Doctor at Fortis Hospital and Kidney Institute, Rashbehari Avenue successfully performed Holmium Laser Prostatic Surgery to treat a 79 year old man patient recently. The patient was suffering from a condition called Benign Prostatic Hyperplasia (BPH) that resulted his prostate to enlarge 11 times its normal size. The team of doctors who performed the surgery was led by, Consultant Urologist, Fortis Hospital and Kidney Institute, Rashbehari Avenue in Kolkata.
Mr Jitesh Sarkar from south Dinajpur in West Bengal was complaining about urinary trouble over a period of time. He went into acute urinary retention. In order to provide immediate relief, Foley Catheterization was done to relieve his retention. He thereafter needed prostate surgery to void normally. The uniqueness about his condition is that the prostate has grown to 224 gms; i.e. 11 times the normal size (20 gms). Given the advance age of the patient and his poor cardiac condition, an open surgery was not a safe option. Hence he was advised to undergo laser prostatic surgery i.e HoLEP Holmium Laser Enucleation of Prostate. Entire HoLEP procedure took 100 min.No blood transfusion was needed as it is a bloodless procedure. Post the surgery, the urinary catheter was removed after 36 hours and he could pass urine normally and he was discharged in 48hrs.
Speaking about the case, Dr Shrinivas Narayan said, “The clinical evaluation was quite challenging due to its size, age and cardiac condition of the patient. After careful examination, it was decided that we will use Holmium Laser Enucleation of the Prostate (HoLEP). In this, a laser is used to remove excess prostate tissue completely in bloodless manner. We chose this unique technique, against the traditional prostate surgery, because it has negligible risk of bleeding, shorter hospital stay, quicker recovery, less need for a catheter and immediate results. Mr Sarkar is doing well and has recovered completely.”
Benign Prostatic Hyperplasia (BPH) is a common disorder among men, especially among senior citizens. Its symptoms may include frequent and urgent need to urinate, difficulty in starting urination, slow or prolonged urination, and infrequent flow of urine. It is also characterized by Nocturia which is increased frequency of urination at night as well as Urinary tract infections. It has been argued that laser surgery has several advantages such as shorter hospital stay early return to work, no need for blood tranfusion as against traditional transurethral resection of the prostate (TURP)[i]. HoLEP can treat prostate gland of any size but TURP can only treat glands up to 75 to 80 gms.
BPH is a aging phenomena that whose prevalence increases with age. Around 50% of men above 65 years of age (more than 80% among men 70-79 years of age) suffer some symptoms of BPH. Over the coming years, however, an increasing number of patients may report prostatic problems as the world’s population is aging. With increasing public awareness about prostate gland, more men are likely to present to their physician. Also, the men in their 50s and 60s no longer consider themselves old and are not prepared to accept the negative impact of BPH on their quality of life. By the year 2020 around 200% increase in the number of persons over 60 years of age is expected.