Holmium Laser Enucleation of Prostate (HoLEP)
Benign Prostatic Hyperplasia (BPH) is one of the common prostate issues among men that leads to obstructed urine flow. To address this problem there is an advanced minimally invasive technique nowadays being popularly recommended by urologists in Hyderabad- the Holmium Laser Enucleation of Prostate (HoLEP).
Arete Hospitals is a multispecialty hospital in Hyderabad having the top-notch urologists and robotic surgeons who are experts in performing HoLEP. Its urology department has the cutting-edge technologies and equipment like modified continuous flow resectoscope to carry out HoLEP procedure. It delivers successful surgical outcomes and exceptional care to its patients.
Benefits of HoLEP
- HoLEP is India's most powerful laser technique highly efficient in performing several urological surgeries. It has been in use in many different parts of the world which ensures its safety and effectiveness.
- Although there are many surgeries available for treatment of Benign Prostatic Hyperplasia, HoLEP offers unique benefits. It is a minimally invasive approach to remove large amounts of prostate tissues without making incisions. It even works for very large prostates that weigh up to or more than 100 grams by rapidly creating large cavities after immediate removal of blocking prostate tissue.
- The procedure is associated with little risk of bleeding and has no extensive downtime. It even provides the prostate tissues for further cancer screening.
- HoLEP relatively does not require blood transfusions at time of operation because of the coagulative ability of the holmium laser that can seal the tissue planes. This even reduces the risk of systemic absorption of fluids.
- Other benefits include reduced requirement for bladder irrigation, shorter catheterization period post-surgery, and reduced length of hospital stay (1-2 days). Furthermore, with HoLEP, there is less likelihood of repeating the procedure. It is potentially affordable surgery for urine obstruction caused by BPH, as compared to other surgeries like TURP and laser vaporisation.
Get BPH treatment and other urology concerns with Arete Hospitals, Best HoLEP Hospital in Hyderabad.
What is HoLEP?
HoLEP is one of the laser surgeries to treat blockage of urine flow in patients suffering from Benign Prostatic Hyperplasia. This minimally invasive laser technique was developed in 1990 as an alternative to TURP and laser vaporisation. It is the only laser approach that got approval by the National Institute of Health and Clinical Excellence for treating urologic conditions.
HoLEP procedure makes use of Holmium YAG laser beam as a precise cutting instrument to telescopically remove obstructing prostate tissues surrounding the urethra- the tube that connects the urinary bladder to the urinary opening. Holmium Laser Treatment for Prostate in Hyderabad, India helps enucleate a bulky prostate. The procedure is performed with a modified continuous flow resectoscope tipped with circular fibre guide. The removed prostate lobes are further passed into the urinary bladder where they are broken into smaller pieces, before removal from the body.
Are you suffering from an enlarged prostate and its related concerns? Arete Hospitals has the best HoLEP LASER treatment. The treatment offers a success rate of about 95% in people suffering from prostate issues.
Before HoLEP Treatment Preparation
The urologist in Hyderabad at Arete Hospitals performs a preoperative work-up for patients diagnosed with Benign Prostatic Hyperplasia. This includes reviewing the patient’s detailed medical history and then conducting a physical examination to check-up on severity of the symptoms.
Before the procedure, following examinations and tests may be performed:
- A digital rectal exam- feeling the enlarged prostate using finger
- A test to measure urinary flow rate and the residual urine in the urinary bladder after urinating- to determine the level of blockage in urine flow
- Laboratory tests- including blood tests, tests to check levels of prostate specific antigen, and urinalysis
- Transrectal ultrasound- to measure the extent of enlargement of prostate
- Cystoscopy- to get a clear picture of inside of prostate and urinary bladder and rule out urethral strictures (the scar tissues)
- Urodynamics- In this test, a catheter is placed in the urinary bladder along with pressure sensors to determine working of urinary bladder and check if prostate tissue removal could reduce the symptoms.
The urologist even provides pre-operative instructions to prepare the patients for the surgery. These include:
- Avoid or discontinue the intake of blood thinning medications for up to 10 days prior to the surgery to prevent excessive bleeding during and after the procedure.
- Keep the bowel and bladder empty for 6-8 hours before the operation.
- Get a urine culture in 2-4 weeks beforehand to minimise risk of infections post-operation.
If one is suffering from BPH, they can get Enlarged Prostate Treatment in Hyderabad at Arete Hospitals, one of the best urology hospitals in India.
What does the HoLEP procedure involve?
The entire HoLEP procedure is usually performed on the patient while asleep with general anaesthesia. In some cases, the patient may be provided with spinal anaesthesia that makes the patient’s body numb down his waist. An antibiotic filled injection is administered into the operation site to prevent infections. The patient is asked to lie down on his backside and his legs are kept elevated throughout the surgery.
The operation commences with the insertion of a modified continuous flow resectoscope through the urethra. The resectoscope has a camera at its one end that allows the urologist to view the anatomical structures of the prostate. Next, the urologist inserts the holmium laser into the resectoscope to free up the large lobes of the prostate from the outer shell (capsule) and then seal the blood vessels. The prostate tissues that have been removed are deposited in the urinary bladder.
Once the blocking prostate tissues are all removed, the urologist replaces the holmium laser with a morcellator. This device helps suction the small pieces of prostate tissues that got left behind in the urinary bladder. When done, the resectoscope is withdrawn and replaced by a urinary catheter.
Good Candidates for HoLEP
HoLEP is an appropriate option for men having signs of bladder obstruction because of their enlarged prostate- a condition called benign prostatic hyperplasia.
Such men with enlarged prostate may notice recurrent issues, including:
- Blood in the urine
- Bladder stones
- Frequent urinary tract infections
- Kidney problems.
HoLEP is an individualised procedure to treat BPH and is recommended to patients as per their situation. The good candidates are those who are otherwise healthy and committed to follow preoperative and postoperative recommended guidelines given by the urologist.
Patients may not be good candidate for HoLEP if they:
- Have bleeding problems
- Cannot lie in the position necessary for the operation
- Have undergone certain kinds of prostate treatments before.
After Discharge
The patients need to go for follow-up appointments within 1-2 days after getting home following the surgery. During this visit, a nurse or medical assistant will check on the urinary catheter and remove it or will tell when to come again for its removal.
To ensure smoother recovery, the patients must follow these aftercare instructions:
- Drink adequate amount of water daily.
- Take proper rest for 1-2 weeks.
- Avoid indulging in any strenuous physical activity or heavy weight lifting for 2-3 weeks or longer, if instructed by the doctor.
Cost of HoLEP in Hyderabad
The actual cost of HoLEP in Hyderabad is determined by various factors such as:
- the surgeon’s expertise
- the complexity of the procedure
- the price of tests and exams conducted before surgery
- the duration of hospital stay
- anaesthesiologist charges
- cost of additional services or other necessary medical supplies (if any).
- insurance coverage.
To get a transparent and reliable estimate for the Holmium laser enucleation of the prostate in Hyderabad, contact Arete Hospitals Urology Department. Some insurance policies may cover the cost of HoLEP surgery completely while some may only cover part of the expenses or will require the patient to meet certain criteria for getting insurance coverage. Our expert team at Arete hospitals will verify the insurance coverage before starting with the surgery. In case the patients have no insurance in their names, our specialists will provide the cost estimate for HoLEP during initial consultation.
Effectiveness of HoLEP
HoLEP has so far been the best in treating urine flow obstruction caused by enlarged prostate. Clinical studies have proven that it is the most effective laser approach for treatment of large volumes of prostate like those larger than 80mL. It is even safer than other surgeries as it reduces postoperative bleeding.
For more information on Prostate Disease Treatment with HoLEP Laser in Hyderabad, schedule a visit at Arete Hospitals to gain more detailed insights.
Risks Associated with HoLEP
The risks associated with HoLEP procedure are very rare if performed by trained and experienced urologists like the urologists available at Arete Hospitals. The common side effects of HoLEP are:
- Urinary incontinence- inability to control flow of urine
- Temporary burning and little blood spotting during urination
- Painful passing of urine which is more frequent than normal
- Retrograde/Backward ejaculation of semen or no ejaculation.
1. How lengthy is the HoLEP procedure?
The HoLEP procedure lasts for anywhere between 1-3 hours. The duration depends upon the size of the prostate and the complexity of the patient’s condition.
2. Is HoLEP an outpatient procedure?
No. HoLEP operation is performed in a hospital and requires the patient to stay for 1-2 days. The length of hospitalisation depends upon the severity of the prostate enlargement.
3. How much time does it take to recover from HoLEP surgery?
The patient can expect to resume the usual routine involving less physical exertion in about 1-2 weeks. In case of a strenuous job, it’s advised to wait for 3-4 weeks.
4. What should I expect after my HoLEP surgery?
You need to stay for at least a day in hospital to allow the urologist to monitor your health status. If you are at high risk of surgical complications, you may need to stay longer in the hospital. You will have to pass urine through the catheter- a tube that runs from inside of the bladder to the bag outside the body, for 1-2 days. This is important till the urine clears of blood.
The best thing about this treatment is that it is best suited for patients with a prostate weightier than 80 grams. This procedure is also safe for patients who are taking blood thinning medications.
For more details, consult a urologist at Arete Hospitals for thorough insights!
