KOCHI: The prostate gland is a part of the male body that is quiet in the first part of his life and makes a lot of noise in the second. It plays a major role in reproductive function. Past one’s sexual prime, it becomes an expendable organ. The prostate gland is a walnut-shaped organ situated in the deep pelvis, below the urinary bladder, wrapped around the urethra. The urethra runs through the centre of the prostate from the bladder to the penis, letting urine flow out of the body. The prostate secretes fluid that nourishes and protects the sperm. It also has a small role in controlling urination.
Of the problems that originate in the prostate, the noncancerous enlargement of the gland is the most common. They are often referred to as benign prostatic hyperplasia (BPH). Almost half the population of men over 60 experience it, and 80 per cent of men over 80 show symptoms of BPH. The increased prostate volume and smooth muscle tone can lead to compression of the urethra, and subsequently, urinary obstruction.
These symptoms can be extremely bothersome. If medical attention is not sought, the disease can progress leading to recurrent urinary infection, the passage of blood in the urine, complete blockage of urine, stone formation in the urinary bladder and even kidney failure.
The recommended first-line treatment options in patients with a prostate greater than 80mL are open prostatectomy, holmium laser enucleation of the prostate (HoLEP), and bipolar enucleation. Lasers have been used in the treatment of prostate enlargement for two decades. But it is only recently that it is gaining popularity. There are different kinds of lasers used for prostate surgery depending on the wavelength. The common ones are Holmium laser, KTP laser or green light laser and Thulmium laser.
Holmium laser has proven benefits because it can vaporise, ablate, resect or enucleate the prostate gland. Enucleation is found to be superior to other techniques. Holmium laser enucleation of the gland ( HOLEP) is equivalent to open surgery for the prostate whereby the entire gland is separated from the prostate capsule, broken down into small pieces and sucked out endoscopically without making any incision in the body.
Symptoms of prostatic enlargement include:
Increased urinary frequency
Poor stream of urination
Need to get up more often in the night to urinate
Feeling that the bladder is still full
Complete blockage of urine
Advantages of HoLEP
Can be used for prostates of any size
No need for complex procedures like an open surgery
Lower retreatment rate compared with TURP
Can be performed safely in elderly patients
Healthy for people with cardiac compromise
Recovery time is shorter than other modalities
You may go home 48 to 72hrs after the operation
Less bleeding and need for blood transfusion
Less chances for erectile dysfunction
Got health concerns you want to share with a doctor? Are you looking for credible answers regarding symptoms, medicines or lifestyle disorders? Write to us on cityexpresskoc@newindianexpress.com, and we will get healthcare professionals to answer them.
The author is a consultant urologist at Medical Trust Hospital, Kochi