Benign prostatic hyperplasia (BPH) is a representative urological disease that commonly 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 feeling of incomplete bladder emptying (residual urine sensation), frequent urination, and nocturia. While symptoms can be managed with medication in the early stages, surgical treatment becomes necessary if the prostate is significantly enlarged or if the response to medication is insufficient.
Among the available options, Holmium Laser Enucleation of the Prostate (HoLEP) is widely performed as a method that completely removes the enlarged prostate tissue using a holmium laser. It offers distinct advantages, including less bleeding, faster recovery, and applicability regardless of prostate size. For these reasons, HoLEP surgery is regarded as one of the standard treatment methods for benign prostatic hyperplasia surgery.
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, surgical time for HoLEP showed a significant tendency to decrease as experience accumulated. The study found that the average surgical time for the initial 100 cases was 67 minutes, whereas it decreased to 43 minutes for the subsequent 100 cases.
A reduction in surgical 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 highlights 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 crucial factor is the presence of an inpatient ward operation and a system with medical staff stationed overnight.
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 benign prostatic hyperplasia surgery where continuous observation is required. Furthermore, in cases of BPH where siblings or acquaintances may undergo surgery together, the operation of multi-bed rooms can help reduce anxiety by allowing patients who have undergone the same surgery to stay together.
Moreover, unexpected pain, bleeding, or urinary discomfort can occur after benign prostatic hyperplasia surgery. The problem is that these symptoms can appear at any time of day or night. In such instances, if a patient experiences discomfort, the availability of a medical environment where immediate action can be taken, regardless of the time of day, becomes a critical criterion for patient safety. There must be a structure in place with an on-call physician and ward nursing staff overnight to continuously monitor the patient's condition and respond promptly if any abnormal findings occur. This can be described as a proactive management system that considers patient safety in advance.
Dr. Ryu Kyung-ho, Director of Goldman Urology Gangnam Branch, stated, "Benign prostatic hyperplasia surgery allows for a safer recovery when it is organically equipped with accurate pre-operative evaluation, skilled execution by the medical team during surgery, stable post-operative ward management, and an overnight response system." He added, "Therefore, if you are considering benign prostatic hyperplasia surgery, it is necessary to check not only the surgical method but also whether an inpatient ward is operated and if there is an emergency response system for night-time situations."