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BPH explanation and diagram
The prostate is a gland that sits at the exit of the bladder. In a young man it is 15-25 cc in volume. Imagine it as a ring donut, with urine passing through the donut hole in the centre. As one grows older, the donut often enlarges, and the hole at the centre closes off, obstructing the flow of urine. This happens most commonly due to a benign process where abnormal tissue growth expands from the centre part of the prostate, replacing the normal central tissue, and compressing the normal glandular tissue at the edge of the prostate gland. This is termed BPH- Benign Prostate Hyperplasia.
Prostate cancer, if present, tends to form at the periphery of the gland, and is not often the cause of urinary symptoms. It can however occur together with BPH.
The HoLEP procedure
HoLEP aims to remove all the abnormal BPH tissue, which is not possible with TURP in a large gland, over 80cc. A laser fibre is used to access a plane between the prostate capsule and the abnormal BPH adenoma, and the adenoma is then ‘shelled out’ and dropped into the bladder. It is then broken down and removed using a special tool. The tissue removed is then sent to the lab for histological analysis. A urinary catheter is placed and the bladder is washed out until the next morning. The catheter is then removed and you are sent home to recover.
Expect that you may leak urine for a short period after the procedure, and expect the retrograde ejaculation as discussed pre-operatively. The rate of long term urinary incontinence is not more than that experienced with other BPH procedures.
Further to the above, urinary urgency, pain, blood in the urine may be expected for up to 4-6 weeks after the procedure.
More information about BPH
