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HoLEP & Thulep

HoLEP

Holmium laser prostate surgery is a minimally invasive treatment for an enlarged prostate. In this procedure, a laser system is used to remove the tissue that blocks the flow of urine from the prostate. A separate instrument is then used to cut the prostate tissue into easily removable pieces.

HoLEP is actually a procedure similar to open prostate surgery, but unlike it, it does not require an incision. HoLEP removes any part of the prostate that may be blocking the flow of urine. It is an important method to treat a severely enlarged prostate. 

HoLEP can treat prostate glands of any size and is so effective that retreatment rates are less than 2%. It leads to rapid relief of symptoms with minimal or no pain during voiding.

The entire procedure usually takes about 1 to 2 hours, but may be shorter or longer depending on the size of your prostate.

A small endoscope with laser probe will be inserted through your urethra, which is used to cut off excess tissue in the prostate that is causing the symptoms of BPH. Prostatic tissue is removed leaving only the prostate capsule. The tissue is typically removed in two to three large pieces that are placed in the bladder. A second device, called a morcellator, will break up the prostate tissue in the bladder and remove it from the body. There may be a small amount of tissue left behind,  that can be safely excreted in the urine.

AFTER SURGERY

 

It is helpful to drink as much fluids as possible in the first 12 hours after surgery because this helps the urine to clear the blood more quickly. Occasionally, a catheter may be used to clear the urine of blood. It is not unusual to see mild blood in the urine within the first 24-48 hours after the catheter is removed.

You will have a follow-up appointment within a day or two days after being discharged from the hospital.

At home; drink plenty of fluids, rest for one to two weeks, and avoid heavy lifting or strenuous physical activity for 3-4 weeks.

You can go back to work in a week or two, especially if you work from home or in a desk job that doesn't require much physical exertion.

If your job involves strenuous physical activity, you may need to wait 3-4 weeks before returning to work. 

There may be some potential side effects; retrograde ejaculation (dry orgasm) anejaculation (inability to ejaculate), fertility problems, transient urinary incontinence, temporary burning or bleeding while urinating.

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