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HOLMIUM LASER E ENUCLEATION OF PROSTATE : A BLOOD LESS TREATMENT FOR PROSTATE


Holmium laser enucleation of the prostate (HOLEP) is a treatment for men with benign prostatic hyperplasia (BPH). The laser surgery removes the entire prostate. This treatment is done without any incisions on the body.

The man who are entering to his middle age, faces a common problem in his day-to-day life in the form of increased frequency, urgency straining for urination. With this condition, the urinary stream may be weak or stop and start. In some cases, it can lead to infection, bladder stones and reduced kidney function and total retention leading to catherisation.

This can be diagnosed through the common blood tests, urine tests, USG abdomen, uroflow

There are also two types of prostatomegaly -
1. Benign enlarged prostate
2. Adenocarcinoma prostate

Laser may be useful in both conditions. A surgical instrument called a resectoscope is inserted through the urethra. The resectoscope includes a camera that allows the surgeon to view the internal structure of the prostate gland, and to see where incisions are being made during surgery. The laser is inserted into the resectoscope and is used to enucleate the enlarged prostate tissue from the capsule (outer shell)and then to seal up any blood vessels. The tissue that has been removed is deposited in the bladder. The laser is removed from the resectoscope and is replaced by a morcellator. This device is used to suction out the tissue that was left behind in the bladder. When tissue removal is complete, the resectoscope is withdrawn and a urinary catheter is put in place. Tissue is send histopathological examination.

It's more effective in CAD, CVA patients because can do the procedure on antiplatelets. Advantages for HOLEP are :Less bleeding, fewer blood transfusions, shorter time with a catheter in place after surgery and shorter hospital stay.

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