Many middle-aged and older men receive a diagnosis of elevated PSA levels during health check-ups. PSA stands for Prostate Specific Antigen. It is a protein component secreted by the prostate, and measuring its concentration in the blood is an important indicator for checking the presence of prostate abnormalities.
Generally, it is known that a detailed examination is necessary if PSA levels exceed 4.0. This can be related to conditions such as benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer. However, high PSA levels do not immediately indicate cancer. Especially in men of middle age and older, benign prostatic hyperplasia is cited as the most common cause.
Benign prostatic hyperplasia (BPH) is a condition where the prostate tissue enlarges, compressing the urethra and causing urination difficulties. It is a common condition affecting more than half of men over the age of 50. The prevalence is known to increase further by the time men reach their 60s and 70s. When the prostate enlarges, symptoms such as a weakened urine stream, frequent trips to the restroom, or waking up multiple times at night to urinate may appear. If these symptoms are left untreated, they can lead to bladder dysfunction, urinary tract infections, and kidney function deterioration.
In cases of early-stage benign prostatic hyperplasia, improvement can mostly be expected with medication. Representative treatments include alpha-blockers and 5-alpha reductase inhibitors. These medications help urination by relaxing the muscles of the prostate and bladder neck or by reducing the size of the prostate. However, prostate medication requires consistent intake for its effects to manifest. Furthermore, there are cases where the drug's effect is limited or where it is difficult to continue treatment due to side effects. Especially if the drug's efficacy decreases over time or the prostate further enlarges, surgical treatment should be considered.
According to Dr. Jo Jung-ho, director of Goldman Urology Clinic Gangnam Branch, the surgical method primarily considered in such situations is HoLEP surgery.
HoLEP surgery is a cutting-edge laser surgical treatment method that uses a high-power holmium laser to completely resect the enlarged prostate tissue. This surgery is performed using a minimally invasive endoscopic approach, rather than open surgery or electrocautery. Above all, it boasts advantages such as less bleeding, faster recovery, and a lower recurrence rate compared to conventional surgical methods. Notably, because the entire prostate tissue is removed, it is also possible to check for the presence of cancer through tissue biopsy.
HoLEP surgery is particularly noteworthy due to its excellent therapeutic effects and low complication rates. Director Jo explained, “Because a high-power laser is used, there is less bleeding, and since the prostate tissue is completely removed, the possibility of reoperation is low. Furthermore, the ability for most patients to be discharged on the same day is a significant advantage.” He added, “It can also be safely performed even for extremely large prostates exceeding 150g, making it suitable for high-difficulty patients.”
Director Jo Jung-ho emphasizes that an increase in PSA levels can be a sign of prostate disease, making accurate diagnosis and prompt action crucial. He stated, “If medication shows limitations, it is necessary to consider HoLEP surgery using laser technology. As prostate health is an important factor affecting men's overall health, it is a wise choice not to hesitate but to visit a hospital and receive appropriate treatment early.”