Laser prostate surgery: “Do you expect me to talk…?!”

By Matthew Liew

Lasers have increasingly been used in medicine, resulting in major treatment advances. This has been evident in prostate surgery, where the ‘menu’ of op tions for treating enlarged prostates is getting longer. The newer options, which include steam treatment (Rezūm) and prostate stapling (UroLift), have the advantage of being relatively quick and al lowing most men to preserve sexual function, partly because they do not ac tually remove prostate tissue – they either shrink it (Rez ū m) or squeeze it (UroLift).

Around 3.2 million men in the UK are affected every day by urinary issues connected to the condition benign pros tatic hyperplasia (BPH) aka benign enlargement of the prostate. However, despite surgical treatment for BPH being readily available for men whose symptoms are a nuisance, only 400,000 of them re ceive treatment.

Men with larger prostates do not generally benefit from treatments such as Rezūm and UroLift. These are not recommended by NICE (National Institute for Health and Care Excellence). If surgery is required to a larger prostate, then removal of part of the tissue is considered the best treatment option.

Transurethral resection of prostate is a standard treatment that removes tissue, but it has limitations on size, time taken to operate and side effects.

HoLEP

However, many consider HoLEP (Holmium Laser Enucleation of the Prostate) to be the ‘gold standard’. In this procedure, a telescope is passed through the waterpipe under anaesthetic and a laser is used to remove most of the enlarged prostate, like peeling an orange internally. This surgery allows all prostate sizes to be treated with dramatic results as the surgery is tailored to the patient’s individual prostate. In many cases, patients can be treated as a day case, so you are in and out the same day.

HoLEP surgery requires specialised training, which is why it is not widely

Mr Matthew Liew Consultant Urological Surgeon

available. It has some of the best outcomes, especially for men with long-term cath eters for urinary retention and those with larger prostates. HoLEP surgery makes over 98% of patients catheter free, which is the highest rate of all prostate surgeries.

Urology Clinics Manchester is the only private HoLEP service in the Greater Man chester and Cheshire area. So, if you are a man with bothersome urinary symptoms or a long-term catheter for re tention, come and see our team.

Being an international man of mystery is optional!