Treatments

Prostate

Holmium Laser Enucleation of Prostate

Today, HOLEP (Holmium Laser Enucleation of Prostate) is world wide accepted modality used in the management of Enlarged Prostate and also known as platinum standard. In this procedure, a 550 Micron Fibre attached to a 100-Watts Holmium Laser machine is used to remove obstructive prostatic tissue and seal blood vessels. The enucleated gland is then pushed into the bladder, which is later sucked out with the help of equipment called Morcellator. The whole procedure takes around 45-90 minutes, depending on the size of the gland. This procedure is nearly bloodless as the laser beam when cuts the gland also seals the blood vessels. In most of the cases there is no need for blood transfusion. At the end of surgery, a catheter is inserted to keep the bladder in place. It continuously drains the urine into a sterile collection bag. The catheter is usually kept for 24 to 48 hrs and the patient is discharged without catheter after giving a catheter free trial.

	HOLEP	TURP	OPEN SURGERY
Size of Prostate	Any size	< 80 gms	Any size
Patients on acnticoagulants	Can be doe safely	Problems encountered	Problems encountered
Catheterisation	Short	Long	Long
Blood transfusion	1 in 1000	10-15 in 100	20-25 in 100
Hospital Stay	36-48 hours	4-7 days	7-10 days
Risk of Stricture	Insignificant	High risk	High risk
Patients with high blood pressure & high blood sugar	Can undergo	Avoidable	Avoidable
Patients with poor cardiac status	Can Undergo	High risk	High risk
Risk of impotence	Less than 2%	Less than 10%	-