BENING PROSTATIC HYPERPLASIA- LASER ENUCLEATION FOR THE PROSTATE

Benign Prostatic Hyperplasia (BPH) is one of the most common urological conditions in men. It affects 50% of men over 40 years old, with this percentage increasing to 80% in men aged 60-80 years. The prostate, a small gland through which the urethra passes, enlarges over the years, making urine flow more difficult.

The size of the prostate progressively increases from the age of 25, while symptoms typically appear gradually at an older age. Symptoms of prostate hyperplasia may include frequent urination, nocturia, urgency, the feeling of incomplete emptying, weak and interrupted urination, and even urinary retention, bladder stones, urinary tract infections, and kidney failure in advanced cases. Although prostate hyperplasia is generally not life-threatening, it can significantly affect the quality of life.

TREATMENT

Treatment of BPH is divided into conservative (pharmacological) and invasive (surgical) approaches.

The conservative treatment mainly focuses on symptomatic relief, addressing the symptoms of hyperplasia to some extent, but it does not cure the underlying cause or prevent further prostate enlargement and disease progression. Additionally, pharmacological treatment is associated with well-documented and frequent side effects, making adherence to the prescribed regimen difficult for some men.

Surgical treatment is the only definitive therapy for benign prostatic hyperplasia. Each method aims to reduce the size of the prostate in order to relieve the obstruction of urine flow. Nowadays, transurethral techniques have largely dominated, offering superior safety and effectiveness compared to the more invasive and traditional open surgical methods.

HOLEP- HOLMIUM LASER ENUCLEATION OF THE PROSTATE

Prostate enucleation via the urethra is not a new concept. If we imagine the prostate as an orange, the philosophy behind enucleation is the removal of the internal part, leaving only the peel. This approach allows for optimal removal of the hyperplastic tissue and maximum effectiveness. Today, this is possible due to advancements in technology and the use of Holmium Laser, along with the development of the HoLEP (Holmium Laser Enucleation of the Prostate) technique, which is now considered the Gold Standard in the surgical treatment of benign prostatic hyperplasia.

MULTIPULSE HOPLUS

The innovative and powerful MultiPulse HoPLUS laser machine, from the German company JenaSurgical GmbH, is a state-of-the-art integrated laser system with a power output of 150 watts. It has been exclusively designed for prostate enucleation (HoLEP). It combines the maximum laser power (150 watts) with the longest pulse duration (1700µs) and the fastest, safest tissue morcellator – technical features that set the standard for the HoLEP method. Urologic surgeons using the MultiPulse HoPLUS equipment have unlimited power at their disposal, which they can apply to the patient with optimal precision, achieving maximum effectiveness combined with optimal safety.

This inspiration was brought to life by the German company RZ Medizintechnik GmbH, which manufactures specialized endoscopic tools and developed a global innovation, the Mini Laser Scope. This equipment, reduced by 30% in diameter, combines the utmost clarity and sharpness of the image with the effectiveness of conventional-sized instruments. In this way, MiLEP (Minimal Invasive Laser Enucleation of the Prostate) was developed as the most minimally invasive application of the HoLEP method