Benign prostatic hyperplasia (BPH) is one of the most common urological conditions affecting men after middle age. As the prostate gradually enlarges, it compresses the urethra, leading to various lower urinary tract symptoms such as delayed urination, a sensation of incomplete bladder emptying, frequent urination, and nocturia. In the early stages, symptoms can often be controlled with medication, but surgical treatment may become necessary when the prostate becomes significantly enlarged or when medication fails to provide sufficient relief.
Among surgical options, holmium laser enucleation of the prostate (HoLEP) is widely performed. This procedure removes the enlarged prostate tissue using a holmium laser. It offers several advantages, including minimal bleeding, relatively fast recovery, and the ability to be applied regardless of prostate size. For these reasons, HoLEP is considered one of the standard surgical treatments for BPH.
However, HoLEP is also a technically demanding procedure, and surgical outcomes may vary depending on the surgeon’s experience and level of expertise. A study published in the international journal *World Journal of Urology* in 2024 reported that even when performed by the same surgeon, operative time significantly decreased as surgical experience accumulated. In the study, the average surgical time for the first 100 cases was 67 minutes, while it decreased to 43 minutes in the later 100 cases.
Shorter operative times are associated with several benefits, including reduced bleeding, lower anesthesia burden, and decreased risk of complications, all of which contribute positively to patient safety and postoperative outcomes. In addition, the total laser energy used during surgery tends to decrease with increasing surgical experience, allowing the same therapeutic effect to be achieved more efficiently. These findings highlight that clinical experience and surgical proficiency are just as important as the equipment or surgical technique itself.
For patients preparing for BPH surgery, it is also important to consider the postoperative care environment in addition to the surgical procedure itself. One key factor is the availability of an inpatient ward and the presence of medical staff during nighttime hours.
An inpatient ward provides an environment where medical staff can continuously monitor the patient’s recovery and respond quickly to changes in the patient’s condition. In cases of BPH surgery, where patients sometimes undergo procedures alongside family members or acquaintances, shared inpatient rooms can also help reduce anxiety by allowing patients with similar experiences to recover together.
Furthermore, unexpected symptoms such as pain, bleeding, or urinary discomfort may occur after BPH surgery, and these symptoms can arise at any time. Therefore, it is important for patients to confirm whether the medical facility has a system in place that allows immediate response regardless of the time of day. A system that includes night-duty physicians and ward nursing staff capable of continuous monitoring and rapid intervention is an essential component of patient safety. Such a system represents a proactive approach to preventing complications and ensuring stable recovery.
Dr. Ryu Kyung-ho of Goldman Urology Clinic Gangnam Branch explained that safe recovery from BPH surgery depends on an integrated process that includes accurate preoperative evaluation, skilled surgical performance, and stable postoperative ward management with an effective nighttime response system. He emphasized that patients considering BPH surgery should evaluate not only the surgical method but also whether the hospital operates an inpatient ward and maintains a reliable system for responding to nighttime emergencies.