Benign prostatic hyperplasia (BPH) is a common urological disease that frequently occurs in middle-aged and elderly men, characterized by urinary dysfunction such as urgency, a sensation of incomplete emptying, and nocturia. If the treatment period for BPH is missed, it can lead to urinary tract infections, deterioration of bladder function, and even kidney damage, requiring careful attention. In the past, when these symptoms became severe, open surgery was virtually considered the only fundamental treatment. However, due to the risk of bleeding, long hospitalization periods, and the burden of scars, patients often found it difficult to make a decision.
In this situation, HoLEP (Holmium Laser Enucleation of the Prostate) surgery has recently emerged as a standard solution commonly recognized by the urological community. HoLEP is a method that uses a high-power holmium laser to excise the enlarged prostate tissue as if scooping it out entirely, while simultaneously stopping bleeding. Thanks to this, there is less bleeding, faster recovery, and a lower incidence of urinary incontinence or other complications. From the patient's perspective, the burden is lower because they can expect the same effects as open surgery without undergoing an abdominal incision.
The distinctiveness of HoLEP surgery is particularly evident in patients with giant prostates. It is known that conventional endoscopic surgery is not easy if the prostate size exceeds 70cc. For super-giant prostates over 150g, even university hospitals often recommended invasive Da Vinci robotic surgery or open surgery. However, HoLEP shows excellent results even in such giant prostates. It is no exaggeration to say that HoLEP is currently the only method available in private practice to safely remove super-giant prostates.
Furthermore, HoLEP is a surgical method covered by national health insurance. This means that patients can receive the most fundamental and effective treatment at a reasonable cost, which is a significant advantage. Moreover, HoLEP not only reduces prostate size but also lowers PSA levels, positively impacting the patient's long-term health management.
Of course, there are aspects to be cautious about with HoLEP surgery. Typically, side effects such as retrograde ejaculation can occur, which is a phenomenon where semen flows backward into the bladder and can affect sexual satisfaction. Therefore, when deciding whether to undergo surgery, it is important to establish a customized strategy that includes the patient's age, lifestyle patterns, and value judgment regarding the preservation of sexual function.
Director Kim Jae-woong of Goldman Urology Clinic, Gangnam Branch, emphasized, "If urinary dysfunction causes discomfort in daily life, you should seek medical attention without delay. Especially for patients with giant prostates exceeding 70cc, HoLEP surgery is the optimal solution, having proven both safety and efficacy, and stable results can be expected."