Benign prostatic hyperplasia (BPH) is a common urological disease that frequently occurs in 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 (residual urine), frequent urination, and nocturia. In the early stages, symptoms can be managed through medication, but surgical treatment becomes necessary if the prostate is significantly enlarged or if the response to medication is insufficient.
Among these, Holmium Laser Enucleation of the Prostate (HoLEP) is widely performed as a method that uses a holmium laser to completely remove the enlarged prostate tissue. It offers several advantages, including less bleeding, faster recovery, and applicability regardless of prostate size. For these reasons, HoLEP surgery is considered one of the standard treatment methods for benign prostatic hyperplasia.
However, HoLEP surgery is a procedure that demands a high level of skill, and outcomes can vary depending on the medical team's experience and proficiency. According to a study published in the international academic journal World Journal of Urology in 2024, even when performed by the same medical team, HoLEP surgery showed a significant reduction in operative time as experience accumulated. The study found that the average operative time for the initial 100 cases was 67 minutes, whereas it decreased to 43 minutes for the latter 100 cases.
A reduction in operative time is known to positively impact patient safety and prognosis, leading to decreased blood loss, alleviated anesthesia burden, and reduced risk of complications. Furthermore, the total laser energy used also decreases with accumulated experience, allowing for the same therapeutic effect to be achieved more efficiently. This underscores why the clinical experience and proficiency of the medical team are as crucial as the equipment or surgical techniques themselves.
Particularly for patients facing benign prostatic hyperplasia surgery, it is necessary to consider the post-operative management environment as much as the surgery itself. Among these, a critical factor is whether an inpatient ward is operated and an overnight medical staff presence system is established.
An inpatient ward provides an environment where medical staff can continuously monitor the patient's recovery progress, identify changes in their condition, and respond promptly, especially in cases like BPH surgery where continuous observation is required. Particularly in BPH cases where siblings or acquaintances sometimes undergo surgery together, operating multi-bed rooms can help patients who have undergone the same procedure to live together and reduce anxiety.
Furthermore, unexpected pain, bleeding, or urinary discomfort can occur after BPH surgery. The problem is that these symptoms can appear at any time of day or night. In such situations, if a patient experiences discomfort, the availability of a medical environment where immediate action can be taken, regardless of the time, becomes a crucial standard for patient safety. There must be a structure in place with an overnight on-call doctor and ward nursing staff to continuously monitor the patient's condition and respond promptly if any abnormal findings occur. This can be considered a proactive management system that prioritizes patient safety.
Dr. Ryu Kyung-ho, Director of Goldman Urology Clinic Gangnam Branch, stated, "Benign prostatic hyperplasia surgery allows for a safer recovery when there is an organically integrated system encompassing accurate pre-operative evaluation, skilled surgical execution by the medical team during the operation, stable post-operative ward management, and an overnight response system." He added, "Therefore, if you are considering BPH surgery, it is necessary to check not only the surgical method but also the operation of the inpatient ward and the system for responding to overnight emergencies."