What is Holep Surgery?
HoLEP, one of the current surgical methods, stands for Prostate Enucleation with Homium Laser. Advanced laser technology is used in HoLEP operation, one of the treatments for benign prostate enlargement.
The HoLEP method, which is as successful as open operations in the treatment of large prostates in size, is also a much more comfortable treatment option for patients. For this reason, it is applied as the standard treatment in today's prostate treatment.
Who Can Holep Be Performed?
HoLEP is suitable for almost all prostate patients. Because HoLEP offers many advantages to both surgeons and patients compared to other surgical options. In particular, the fact that it can be applied even to patients where other surgical methods cannot be applied makes it more widely used. For example, open surgery methods are recommended for the treatment of prostates larger than 80 g. Because it is not possible to remove the prostate with closed methods at this size. However, when it comes to the HoLEP method, it is possible to successfully remove prostates of 80 g and larger.
HoLEP treatment can be applied not only in prostate treatment but also in patients with stones in the bladder and urinary tract stenosis. All these problems are easily solved with a single operation.
Finally, it is the most suitable treatment option for people with cardiovascular diseases and people who use blood thinners for various reasons. These health problems, which are a problem in other treatment options, are not important for HoLEP treatment. For this reason, it is a much safer option compared to other options.
Conditions requiring HoLEP treatment
The conditions required for the application of HoLEP treatment include the following:
- Patients do not show any improvement despite taking medication
- Frequent bleeding and stones in the urinary tract
- Impairment of kidney function
- Frequently recurring and persistent urinary tract infections
- Need for catheter use
- Urine remaining in the bladder after urination
How to prepare for HoLEP surgery?
Patients undergo various tests before HoLEP surgery. If it is decided to remove the prostate after these examinations, patients are operated with the HoLEP method. The tests performed on patients include the following:
- Prostate examination
- Urine flow test
- Blood test (PSA)
How is HoLEP surgery performed?
In HoLEP operations, general anesthesia can be applied to patients or only below the waist can be anesthetized. Afterwards, a special tool with a camera is inserted through the urinary tract of the patients.
When the prostate tissue is reached, the tissue is cut with an advanced technology laser and then carefully separated from the capsule and thrown into the bladder. After this stage, a different tool is used. This instrument is called a morcellator and its job is to break down the tissue in the bladder and vacuum it out.
The patient is catheterized and the procedure is completed. Total operation time varies between 1 and 1.5 hours. The pieces taken from the prostate are sent to pathology laboratories for necessary examinations.
Complications of the HoLEP method
As with any surgical operation, some complaints are observed in patients after HoLEP surgeries. However, the symptoms usually resolve spontaneously within a short period of time. After HoLEP surgery, patients may experience color changes in their urine. Blood may be seen especially at the beginning and end of urine. However, this situation will soon pass. These bleeding, which is the most common complaint in HoLEP method, will disappear within the first few weeks.
After surgery, patients may experience dripping and inability to control urine due to the removal of the prostate. These complaints are more common in diabetics, patients with long catheterization and people with neurological diseases. Exercise and medication are used to relieve these complaints.
In patients who use catheters for a long time and have a weak immune system, the likelihood of infection increases. To prevent this, a urine culture should be taken beforehand.
Life After Holep Surgery
After HoLEP surgeries, patients need to go through a 2- to 3-month rest period in order to return to their normal lives. During this process, it is possible for patients to do light exercise without tiring themselves. After surgery, patients are advised to consume foods rich in fiber content. In this way, patients are tried to prevent constipation.
In the first 1 month after surgery, patients should avoid carbonated drinks and spicy foods. In addition, they have to wait 4-6 weeks before they can return to their sexual life. During the first intercourse after the operation, it is possible for semen to escape back into the bladder. In this case, it does not pose any health problems. There may also be blood in the urine or semen after the first intercourse.
Among the points that patients should pay attention to after HoLEP surgery are the following:
- Patients should be careful not to lift heavy objects.
- Sexual intercourse should be avoided within the specified periods.
- Patients need to make sure they drink enough water.
The feature that makes HoLEP the gold standard treatment in prostate treatment is of course the advantages it provides to patients and physicians compared to other treatment methods. These advantages include the following. The size of the prostate is not important for the application of the method:
Subordinates whose catheter is removed after surgery do not experience burning during urination.
- Even if the size of the prostate is very large, patients are not subjected to any incision procedure.
- Hospitalization is limited to only 1 to 2 days.
- It is the most successful alternative to open surgery.
- Even patients on blood thinners can undergo the procedure using blood thinner needles.
- The chance of recurrence is extremely low.
- Blood transfusion is usually not needed during surgery as the risk of bleeding is very low
- It does not harm sexual function.
- Patients can return to their normal lives in a short time.
- The healing process is much faster and more comfortable.
- It can be safely applied even to people who use blood thinners.