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Suggest Treatment For Benign Prostatic Hyperplasia

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Posted on Thu, 7 May 2015
Question: Hi, what is the best procedure for BPH ? Turp, Green Light Laser, Holep by Holmium Laser or Thulium Laser ?
doctor
Answered by Dr. Shafi Ullah Khan (13 minutes later)
Brief Answer:
Minimal imvasive surgeries are better

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. Every surgery that is minimally invasive and with better outcomes is best. TURP also called transurethral resection of prostate or as per se total prostatectomy are not done these days quite often unless necessary in cases like BOO Bladder outlet obstruction.

Apart from it all the minimally invasive surgeries are great and more beneficial.

Discuss all these minimally invasive options with your urologist and let them help you select the best one for you.

Transurethral incision of the prostate (TUIP)
Laser treatment - Used to cut or destroy prostate tissue
Transurethral microwave therapy (TUMT) - Generates heat that causes cell death in the prostate, leading to prostatic contraction and volume reduction
Transurethral needle ablation of the prostate (TUNA)
High-intensity ultrasonographic energy therapy - Currently in the clinical trial stage
Prostatic stents - Flexible devices that expand when put in place to improve the flow of urine past the prostate
Laparoscopic prostatectomy

I hope it helps. Take good care of yourself and dont forget to close the discussion please.

Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan (3 days later)
Thank you Dr XXXXXXX for your reply.
I understand minimal invasive procedures are best.
But I have heard that the benefits of Green Laser procedure often only lasts up to about 5 years with readmission required.
My reading indicates that the HoLEP procedure is now the Platinum standard but very few urologists appear to carry out this procedure. Is there a problem with this method ? And some use a Thulium Laser. How is this different to HoLEP ?
Can you help me because most urologists still seem to prefer TURP.
Thank you, XXXXXXX
doctor
Answered by Dr. Shafi Ullah Khan (10 hours later)
Brief Answer:
Do What your doctor thinks is best for you

Detailed Answer:
Thank you for getting back to me

As i mentioned every procedure has its pros and cons. If you go for Turp that extensive a procedure and age limits of geriatric range of 74 , the anesthesia complications, strictures formation, healing delay, wound complications and many more serious and grievous concerns, and last but not the least erectile dysfunctions and in many case urinary incontinences.

There are different types of prostate laser surgery, such as:

Photoselective vaporization of the prostate (PVP) also called Green light laser surgery. A laser is used to melt away (vaporize) excess prostate tissue to enlarge the urinary channel.
Holmium laser ablation of the prostate (HoLAP). This is a similar procedure to PVP, except that a different type of laser is used to melt away (vaporize) the excess prostate tissue.
Holmium laser enucleation of the prostate (HoLEP). The laser is used to cut and remove the excess tissue that is blocking the urethra. Another instrument, called a morcellator, is then used to chop the prostate tissue into small pieces that are easily removed.

i hope it explains. If your urologist believes in going for TURP i believe he is either incompetent enough to go with minimal invasion or he believes the size of the prostate is large enough to be beyond the reach of laser and a complete laser resection is unlikely. I would suggest trust your doctor. Get a second opinion from another urologist. If least bit favours laser and minimal invasion, go for it. Forget the 5 or other years statistics. Go for the safest and less complicated ones with minimal adverse effects and morbidities.

i hope it helps.
Regards
Khan

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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Suggest Treatment For Benign Prostatic Hyperplasia

Brief Answer: Minimal imvasive surgeries are better Detailed Answer: Thank you for asking I read your question and i understand your concern. Every surgery that is minimally invasive and with better outcomes is best. TURP also called transurethral resection of prostate or as per se total prostatectomy are not done these days quite often unless necessary in cases like BOO Bladder outlet obstruction. Apart from it all the minimally invasive surgeries are great and more beneficial. Discuss all these minimally invasive options with your urologist and let them help you select the best one for you. Transurethral incision of the prostate (TUIP) Laser treatment - Used to cut or destroy prostate tissue Transurethral microwave therapy (TUMT) - Generates heat that causes cell death in the prostate, leading to prostatic contraction and volume reduction Transurethral needle ablation of the prostate (TUNA) High-intensity ultrasonographic energy therapy - Currently in the clinical trial stage Prostatic stents - Flexible devices that expand when put in place to improve the flow of urine past the prostate Laparoscopic prostatectomy I hope it helps. Take good care of yourself and dont forget to close the discussion please. Regards Khan