Lazer method treats enlarged prostate

Known as HoLEP, it eases flow of urine

THE 100th holmium laser enucleation of the prostate (HoLEP) procedure to treat the debilitating symptoms of enlarged prostate was performed at the Netcare Parklands District Hospital in Durban.

Paul Shannon, 59, was the 100th patient, and said he was grateful to have had the procedure that was first introduced to South Africa a year ago.

Shannon’s procedure was led by Dr Amit Kalpee and his team at the hospital.

Kalpee said it was to be expected that a man’s prostate would enlarge with age, as the cells of the prostate begin to swell.

In some older men, however, the prostate becomes so enlarged that it starts to obstruct the urethra through which urine drains, resulting in symptoms such as difficulties in passing urine, Kalpee said.

“As affected men will tell you, this results in them having to go to the toilet much more often, and many have to get up at intervals throughout the night.

“Such symptoms can therefore have a negative impact on older men’s quality of life and may increase the risk of bladder infection.

“Serious blockages carry the risk of kidney complications if they are not treated,” Kalpee said.

HoLEP involves using a special high-powered laser to remove the gland that causes obstruction of the urethra.

The procedure therefore works to resolve symptoms such as urine blockage.

Shannon said there had been no hiccups since his procedure last month.

“I had very little pain following the procedure and was able to go home the next day.

“While it is early days still, I have had no negative side effects other than some tenderness, and the procedure has assisted in relieving my symptoms.

“My recovery was so quick that I have just returned from an overseas trip where I was able to walk around 10km a day,” Shannon said.

Kalpee said that HoLEP was completed under anaesthetic with the assistance of a tiny camera which, together with the laser instrument, was mounted on a fine telescopic rod that was inserted into the urethra via the penis.

It was a less invasive alternative to the traditionally used procedure for bladder outflow obstruction caused by an enlarged prostate, which was known as the transurethral resection of the prostate procedure. Patients were therefore usually able to go home the day after the procedure.

“The procedure does not generally affect erectile function or continence, although the possible urinary symptoms may take a few weeks to settle down afterwards.

“Patients are advised to take it easy and to avoid straining or heavy lifting for four weeks after the procedure,” Kalpee said.