HoLEP Eliminates 85 percent of Drug Use in the Treatment of Benign Prostate Enlargement

Stating that benign prostate enlargement is commonly seen in men, especially after the age of 50, Urology Specialist Assoc. Prof. Dr. İlter Alkan stated that when drug treatment is not sufficient or has some side effects in the short and long term, they can recommend surgical procedures according to the course of the disease. Yeditepe University Kozyatağı Hospital Urology Specialist said, "The study shows that 85 percent of patients do not need drug treatment after closed prostate operations such as HOLEP, which is a candidate to be the 'gold standard' in the treatment of prostate enlargement, where the growing tissue is completely removed."
According to a study conducted on 5,100 patients with benign prostate enlargement in the USA who underwent endoscopic (closed) surgery and were followed up, it was observed that 80-85 percent of patients did not need drug treatment, especially after closed surgical methods such as HOLEP, in which the growing tissue was completely removed.

The Prevalence of the Disease Increases with Age

Evaluating the results of the study and giving information about the disease and treatment methods, Yeditepe University Kozyatağı Hospital Urology Specialist stated that one of the most common disorders we see in urology is benign prostate enlargement. The incidence of the disease increases with age. According to statistics, benign prostate enlargement is seen in 50-60 percent between the ages of 50 and 60. After the age of 70, this rate increases to 80-90 percent. In this study, it was shown that after closed prostate operations, the patients' problem was solved and the need for medication was largely eliminated. In this way, patients do not have to use medication for life, and more importantly, patients are saved from the possible side effect risks of drugs and the financial burden of drug treatments."

"Treatment Is Initiated Based on Complaints and Obstruction in the Urinary Tract"

Explaining that in the treatment of people with benign prostate enlargement, the patient is first evaluated and the treatment needed is determined, Urology Specialist gave the following information about the treatment approach to be applied: "We decide on the treatment according to the patient's complaints, the obstruction caused by the tissue of the benign enlarged prostate in the urinary tract or the risk of complications. If the patient does not have many complaints and the obstruction is mild, we primarily prefer drug treatment. Sometimes, despite the use of medication, the patient's complaint does not go away or may increase over time or there may be side effects due to the use of medication, then we may prefer surgery. In this case, we apply surgical treatment without wasting time with drug treatment. At this point, we can say that there have been very important developments in technology. Especially in recent years, it has become more widely used. There is HOLEP (holmium laser technology) technique. This technology is actually not new. It has been used since the early 2000s. However, as the long-term results of the technology began to be seen, it was seen to be very advantageous and became a priority method in the surgical treatment of benign prostate enlargement. The number of urologists who know this method in the world and in Turkey is increasing and it is about to reach the point where it will be accepted as the best method we call the 'gold standard'." 

Low Risk of Bleeding

Stating that HoLEP technology provides many gains for both the physician and the patient, Urology Specialist said, "We use holmium laser energy during surgery, so the risk of bleeding is much lower. Since it is a closed surgery, the hospitalization period is much shorter. It is usually enough for the patient to stay in the hospital for one night, and we can discharge them the next day. Since the tissue is completely removed with closed surgery, the risk of recurrence is very low."
Stating that some patients may be afraid of surgery due to some misinformation, but the risk of complications will increase over time, especially in the patient group requiring surgery, Urology Specialist continued his words as follows: "The drug is effective as long as we use it, if you stop the drug, the complaints will start again. You need to use the drug throughout your life, it can also have some side effects. These can negatively affect people's sexual life. In addition, some scientific studies have reported that long-term drug use increases the risk of diseases such as dementia and neurocognitive disorders."

No Need for Drug Treatment

Stating that the research reveals the effect of closed methods (such as HoLEP), in which the whole tissue is removed, Urology Specialist said, "In the study conducted in the USA and in which 5 thousand hundred patients were examined, it was investigated whether the patient treated with endoscopic (closed; no incision required) methods needed drug treatment again. It was found that 80-85 percent of the patients did not need medications and they were discontinued. This shows how effective the HOLEP method is.".

"We can treat 150-200 Gram Prostates with Holep Method"

Stating that they performed the first operations with this technique in 2003-2004, Yeditepe University Kozyatağı Hospital Urology Specialist said, "With the HoLEP method, we can perform even large prostates such as 150-200 grams in a closed way without the need for open surgery. This is a great advantage for patients. We have abolished open surgery with the HoLEP technique in large prostates. Patients do not have erectile dysfunction after surgery. Since this issue is misunderstood by our patients, they may prefer to use the medication by avoiding closed operations. However, as I mentioned, the risk of erectile dysfunction after closed operations for benign prostate enlargement is very low. In addition, it should not be forgotten that drugs used in the treatment of prostate enlargement can cause sexual problems such as loss of libido and erectile dysfunction.
Urology Specialist also stated that the treatment method to be applied depends on many factors and that the patient should decide with a urologist for the selection of the most accurate method.