experiencing symptoms due to significantly enlarged prostates. These symptoms may include:
- Hematuria (blood in the urine)
- Painful urination
- Frequent nighttime urination, disrupting sleep
- Difficulty lying on the back with raised legs
If these symptoms cannot be alleviated through medication or less invasive treatments, laser therapy such as HoLEP prostatectomy, water vapor therapy, or transurethral resection of the prostate (TURP) may be considered.
Preparation before HoLEP surgery
The initial clinical examination will include taking a complete medical history to assess the severity of the symptoms, performing a digital rectal exam (DRE) to feel the prostate, measuring the urine flow rate, and conducting a post-void residual (PVR) test to determine the amount of urine left in the bladder after urination.
These tests will help determine the level of urinary tract obstruction and the degree of prostate enlargement. Laboratory tests will include blood tests, urine analysis, and measuring PSA (prostate-specific antigen) levels. If PSA levels are elevated, a biopsy (tissue sample) may be taken to rule out prostate cancer.
A transrectal ultrasound (TRUS) will also be performed to estimate the prostate gland’s size accurately. The larger the gland, the longer the surgery may take. Some doctors may also perform a cystoscopy to rule out other causes of urethral narrowing, such as stones, fibrous tissue, or tumors. Additionally, a urodynamic test may be performed to assess bladder function and determine if prostate removal is likely to reduce obstructive symptoms.
Once the procedure is scheduled, your doctor will advise you to stop taking certain medications, such as blood thinners, and to refrain from eating or drinking after midnight before the procedure. Antibiotics may be prescribed to reduce the risk of infection during the green laser prostate surgery.
How is the Holep operation performed?
You will be given either general or regional anesthesia so that you do not feel pain or discomfort during the operation. The doctor will insert a thin instrument called a “resectoscope” into the urethra through the tip of the penis. This resectoscope is connected to a small laser device that generates laser beams to cut and remove the overgrown prostate tissue, reducing the size of the gland and relieving the urinary obstruction.
The removed prostate tissue is collected in the bladder and then suctioned out using a unique instrument. The tissue is later sent to the laboratory for microscopic examination.
When you wake up from the anesthesia, the operation will be complete, and the excess prostate tissue will have been removed with a urinary catheter placed. You will be transferred to the recovery unit after the procedure, where you will stay for about two hours to monitor the results and ensure that no complications related to the procedure arise.
What to expect after laser prostatectomy?
The patient will stay overnight in the hospital for monitoring. Light bleeding from the prostate is expected after the surgery, and for most patients, this bleeding will subside within 12 hours. It is rare for patients to require a blood transfusion due to excessive bleeding after HoLEP surgery.
Fluids will be flushed through the catheter to remove blood from the urine after surgery. Once they can safely do so, patients are allowed to eat and drink on the same day of the procedure. If there is no severe bleeding, the catheter is usually removed the morning after the surgery.
If the patient can urinate well (at least two to three times after catheter removal), they can go home without the catheter. If they cannot, a new catheter is placed and removed within a week. In some cases, such as scar tissue forming in the urethra, the catheter may be left in place for a week after surgery and then removed in the clinic.
In the first few days after prostate gland laser surgery, urination may be painful and more frequent than usual. Medications can alleviate these symptoms until some improvement is noticed, usually within a few days. Patients are encouraged to drink plenty of fluids once the catheter is removed, as fluids, especially water, help cleanse the blood from the urine more efficiently.
Symptoms such as frequent urination and nighttime urination may take several months to improve permanently, as the bladder must adjust to the removal of prostate tissue.
Most patients require at least one to two weeks of rest at home before returning to work. Some patients may need 3 to 4 weeks to recover, especially if the work is physically demanding. Heavy lifting should be avoided during recovery, but patients are expected to walk and engage in light activities during this time.
Advantages of laser therapy for prostate cancer in Turkey
Laser enucleation of the prostate to treat BPH has proven to be a safe and effective procedure in various parts of the world. Although several types of BPH surgeries are available, the Holmium laser offers a unique advantage in its ability to remove a large amount of tissue without any incisions in the body, even in very large prostates, reducing the risk of bleeding and providing tissue for pathological examination (to check for prostate cancer). It also minimizes the need for blood transfusions during surgery, reduces the hospital stay to one or two days, and decreases the need for repeat treatment.
Recent studies predict that laser prostate treatment will become a preferred alternative to transurethral resection of the prostate (TURP) due to fewer side effects and the ability to detect cancer early. If pathological examination results indicate the presence of cancerous cells, prostate cancer can be treated with HIFU (High-intensity focused ultrasound) therapy.
If you are experiencing bothersome symptoms of BPH and wish to relieve them, you can consult our medical team for free. The Bimaristan team guides patients to the best available treatment options according to each patient’s condition and arranges appointments with the best doctors in Turkey. All you need to do is contact us.
Prostate laser surgery (Holep) side effects and risks
No medical procedure is entirely free of side effects and risks, even if the chances are meager. Holep (holmium laser enucleation of the prostate) may be associated with some complications, including:
- Temporary burning sensation and bleeding during urination
- Seeing some blood in the urine for weeks after Holep surgery
- Urinary incontinence (inability to control urine flow during the first days or weeks after treatment)
- Injury to the urethra or later development of scar tissue
- Injury to the bladder, ureters, testicles, or kidneys
- Retrograde ejaculation
- Recurrence of urinary tract obstruction later, requiring another procedure (in 1 to 2% of cases)
- The need for a blood transfusion or reoperation due to bleeding
- Incomplete relief of all symptoms or the need for long-term catheter use after Holep surgery
- Anesthesia-related risks
Performing pelvic floor exercises can help reduce urine leakage from stress maneuvers such as coughing, sneezing, or lifting weights. The risk of persistent urinary incontinence after holmium laser enucleation of the prostate is infrequent. The risk of urge incontinence depends on several factors, including age, prostate size, symptoms, and other medical problems.
Some patients may experience a sudden urge to urinate, which can be managed with medication.
Marital life after Holep prostate therapy
Impact of Holep Prostate Removal on Marital Life:
Prostate removal can affect marital life in various ways, but it is important to note that the impact varies from person to person.
Common challenges:
- Erectile dysfunction: This is the most common side effect after prostate removal.
- Urinary incontinence: Loss of bladder control, which may lead to urine leakage.
- Decreased sexual desire: Some men may experience a decrease in sexual desire after surgery.
- Pain: Some men may experience pain in the pelvic area or genitalia.
- Psychological changes: Some men may experience anxiety or depression.
However, there are many things that men and their spouses can do to overcome these challenges and maintain a healthy marital life.
Holep procedure cost in Turkey
The cost varies from patient to patient, depending on the condition, prostate size, and procedure duration. Prices also vary from one center to another in Turkey, but treatment costs typically start at $6,000 US Dollars. You can contact us to book an appointment with the most experienced holep surgeons at the lowest possible price. We also arrange travel and accommodation in Turkey with free consultations until your treatment is completed.
In conclusion, Holep (holmium laser enucleation of the prostate) to treat BPH is an excellent option for effectively relieving urinary obstruction symptoms with minimal risk of side effects. It is safer than other options and allows for microscopic examination of prostate tissue to rule out cancer. It is also suitable for most patients who do not respond to medical treatment.
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