Holmium laser enucleation of the prostate is a relatively new laser surgery technology in removing enlarged prostate tissues, especially those caused by a benign prostatic hyperplasia or BPH. The overall goal of the procedure is to improve urine flow, and to remove noncancerous tissues in the prostate that block such flow.
The treatment is still specialized and is not available everywhere. Special training and skills is necessary to perform this type of laser surgery, which is classified as effective and safe in reducing enlarged prostate glands, as well as increasing urinary channels through the prostate.
HoLEP treatment is limited to the approach for treatment of benign prostatic hyperplasia or enlarged prostate, commonly found in over 40% of men over the age of 60 and the leading cause of urinary or voiding issues. The procedure is designed to prevent or reduce the risk of urinary tract infections, calculi (stones) in the bladder, and urinary retention.
Transurethral resection of the prostate, known as TURP, is still the most commonly used surgical approach for benign prostatic hyperplasia, but HoLEP treatment further reduces the risk of tissue morbidity and bleeding, as well as post-surgical complications. The HoLEP procedure utilizes energy modalities that not only minimize risk of complications, but also reduce hospital stays, bleeding, and surrounding tissue damage.
The use of the Holmium YAG laser has increased in the past five years as equipment and techniques are refined. The laser treatment enables the literal vaporization of tissues to complete removal or enucleation of still intact lobes of enlarged prostatic tissues. Combined with the latest in technologies in regard to resection techniques, very large prostate glands that would have formally required open surgery or prostatectomy can now be effectively treated with an overnight stay.
The patient is prepared for the procedure under general anesthesia, and then calibration is performed on the anterior or front urethra. A scope is inserted into the urethra and secured into place. The HoLEP laser enables a high powered video system for viewing, and with a camera placed on the end, the hand piece is loosened to enable easy rotation while the camera maintains a stationary position. The enlarged portion or tissues of the prostate are then resected , dissected or completely enucleated or removed through a variety of approaches and techniques.
Benefits of the HoLEP Technique
The HoLEP technique utilized worldwide has been shown to be both safe and effective, an alternative for traditional surgical treatment of benign prostatic hyperplasia. The Holmium laser provides the benefits of combined cutting and coagulation technology, reducing bleeding, the need for transfusions, and reducing hospital stays. Most patients are discharged catheter free. The HoLEP technique has great potential for becoming the new standard in surgical management of BPH
Cost of HoLEP
A traditional TURP approach to enlarged prostate surgery averages about $5,000, while the cost of HoLEP can be significantly higher, averaging just over $11,000 depending on geographic location of the facility. Because the treatment is not mainstream as yet, a handful of facilities around the world perform the procedure, including the Mayo Clinic in the United States. The treatment may or may not be covered by traditional medical insurance policies.
Who performs HoLEP procedures
Urologic surgeons perform HoLEP procedures, followed by specialized training and experience in performing holy and laser prostate surgery. Urology surgeon's start out with a least one year of general surgery and urology training, and then can move into specialized areas of surgery including Holmium laser and da Vinci technologies. Choose a surgeon who has undergone basic and comprehensive education in general surgery, who then undergoes additional training in urology, a surgical subspecialty. He or she should be approved to practice in accredited healthcare facilities or hospitals. Specialists should be experienced and knowledgeable regarding specific conditions.
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