Benign prostatic hyperplasia (BPH) is a well-known condition that commonly affects men in middle age and beyond. It is particularly characterized by the prostate gland compressing the urethra, leading to various urinary disorders. In the early stages of onset, symptoms can be managed with medication, but surgical treatment becomes necessary if the prostate size is large or if there is no response to medication. Among these, Holmium Laser Enucleation of the Prostate (HoLEP) is considered a valuable treatment method that uses a holmium laser to completely enucleate the hypertrophied prostate tissue. Its primary strengths include minimal bleeding, rapid recovery, and excellent therapeutic efficacy.
According to a paper published in the 'World Journal of Urology' in 2024, the effectiveness of HoLEP surgery showed clear differences depending on the experience of the medical team. In an analysis conducted by one medical team involving 500 patients, the average surgical time for the first 100 patients was 67 minutes, whereas it was shortened to 43 minutes for the last 100 patients. This is a factor that positively influences patient safety and prognosis, including reduced blood loss, faster recovery, and decreased risk of complications.
In particular, as the time required to enucleate the prostate decreases, the patient's systemic burden is reduced, and post-operative recovery tends to proceed more rapidly. The total energy used by the holmium laser also decreases with accumulating experience, allowing the same therapeutic effect to be achieved more efficiently with less energy. This highlights why the medical team's technique and proficiency are as crucial as the equipment's performance.
Furthermore, while various laser surgical techniques and methods utilizing different energy sources are being introduced, the research findings of the aforementioned paper indicate that the proficiency of the medical team performing the surgery has a greater impact on the outcome than the specific technique employed.
Benign prostatic hyperplasia is not a condition that can be judged solely by prostate size. A comprehensive consideration is required, including not only the size of the hypertrophied prostate tissue but also its location and pattern of enlargement, the severity of lower urinary tract symptoms (LUTS), changes in bladder or kidney function, the presence of accompanying complications, the duration of the disease, and previous treatment history. If surgery is deemed necessary, an individualized surgical approach optimized for each patient must be selected based on these diverse factors. This is only achievable when supported by a system capable of performing all surgical treatments and extensive clinical experience.
Dr. Ryu Kyung-ho, Director of Goldman Urology Clinic Gangnam Branch, stated, "Benign prostatic hyperplasia surgery is a complex medical procedure that goes beyond merely removing tissue with a laser. Because each patient's prostate size, shape, and symptom severity differ, a customized approach based on ample experience is crucial." He added, "Especially for surgeries with a long learning curve, such as HoLEP, the surgeon's experience directly impacts the patient's recovery speed and satisfaction with the surgery. Since skilled experience is the result of accumulated time and effort, not mere chance, if you are considering BPH surgery, it is a wise choice to carefully examine not only the surgical technique but also the medical team's experience and the number of accumulated cases."