Holmium laser enucleation for geriatric prostate hyperplasia

Recently, Professor He Le Ye, head of the Department of Urology, successfully performed transurethral holmium laser prostatectomy on five elderly patients with prostate enlargement, the oldest of whom was 84 years old and had a prostate volume of about 100 ml. The catheter was successfully removed on the third day after surgery, and all patients were able to urinate freely and were discharged from the hospital. The procedure is the first new technique carried out in the province. Prostate enlargement is a common disease in the elderly, with a high incidence. 80% of men in their 80s have prostate enlargement. These patients often show frequent urination, increased nocturia, incomplete urination, dripping and difficult urination, waiting and interruption of urination, and even acute urinary retention due to inability to urinate, which seriously affects the patient’s quality of life or even endangers the patient’s life and requires surgery. The majority of patients with prostate hyperplasia currently undergo transurethral resection surgery, which is also minimally invasive, but older patients often combine multiple organ dysfunctions and have poor surgical tolerance, which still carries a higher risk. Laser treatment of prostate hyperplasia has the advantages of less trauma, less bleeding and fewer complications, and is currently an internationally advanced minimally invasive technique. Since 2010, under the leadership of Professor He Le Ye, the prostate subspecialty of this department has carried out clinical exploration of new technologies such as green laser, thulium laser and semiconductor laser for the treatment of prostate hyperplasia, and also hosted a multicenter clinical trial with satisfactory results of 1 year of clinical observation. The Holmium laser was used to remove the hyperplastic prostate tissue (HoLEP), which is another new technique that our department has tried to carry out. This technique is also known as the “orange peeling method” to remove the hyperplastic prostate. By outputting 100 watts of power, the efficiency of cutting and hemostasis of the gland is significantly enhanced. The procedure takes about one hour, with little blood loss, and the catheter can be removed 2-3 days after the procedure. The procedure is less risky and safe, and is ideal for patients with advanced age, high risk and huge volume of prostate enlargement. The urology department is constantly seeking to explore more minimally invasive and safer surgical methods in the treatment of prostate hyperplasia. The prostate disease team led by Prof. He Le Ye has gradually transitioned from traditional open surgery in the early days to transurethral electrodesis of the prostate, transurethral vaporization of the prostate, transurethral plasma electrodesis of the prostate, enucleation of the prostate, and then to the various laser surgeries currently being explored, all the way to the endless pursuit. The goal is to reduce patient pain, shorten hospitalization time, ensure surgical safety, and provide better medical care for elderly patients.