Benign prostatic hyperplasia (BPH) is a common condition that affects men as they age. It is characterized by the prostate gland abnormally enlarging and compressing the urethra, thereby causing urinary dysfunction. While a normal prostate gland typically weighs around 20g, as hyperplasia progresses, it can exceed 100g, and in severe cases, develop into a super-large prostate weighing up to 200g. In such conditions, symptoms like a sensation of incomplete bladder emptying (post-void dribbling), frequent urination (pollakiuria), nocturia (nighttime urination), and decreased urinary flow rate appear, leading to significant discomfort in daily life. Furthermore, the risk of complications such as bladder dysfunction, urinary retention, and kidney function deterioration also increases.
To address such benign prostatic hyperplasia, a recently spotlighted treatment method is HoLEP (Holmium Laser Enucleation of the Prostate) surgery. HoLEP surgery is a cutting-edge endoscopic surgical technique that uses a holmium laser to resect the enlarged prostate tissue. It is gaining attention because, unlike conventional transurethral resection of the prostate (TURP), it can be applied even to large prostates exceeding 100g.
The holmium laser is characterized by its high water absorption rate and shallow energy penetration depth, which results in minimal damage to surrounding tissues. By utilizing this, the boundary between the prostatic capsule and the hyperplastic tissue can be precisely separated and resected, allowing for the complete removal of unnecessary tissue while minimizing bleeding. Furthermore, because hemostasis occurs simultaneously with resection, there is less bleeding during surgery, and maintaining a clear surgical field is easier.
HoLEP surgery is a minimally invasive procedure performed endoscopically without open incision, leading to rapid recovery and a short hospital stay. Typically, the urinary catheter can be removed the day after surgery, and most patients can be discharged within a few days. Above all, the greatest advantage of HoLEP is its ability to safely resect even super-large prostates weighing up to 200g, whereas conventional TURP surgery had a limited scope of applicability depending on prostate size.
Moreover, due to minimal bleeding, elderly patients with chronic diseases such as hypertension and diabetes can undergo the procedure without significant burden, and blood transfusions are rarely required. The low recurrence rate after surgery and the ability to examine the resected tissue pathologically to check for other diseases like cancer are also clinically significant. The incidence of complications such as urinary incontinence or erectile dysfunction is reported to be less than 1%, demonstrating its proven safety.
Furthermore, the cost is not a significant burden for patients as it is covered by national health insurance, and it is more efficient in the long term than continuously relying on medication. Surgical treatment should be considered if symptoms do not improve with medication, if there is a large amount of residual urine, or if urinary retention recurs repeatedly.
Dr. Kim Byung-hoon, director of Goldman Urology Incheon Branch, stated, "HoLEP surgery has established itself as a representative treatment for benign prostatic hyperplasia, capable of safely and effectively restoring urinary function regardless of prostate size or patient age." He added, "If urinary discomfort due to BPH persists or if difficulty sleeping due to nocturia occurs, it is crucial to consult a urology specialist for an accurate diagnosis and appropriate treatment."