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HoLEP Prostatectomy

HoLEP Prostatectomy

HoLEP (Holmium Laser Enucleation of the Prostate) is a minimally invasive surgical procedure used to treat benign prostatic hyperplasia (BPH), which is a non-cancerous enlargement of the prostate gland. As the prostate enlarges, it can compress the urethra and obstruct the flow of urine, leading to uncomfortable urinary symptoms like frequent urination, weak urine flow, or difficulty starting and stopping urination. HoLEP involves the use of a holmium laser to remove the excess prostate tissue that is causing the blockage, restoring normal urine flow.

This procedure is considered highly effective for patients with moderate to severe symptoms of BPH, offering significant relief while preserving healthy prostate tissue. HoLEP is known for its precision, minimal bleeding, and the ability to remove larger amounts of prostate tissue compared to traditional methods, making it suitable even for patients with very large prostates. Additionally, it is associated with a shorter hospital stay, faster recovery, and a lower risk of needing further treatment compared to other BPH surgeries. The holmium laser provides a precise, controlled method of removing prostate tissue, which reduces complications and improves patient outcomes, making HoLEP an increasingly popular choice among urologists for treating BPH.

Introduction

Introduction

Patient Eligibility

HoLEP (Holmium Laser Enucleation of the Prostate) is a highly effective treatment for benign prostatic hyperplasia (BPH), but not all patients may be ideal candidates for this procedure. The eligibility for HoLEP is determined based on several factors, including the severity of symptoms, the size of the prostate, overall health, and individual medical history. Below are the key criteria that determine whether a patient is suitable for a HoLEP procedure:

 

1. Severity of Symptoms

- Moderate to Severe Urinary Symptoms: HoLEP is typically recommended for men who are experiencing moderate to severe lower urinary tract symptoms (LUTS) due to BPH. Common symptoms include frequent urination (especially at night), weak or interrupted urine flow, difficulty starting or stopping urination, and a sensation of incomplete bladder emptying.

 

2. Size of the Prostate

- Large Prostate Gland: HoLEP is especially beneficial for patients with a significantly enlarged prostate. It is effective for all sizes of prostate, but it is particularly advantageous for treating very large prostates, typically those greater than 80 grams. Unlike some other minimally invasive procedures, HoLEP allows the removal of substantial amounts of prostate tissue, making it suitable for men with very enlarged prostates.

 

3. Previous Treatment Failures
- Unsuccessful Medical Management: Patients who have not responded well to medication for BPH, such as alpha-blockers or 5-alpha reductase inhibitors, are good candidates for HoLEP. When medication is insufficient to alleviate symptoms or causes significant side effects, HoLEP provides a long-term solution.

 

4. Patients with Recurrent Urinary Retention
- Recurrent Urinary Retention: Men who have experienced urinary retention—an inability to empty the bladder completely—are also suitable candidates for HoLEP. The procedure effectively removes the obstructive tissue, allowing for better bladder emptying and reducing the risk of future retention episodes.

 

5. Presence of Bladder Stones or Other Complications
- Bladder Stones: Men who have developed bladder stones due to BPH-related urinary retention can also benefit from HoLEP. By removing the excess prostate tissue, HoLEP can alleviate the cause of bladder stones and improve bladder function.
- Recurrent Urinary Tract Infections (UTIs): Patients experiencing frequent UTIs as a result of incomplete bladder emptying may be eligible for HoLEP, as improving urine flow can help reduce the risk of infection.

 

6. Overall Health Status
- Patients Suitable for General or Spinal Anesthesia: HoLEP is performed under general or spinal anesthesia, so candidates must be in sufficient health to tolerate anesthesia. A thorough medical evaluation will be conducted to assess the patient's cardiovascular and respiratory health.
- Anticoagulation Therapy: One of the advantages of HoLEP is that it can often be performed on patients who are taking blood thinners (anticoagulants) such as warfarin or aspirin. Unlike other surgical procedures, HoLEP has a lower risk of bleeding, making it a safer option for patients who cannot discontinue their anticoagulation therapy.

 

7. Previous Prostate Surgery
- History of Failed Prostate Surgery: Men who have had previous prostate surgeries (such as transurethral resection of the prostate, or TURP) but continue to have symptoms of BPH may still be candidates for HoLEP. The precision and effectiveness of the holmium laser make it suitable for addressing residual or recurrent prostate tissue.

 

8. Patient Preference
- Minimally Invasive Procedure with Long-Term Benefits: HoLEP is a minimally invasive alternative to traditional prostate surgeries, and many patients choose it for its **shorter recovery time**, lower risk of bleeding, and long-lasting results. Men who are looking for a durable solution to BPH with fewer risks of needing re-treatment may prefer HoLEP over other options.

Who Might Not Be Eligible for HoLEP?


1. Patients with Specific Health Conditions:
   - Men who are not suitable candidates for general or spinal anesthesia may not be eligible for HoLEP.
   - Patients with severe, uncontrolled health conditions, such as advanced heart disease or severe respiratory problems, may need alternative treatment options.
 
2. Patients with Small Prostates:
   - HoLEP is particularly advantageous for larger prostates. For patients with a small prostate, other minimally invasive procedures may be more appropriate.

 

3. Patients with Certain Anatomical Issues:
   - Patients with severe urethral stricture disease or significant bladder contractility issues may not be suitable candidates for HoLEP, as these conditions can complicate the procedure and its outcomes.

Summary
HoLEP is an effective treatment option for men with moderate to severe symptoms of BPH, particularly for those with large prostate glands, recurrent urinary retention, or those who have not responded well to medication. The procedure is also suitable for patients with certain complicating factors like bladder stones or those on anticoagulation therapy. However, eligibility must be assessed on an individual basis, with consideration of the patient's overall health and specific medical conditions. A thorough evaluation by a urologist is essential to determine whether HoLEP is the right choice, offering significant symptom relief, improved quality of life, and long-term benefits for those struggling with BPH.

Patient Eligibility for HoLEP Prostatectomy

Preparation and Preoperative Care

Preparation and Preoperative Care for HoLEP Prostatectomy

 

Proper preparation and preoperative care are essential to ensure the success of the HoLEP (Holmium Laser Enucleation of the Prostate) procedure and to minimize potential complications. Below is a detailed overview of the steps that patients need to follow in preparation for HoLEP, including medical evaluations, lifestyle adjustments, and preoperative instructions.

1. Medical Evaluation and Assessment
- Consultation with the Urologist: The preparation for HoLEP begins with a thorough consultation with the urologist. During this consultation, the patient's symptoms, medical history, and medications are reviewed to determine suitability for the procedure.
- Imaging TestsImaging studies, such as an ultrasound, may be performed to assess the size of the prostate and any potential anatomical issues that could affect the procedure.
- Urodynamic Studies: Urodynamic testing may be done to evaluate the function of the bladder and the degree of obstruction caused by the prostate.
- Blood Tests: Blood tests, including complete blood count (CBC), kidney function tests, and coagulation tests, are done to ensure the patient is in good health and to rule out any underlying conditions that could affect the surgery.
- Urine Analysis: A urine test is conducted to check for any urinary tract infections (UTIs). If an infection is present, it must be treated with antibiotics before proceeding with the surgery.

 

2. Medication Adjustments
- Anticoagulants and Blood Thinners: Patients who are taking blood thinners (such as warfarin, aspirin, or clopidogrel) may need to adjust their medication in the days leading up to the surgery. HoLEP has a lower risk of bleeding compared to other procedures, but the urologist will decide whether the patient should stop or continue taking blood thinners.
- Other Medications: Patients should inform the doctor of all medications, including over-the-counter drugs and herbal supplements, as some may interfere with anesthesia or increase bleeding risk. Certain medications may need to be stopped or adjusted before the procedure.

 

3. Preoperative Instructions
- Fasting: Patients are usually instructed to fast for at least 6 to 8 hours before the surgery. This means avoiding both food and drink, including water, starting from midnight the night before the procedure. Fasting is important to reduce the risk of complications related to anesthesia.
- Hydration: Although patients must fast before the surgery, it is important to be well-hydrated in the days leading up to the procedure. This helps ensure proper kidney function and prepares the body for anesthesia.

 

4. Lifestyle Adjustments Before Surgery
- Quit Smoking: Smoking can interfere with the body's ability to heal and can increase the risk of complications during surgery. Patients are advised to quit smoking at least several weeks before the procedure.
- Alcohol: Alcohol consumption should be limited or avoided before surgery, as it can interact with anesthesia and affect the body's ability to recover.
- Healthy Diet: Maintaining a balanced diet rich in vitamins and minerals is important for proper healing. Eating well in the weeks leading up to surgery can boost the immune system and improve overall health.

 

5. Preoperative Anesthesia Assessment
- Meeting with the Anesthesiologist: Before the procedure, patients will meet with an anesthesiologist to discuss anesthesia options and ensure that the patient is in good condition to undergo anesthesia. The anesthesiologist will review medical history, including allergies and any past experiences with anesthesia, to determine the safest option.
- General or Spinal Anesthesia: HoLEP can be performed under general anesthesia (which puts the patient to sleep) or spinal anesthesia (which numbs the lower part of the body while the patient remains awake). The choice depends on the patient's health and preference, as well as the recommendation of the anesthesiologist.

 

6. Arrangements for After the Surgery
- Transportation: Since HoLEP is usually performed under anesthesia, patients will need someone to drive them home after the procedure. It is important to arrange transportation in advance, as the effects of anesthesia can last for several hours.
- Recovery Assistance: It may be helpful to arrange for a friend or family member to assist during the first few days after surgery. While recovery from HoLEP is generally quick, patients may need some help with daily activities immediately following the procedure.

 

7. Bowel Preparation
- Enema or Laxatives: In some cases, the urologist may recommend a mild enema or laxative before surgery to ensure that the bowels are empty. This is done to reduce pressure on the prostate area and to minimize the risk of complications during the procedure.

 

8. Day Before Surgery
- Follow Instructions Closely: The day before surgery, patients should review all preoperative instructions given by their healthcare team. This includes medication adjustments, fasting requirements, and timing for arriving at the hospital or surgical center.
- Personal Hygiene: Patients may be asked to shower using an antiseptic soap to reduce the risk of infection. Removing jewelry, nail polish, and other personal items is also recommended before arriving for surgery.

 

Summary
Preparing for HoLEP prostatectomy involves a thorough medical evaluation, imaging tests, and laboratory work to ensure that the patient is in the best possible condition for surgery. Patients must follow specific preoperative instructions, such as fasting, medication adjustments, and quitting smoking, to minimize the risk of complications. Proper preparation and adherence to the preoperative care plan help improve the success of the procedure and facilitate a smooth recovery. The urologist, anesthesiologist, and medical team will provide guidance to ensure that patients are well-prepared and comfortable before undergoing HoLEP.

Διεγχειρητικά Βήματα

Intraoperative Details of HoLEP Prostatectomy

 

The HoLEP (Holmium Laser Enucleation of the Prostate) procedure is a minimally invasive surgery that uses a holmium laser to remove excess prostate tissue, relieving urinary obstruction caused by benign prostatic hyperplasia (BPH). The surgery is typically performed in a hospital or outpatient surgical center by a specialized urologist. Below, the key steps and intraoperative details of the HoLEP procedure are outlined, providing a better understanding of what occurs during the operation.

1. Anesthesia
- Type of Anesthesia: The procedure is performed under general anesthesia (where the patient is completely unconscious) or spinal anesthesia (where the lower part of the body is numbed, but the patient remains awake). The choice depends on the patient's health, preference, and the recommendation of the anesthesiologist.
- Patient Preparation: Once anesthesia is administered, the patient is placed in the lithotomy position (lying on the back with legs raised and supported in stirrups). This position provides the surgeon with optimal access to the prostate and urinary tract.

 

2. Insertion of the Resectoscope
- Resectoscope Insertion: A resectoscope, which is a thin, tube-like instrument equipped with a camera and working channel, is inserted through the urethra (the tube that carries urine from the bladder to the outside of the body). The resectoscope allows the surgeon to view the interior of the urethra, bladder, and prostate.
- Visualization**: The camera provides a clear view of the prostate and surrounding structures on a monitor, allowing the surgeon to precisely navigate and identify the tissue that needs to be removed.

 

3. Laser Enucleation
- Use of the Holmium Laser: The holmium laser, which is delivered through a fiber passed through the resectoscope, is used to carefully enucleate the excess prostate tissue. The laser emits high-energy pulses that precisely separate the enlarged prostate tissue from the capsule (the outer layer of the prostate).
- Enucleation Process: The surgeon works in a systematic manner to separate the obstructive prostate tissue, moving from one lobe of the prostate to another. Typically, the prostate is divided into three lobes (two lateral lobes and a median lobe), and each lobe is removed sequentially. The holmium laser is effective in cutting the tissue while minimizing bleeding.
- Hemostasis: One of the key benefits of the holmium laser is its ability to achieve excellent hemostasis (control of bleeding) during tissue removal. The laser coagulates small blood vessels, resulting in minimal blood loss during the procedure.

 

4. Morcellation of the Prostate Tissue
- Tissue Morcellation: Once the prostate tissue is completely enucleated, it is left floating in the bladder. To remove this tissue, a specialized instrument called a morcellator is inserted through the resectoscope. The morcellator cuts the tissue into smaller fragments, which are then suctioned out of the bladder.
- Removal of Tissue: The removed prostate tissue is usually sent to a laboratory for histopathological analysis to check for any abnormalities, such as prostate cancer, even though HoLEP is primarily used to treat BPH.

 

5. Continuous Bladder Irrigation
- Irrigation to Maintain Clear Visibility: Throughout the procedure, sterile irrigation fluid is used to maintain a clear field of view and to flush away any small tissue fragments or blood clots. The continuous flow of irrigation fluid helps prevent the buildup of debris and ensures that the surgeon has an unobstructed view of the operating area.

 

6. Final Inspection and Hemostasis
- Inspection of the Surgical Site: After all prostate tissue has been removed and morcellated, the surgeon inspects the surgical site to ensure that there are no remaining tissue fragments and that bleeding is well controlled.
- Laser Coagulation: Any small bleeding vessels that are identified are coagulated using the holmium laser to achieve complete hemostasis before concluding the procedure.

 

7. Placement of a Catheter
- Insertion of a Foley Catheter: At the end of the procedure, a Foley catheter is inserted through the urethra and into the bladder. The catheter is usually equipped with a balloon that is inflated to keep it securely in place.
- Continuous Bladder Irrigation: In some cases, continuous bladder irrigation (CBI) may be started through the catheter to prevent blood clots from forming in the bladder. The irrigation fluid is used to flush out any residual blood, helping to keep the urine clear during the initial recovery period.

Duration of the Procedure
- Procedure Length: The duration of the HoLEP procedure depends on the size of the prostate and the complexity of the case but typically takes between 60 to 90 minutes. Larger prostates may require more time due to the increased amount of tissue that needs to be enucleated and morcellated.

Intraoperative Monitoring and Safety


- Patient Monitoring: Throughout the procedure, the patient's vital signs—heart rate, blood pressure, oxygen levels, and respiratory status—are closely monitored by the anesthesiologist and surgical team to ensure the patient's safety.
- Minimizing Risks: The precision of the holmium laser, combined with real-time visualization, helps to minimize risks such as bleeding, injury to surrounding tissues, and the risk of complications.

 

Summary
The intraoperative phase of HoLEP prostatectomy involves the precise removal of excess prostate tissue using a holmium laser, followed by the morcellation and removal of the enucleated tissue from the bladder. The procedure is performed under either general or spinal anesthesia, and it typically takes about 60 to 90 minutes. The holmium laser allows for effective enucleation with minimal bleeding, making it a safe and highly effective treatment for BPH. The placement of a Foley catheter at the end of the procedure facilitates healing and helps manage urine flow during the initial recovery period. Overall, HoLEP is an advanced, minimally invasive procedure that offers significant relief for patients with an enlarged prostate, while reducing the risks of complications and ensuring a faster recovery.

Ανάρρωση και Μετεγχειρητική Φροντίδα 

Recovery and Postoperative Care After HoLEP Prostatectomy

 

Proper postoperative care and recovery after HoLEP (Holmium Laser Enucleation of the Prostate) are essential to ensure the best possible outcomes and minimize complications. Following HoLEP, patients can expect significant improvement in their urinary symptoms, but the recovery period may include some temporary side effects that need to be managed. Below is a detailed guide on what to expect during recovery and how to care for yourself following the procedure.

 

1. Hospital Stay and Immediate Postoperative Care
- Duration of Hospital Stay: HoLEP is typically performed as an inpatient procedure, and most patients stay in the hospital for one night. In some cases, patients may be discharged the same day if their recovery is smooth and there are no complications.
- Monitoring in the Recovery Room: Immediately after surgery, patients are taken to a recovery room, where they are closely monitored as the effects of anesthesia wear off. Vital signs, such as heart rate, blood pressure, and oxygen levels, are continuously observed to ensure stability.
- Foley Catheter: A Foley catheter is placed during the surgery and remains in place for typically 12 to 24 hours postoperatively. The catheter helps drain urine from the bladder and flush out any small blood clots. The catheter is usually removed before the patient leaves the hospital, but in some cases, it may remain in place for a longer period, depending on the patient's condition.

 

2. Managing Postoperative Symptoms
- Blood in Urine (Hematuria): It is normal to have blood in the urine for several days to weeks after HoLEP. The urine may appear pink or reddish, and this typically decreases over time as healing progresses. Drinking plenty of water helps flush the bladder and reduce the presence of blood.
- Frequent Urination and Urgency: Patients may experience frequent urination, urgency, and a burning sensation during urination in the first few weeks after surgery. This is due to the irritation caused by the procedure and should improve as the healing process continues.
- Mild Pain or Discomfort: Some patients may feel mild discomfort or pain in the pelvic area or during urination. Over-the-counter pain relievers, such as ibuprofen or paracetamol, can be used to manage these symptoms. Any severe or persistent pain should be reported to the healthcare provider.

 

3. Activity Restrictions and Recommendations
- Rest and Light Activity: Rest is important in the first few days after surgery, but patients are encouraged to engage in light activity such as walking. Walking helps improve blood circulation, prevent blood clots, and promote healing. However, strenuous activities should be avoided for at least 2 to 4 weeks.
- Avoid Heavy Lifting: Patients should avoid lifting heavy objects (more than 5 kg) for at least four weeks after surgery, as this may put undue pressure on the pelvic area and interfere with healing.
- Driving: Patients should avoid driving while the catheter is in place and for at least a few days after the catheter is removed. It is also important not to drive while taking any pain medication that may cause drowsiness.

 

4. Hydration and Diet
- Increase Fluid Intake: Drinking plenty of fluids, especially water (at least 8 to 10 glasses a day), is essential during recovery. Adequate hydration helps flush out the bladder and reduce the risk of blood clots or infection.
- Healthy Diet: Eating a balanced diet with plenty of fruits, vegetables, and fiber is important for overall recovery. A high-fiber diet helps prevent constipation, which is important since straining during bowel movements can put pressure on the surgical site.

 

5. Bladder Training and Managing Urinary Symptoms
- Improvement in Urinary Symptoms: The frequency and urgency of urination, as well as other urinary symptoms, generally improve significantly within a few weeks after HoLEP. However, it is common for patients to have some residual symptoms, such as mild incontinence or leakage, during the initial recovery phase.
- Bladder Training Exercises: In some cases, pelvic floor exercises (Kegel exercises) may be recommended to help strengthen the muscles around the bladder and urethra, reducing leakage and improving bladder control.

 

6. Follow-Up Appointments
- Postoperative Follow-Up: Patients will typically have a follow-up appointment with their urologist within 2 to 4 weeks after the procedure. During this visit, the urologist will assess the healing progress, check for any complications, and discuss any concerns the patient may have.
- Monitoring Urinary Flow: In follow-up visits, the urologist may perform a urine flow test and a bladder ultrasound to assess the effectiveness of the procedure and ensure that the bladder is emptying properly.

 

7. Managing Possible Complications
- Infection: Though rare, infections can occur after HoLEP. Signs of infection include fever, chills, severe pain, or foul-smelling urine. If any of these symptoms occur, patients should contact their healthcare provider immediately, as antibiotics may be needed.
- Urinary Incontinence: Temporary urinary incontinence is common immediately following HoLEP, as the bladder adjusts to the removal of the obstructing prostate tissue. This usually improves with time, and most patients regain full control within a few weeks to a few months. Pelvic floor exercises may be recommended to aid recovery.
- Urethral Stricture: In rare cases, patients may develop a urethral stricture (narrowing of the urethra) after HoLEP, which can lead to difficulty urinating. If patients experience a decrease in urine flow or difficulty urinating, they should consult their urologist for evaluation and management.

 

8. Resuming Normal Activities
- Sexual Activity: Most patients can resume sexual activity about 4 to 6 weeks after surgery, once they feel comfortable. It is normal to experience changes in ejaculation, such as retrograde ejaculation (where semen flows backward into the bladder instead of out through the penis). This is a common side effect of HoLEP but does not affect sexual pleasure or erectile function.
- Return to Work: Depending on the patient's occupation, most can return to work within 1 to 2 weeks after HoLEP, especially if their job is not physically demanding. For those with more physically strenuous jobs, a longer recovery period may be required.

Summary
Recovery after HoLEP prostatectomy typically involves a short hospital stay, followed by a few weeks of at-home recovery. Patients can expect some blood in their urine, frequent urination, and mild discomfort initially. Adequate hydration, avoiding strenuous activities, and attending follow-up appointments are essential components of postoperative care. Most patients experience significant improvement in their urinary symptoms after the procedure, although temporary side effects, such as urinary incontinence, may occur. With proper care and adherence to the postoperative guidelines provided by the healthcare team, most patients can return to their normal activities within a few weeks and enjoy long-term relief from BPH symptoms.

 

HoLEP (Holmium Laser Enucleation of the Prostate) is a modern, minimally invasive surgical procedure that has proven to be highly effective in treating benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate. It offers several advantages over traditional treatment options, such as Transurethral Resection of the Prostate (TURP) and open prostatectomy, making it a preferred choice for many patients and urologists. Below are the key advantages of HoLEP:

 

1. Effective for Large Prostates
- Suitable for All Prostate Sizes: One of the primary advantages of HoLEP is that it is highly effective for treating large prostates, even those greater than 80 to 100 grams. Unlike other procedures that may be less effective or require multiple sessions for large prostates, HoLEP can completely remove the obstructive tissue in a single procedure.
- Complete Tissue Removal: HoLEP allows for the complete enucleation of the enlarged prostate tissue, leading to significant and long-lasting symptom relief. This makes it an excellent option for men with very large prostates who might otherwise require open surgery.

 

2. Minimally Invasive Procedure
- No External Incisions: HoLEP is a minimally invasive procedure performed entirely through the urethra, without the need for external incisions. This results in less scarring, reduced pain, and faster recovery times compared to open prostatectomy.

 

3. Lower Risk of Bleeding
- Holmium Laser Coagulation: The holmium laser used in HoLEP not only cuts through the prostate tissue but also coagulates blood vessels as it works. This results in minimal blood loss, making it an ideal option for patients at higher risk of bleeding, such as those on anticoagulant (blood-thinning) medications.
- Suitable for Patients on Anticoagulants: Due to the reduced risk of bleeding, many patients who are on blood thinners can safely undergo HoLEP without needing to discontinue their medication, which is not always the case with other surgical options.

 

4. Shorter Hospital Stay and Faster Recovery
- Quicker Discharge: Most patients undergoing HoLEP can expect a short hospital stay, usually overnight, with some even being discharged the same day. This is shorter compared to the stay required for traditional open surgery or TURP.
- Faster Return to Normal Activities: Patients generally experience a faster recovery and can return to normal daily activities, including work, within 1 to 2 weeks after the procedure, depending on their overall health and occupation.

 

5. Durable and Long-Lasting Results
- Low Re-Treatment Rate: Studies have shown that HoLEP offers durable and long-lasting results, with a very low risk of needing repeat treatment for BPH. Unlike some other procedures where prostate tissue may regrow, the complete removal achieved with HoLEP reduces the likelihood of recurrence, providing long-term relief from symptoms.
- Significant Symptom Improvement: Patients experience significant improvement in symptoms such as frequent urination, weak urine flow, and urinary retention. The procedure also improves bladder emptying, which helps prevent complications like urinary tract infections and bladder stones.

 

6. Improved Urinary Flow and Bladder Function
- Immediate Symptom Relief: Many patients notice an immediate improvement in their urinary symptoms after HoLEP, including a stronger urine stream and reduced urinary frequency and urgency.
- Bladder Function Restoration: By removing the obstruction caused by the enlarged prostate, HoLEP helps restore bladder function and improves the ability to fully empty the bladder, which is especially beneficial for patients who have experienced long-term urinary retention.

 

7. Low Risk of Sexual Dysfunction
- Preservation of Erectile Function: HoLEP has a low risk of causing erectile dysfunction compared to some other surgical treatments for BPH. The procedure is highly targeted, allowing the surgeon to remove only the obstructive tissue without damaging surrounding nerves that are important for erectile function.
- Retrograde Ejaculation: While retrograde ejaculation (where semen flows backward into the bladder instead of out through the penis) is a common side effect of HoLEP, this does not affect sexual pleasure or the ability to have an erection. For many men, the improvement in urinary symptoms outweighs the impact of retrograde ejaculation.

 

8. Less Risk of TUR Syndrome
- Reduced Risk of TUR Syndrome: Traditional TURP involves the use of an irrigation fluid that, in rare cases, can be absorbed into the body, causing TUR syndrome—a potentially dangerous imbalance of electrolytes. HoLEP uses saline irrigation, which significantly reduces the risk of this complication, making the procedure safer for patients.

 

9. Comprehensive Tissue Removal for Pathological Examination
- Tissue Sample for Analysis: During HoLEP, the entire prostate adenoma is removed in pieces, which can then be sent to the laboratory for pathological examination. This allows for the detection of any cancerous changes or abnormalities in the prostate tissue, providing additional peace of mind for patients.

 

10. Suitable for Older Patients
- Effective and Safe for Elderly Patients: HoLEP is an effective treatment for older men, who often have larger prostates and may be at higher risk for complications with other surgical procedures. The minimal invasiveness, low risk of bleeding, and shorter hospital stay make HoLEP an ideal choice for elderly patients who may have other health conditions.

Summary
HoLEP prostatectomy offers numerous advantages over traditional treatments for benign prostatic hyperplasia, particularly for patients with large prostates. The procedure is minimally invasive, has a lower risk of bleeding, and provides faster recovery and long-term relief from urinary symptoms. It is an effective option for patients on anticoagulants, has a low risk of complications like erectile dysfunction, and allows for comprehensive tissue analysis. Overall, HoLEP provides a safe and highly effective solution for relieving the symptoms of BPH and improving the quality of life for men experiencing urinary difficulties due to an enlarged prostate.

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Advantages of HoLEP Prostatectomy

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Meet Our Exceptional Surgical Team

At RhodosUrology, we are privileged to have a distinguished surgical team renowned for their expertise and contributions to the field of urology. Led by the esteemed Prof. Liatsikos Evangelos, our team is committed to delivering exceptional care and achieving optimal outcomes for our patients. Allow us to introduce you to the remarkable individuals who make up our Rezum surgical team:

1. Prof. Liatsikos Evangelos, MD, PhD, FEBU (Chairman, European Urology Association and Greek Urology Association):
Prof. Liatsikos Evangelos is a globally recognized urologist and a leader in the field of minimally invasive urological procedures. With extensive experience and a commitment to innovation, Prof. Evangelos has played a pivotal role in advancing the use of Rezum Water Vapor Therapy for the treatment of benign prostatic hyperplasia (BPH). His dedication to patient care and research has earned him prestigious positions as Chairman in both the European Urology Association and the Greek Urology Association.

2. Dr. Vasilas Marinos, MD, PhDc (Urologist):
Dr. Vasilas Marinos is a highly skilled urologist with a focus on minimally invasive techniques, including Rezum Water Vapor Therapy. With a passion for patient-centered care and a commitment to excellence, Dr. Marinos brings a wealth of knowledge and expertise to our Rezum surgical team. His dedication to improving patient outcomes and quality of life makes him an invaluable asset to our practice.

3. Dr. Iason Kyriazis, MD, PhD, FEBU (Urologist):
Dr. Iason Kyriazis is a dedicated urologist with a special interest in the treatment of benign prostatic hyperplasia (BPH) using Rezum Water Vapor Therapy. With a focus on personalized care and the latest advancements in urology, Dr. Kyriazis is committed to providing our patients with the highest quality of treatment and support. His expertise and compassion ensure that each patient receives individualized care tailored to their unique needs.

Our Rezum surgical team, led by Prof. Liatsikos Evangelos, is dedicated to providing exceptional care and achieving the best possible outcomes for our patients. With a focus on Rezum Water Vapor Therapy, we combine advanced technology, expertise, and a patient-centered approach to deliver outstanding results. We understand the importance of your health and well-being, and we are honored to be part of your journey to improved urinary function and quality of life.

We are here to answer your questions, address your concerns, and provide you with the support you need every step of the way. Choosing RhodosUrology means entrusting your care to a team of experts who are committed to your health, comfort, and satisfaction. We look forward to serving you with excellence, compassion, and dedication.

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