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PROSTATE HYPERPLASIA

WHAT IS BENIGN PROSTATE HYPERPLASIA?

Prostate hyperplasia refers to a benign growth of the prostate gland. It is a frequent pathology, affecting 40% of men over 40. Prostate hyperplasia causes urinary symptoms and urogenital alterations. While moderate cases can be treated with drugs, surgery will be required for severe cases.

Patients with prostate hyperplasia usually present slow urinary flow, difficulty to start urination, need to urinate at night, a frequent need to urinate during the day and urge to urinate. These symptoms worsen the quality of a patient’s life substantially. Prostate hyperplasia can also lead to complications that include bleeding, swelling, formation of stones in the bladder, deterioration of the kidney function or even cessation of the urinating capability, which would require a bladder catheter.

TREATMENT

Symptoms can be controlled with medication for the most cases. When medical treatment is not effective, surgery may be required. An evaluation will be necessary to choose the best type of prostate surgery for the patient.

Hyperplasia under 60cc has usually been treated with a transurethral resection of the prostate (TURP), which consists of removing the prostate adenoma through the urethra without any incisions. If the adenoma is bigger than 60cc, open surgery is required, as the tissue cannot be removed through the urethra. Open surgery is more aggressive but allows removing the whole prostate adenoma.

Lasers allow drying out the tissue through the urethra with fewer complications for the patient. Green laser has proven to be effective for small-size prostates. On the other hand, Holmium laser has proven to be as effective as open surgery for all prostate adenoma sizes without the need of incisions. And so it is: no incisions, no bleeding, lower transfusion rate, 24 hours of bladder catheter, reduced length time spent in the hospital, quicker return to the normal lifestyle and same final result as open surgery. For all these reasons, Guías Europeas de Urología (European Urology Guides) rate enucleation with Holmium laser as the best treatment for benign prostate hyperplasia.

BENIGN PROSTATE HYPERPLASIA SURGERY, ENUCLEATION WITH HOLMIUM LASER

Enucleation with Holmium laser first appeared in 1997. It has proven to be safe, effective and valid for 30 years. Good Clinical Practice has described it as the best technique and technique of choice to treat benign prostate hyperplasia. Green laser has also been accepted for small prostates.

The prostate grows as years go by, which can create an obstruction of the bladder’s urinary channel. Slow urinary flow, difficulty to start urination, need to urinate at night, a frequent need to urinate during the day and urge to urinate may appear, worsening the quality of a patient’s life substantially. Prostate hyperplasia can also lead to complications that include bleeding, swelling, formation of stones in the bladder, deterioration of the kidney function or even cessation of the urinating capability, which would require a bladder catheter.

Different types of surgery can be performed to decrease the gland’s size. Hyperplasia under 60cc has usually been treated with a transurethral resection of the prostate (TURP), which consists of removing the prostate adenoma through the urethra without any incisions. If the adenoma is bigger than 60cc, open surgery is required, as the tissue cannot be removed through the urethra. Open surgery is more aggressive but allows removing the whole prostate adenoma. The removal of the whole adenoma avoids the recurrence of this condition.

Lasers allow drying out the tissue through the urethra with fewer complications for the patient. Green laser has proven to be effective for small-size prostates. On the other hand, Holmium laser has proven to be as effective as open surgery without the need of incisions for all prostate adenoma sizes. And so it is: no incisions, no bleeding, lower transfusion rate, 24 hours of bladder catheter, reduced length time spent in the hospital, quicker return to the normal lifestyle and same final result as open surgery.

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