Intervention that allows the removal of benign prostatic hyperplasia with laser by vaporizing the hyperplastic tissue or by allowing the enucleation of all the tissue and subsequently extracting it in small fragments.
Holmium laser enucleation of the prostate (HoLEP), It is a minimally invasive and safe surgical technique for treating benign prostatic hyperplasia (HBP).
It allows the treatment of any prostate volume, with good results, a lower rate of complications such as bleeding, and a short hospital stay, usually less than 24 hours.
It is a complex technique that requires experience to achieve good functional results. At ICUA we have a Extensive experience with over 10000 procedures completed. We are completing about 500 surgeries using this technique per year, being one of the world's leading centers.
The HoLEP technique involves separating the prostatic adenoma from the prostatic capsule in the same way that segments are separated from an orange. It achieves the same effect as open surgery but without incisions, instead accessing the area through the urethra. The separated tissue is then placed in the bladder, and using a device called a morcellator, it is chopped into pieces and removed endoscopically.
The technique that has been developed Dr. Gómez Sancha Over the past few years, the goal has been to achieve better results in terms of continence. en bloc enucleation of the adenoma with early apical releaseThis allows us to more safely respect the sphincter and its mucosa, significantly reducing the rate of early postoperative incontinence.
At ICUA we also have cutting-edge holmium laser technology: Pulse-modulated lasers (MOSES and Virtual Basket). The initial pulse generates a vapor bubble through which a second pulse passes, traveling without interference and optimizing energy transmission to the target tissue, achieving greater distances. This results in more precise incisions and improved tissue coagulation.
Unlike vaporization techniques, enucleation allows for the complete removal of the adenoma. lower rate of long-term reinterventions And being able to extract the prostate tissue allows us to perform a histological study and detect unsuspected cancers.
The procedure lasts less than an hour, depending on the size of the prostate gland. In over 90% of cases, the patient remains hospitalized for less than 24 hours.
Postoperative recovery is usually quite rapid compared to other, more invasive techniques, although in some cases irritative symptoms (increased urinary frequency and urgency) may occur, lasting for days or weeks but gradually subsiding. These episodes are more frequent in patients who already had irritative symptoms prior to surgery.
Currently, and with many studies to support it, it is the selection technique for the surgical treatment of BPH according to all European and American clinical practice guidelines.
