Benign prostatic hyperplasia (BPH) is a common urologic condition among middle-aged and older men and is known to significantly affect quality of life. The situation can become more serious when bladder stones occur together with the condition. For this reason, understanding the disease and selecting an appropriate treatment method are essential for restoring a patient’s normal daily life.
The prostate is a walnut-sized organ found only in men, and it tends to enlarge gradually with age. This enlargement is referred to as benign prostatic hyperplasia and is a major cause of difficulty in urination. When urine cannot be properly expelled, the likelihood of bladder stone formation increases.
The problem becomes more pronounced when the prostate becomes excessively enlarged. The average prostate size is known to be around 20 grams, but some cases can be four to five times larger than this. Ultrasound examinations can reveal situations in which the enlarged prostate protrudes into the bladder.
In such cases, holmium laser enucleation of the prostate (HoLEP) can be an effective treatment. One of the greatest advantages of HoLEP is that it can address both benign prostatic hyperplasia and bladder stones simultaneously. The holmium laser effectively removes enlarged prostate tissue while also fragmenting and removing bladder stones. Because the laser breaks stones into small fragments that can be naturally expelled, HoLEP is particularly suitable for patients with BPH accompanied by bladder stones. As a result, patients often report high satisfaction after surgery, and urinary symptoms are frequently resolved effectively.
Interestingly, however, not all urinary symptoms are caused by an enlarged prostate. In some cases, patients may experience symptoms such as frequent urination even when the prostate is not significantly enlarged. These symptoms may instead be caused by other conditions, such as urethral stricture. Urethral stricture refers to the narrowing of the urethra, which makes it difficult for urine to pass through. Laser techniques are also used in the treatment of urethral strictures. The laser can widen the narrowed section of the urethra, and a stent may be inserted to maintain the expanded passage.
In a recent case, a urethra that had narrowed to nearly the size of a needle was successfully widened using a laser procedure followed by stent insertion. Before surgery, the patient’s maximum urinary flow rate was 4.1 ml/sec, but after the procedure it improved to 37.8 ml/sec—nearly ten times faster. Prior to treatment, urine flow was severely restricted due to the narrowed urethra, but it improved significantly after the procedure. Considering that the average maximum urinary flow rate for adult men is generally reported to be around 15–20 ml/sec, this represents a substantial improvement.
Dr. Min Seung-gi of Goldman Urology Clinic Jamsil Branch explained that treatment methods for urinary disorders, including benign prostatic hyperplasia, continue to evolve as part of ongoing efforts to provide better care for patients. He advised that individuals experiencing urinary symptoms should not delay seeking medical attention and should visit a urology clinic for thorough examination and personalized treatment.