HOLEP is a completely endoscopic procedure, and has several advantages over TURP 

The prostate is a male gland, and lies close to the urinary bladder. The gland performs vital functions related to reproduction during a man’s youthful period, but is often a  trouble maker as old age approaches. An enlarged prostate can block free flow of urine and  could lead to other complications, necessitating surgery in certain situations. 

The usual way of clearing an enlarged prostate is TURP (Transurethral Resection of  Prostate). It is an endoscopic surgery that involves no cutting of the flesh. An instrument is inserted into the urethra and the prostate is split into small pieces using electric  current.

This procedure has undergone a modern version using LASER and removing  the prostate through a surgery called HOLEP (Holmium Laser Enucleation of Prostate). This operation facilitates cutting of the prostate into two or three chunks instead of  several tiny pieces. These chunks are subsequently removed with a morcellator  endoscopically. Like TURP, HOLEP is a completely endoscopic procedure. HOLEP has  several advantages over TURP. 

HOLEP does away with physical wounds

Being endoscopic, HOLEP creates no physical wounds inside the body. A common  complication of prostate surgery is bleeding. The blood-loss during HOLEP will be  significantly less. This kind of surgery is particularly beneficial for patients regularly using medicines such as aspirin and clopidogrel that adds to the body’s propensity to  bleed.

The post-surgery pain and issues related to urine passage like burning sensation is relatively far less in the case of HOLEP. HOLEP has a significant advantage in dealing  with large prostates. Where as in the yester years, a significantly enlarged prostate  needed open surgery, HOLEP can obviate the need of creating a wound and can be done  as a completely endoscopic procedure. It facilitates discharge of the patient from the  hospital without much delay, helping smooth and early return of routine to normal.

Dr Renu Thomas, the author, is a Senior Consultant and Coordinator, with the Department of Urology at KIMSHealth

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