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LVHN Offers HoLEP Laser Treatment for Prostate Enlargement

Men with BPH can benefit from minimally invasive procedure

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Jim Johannes, MD Urology

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Men who experience prostate enlargement can now be treated for symptoms such as frequent urination, difficulty getting a stream going, weak stream, dribbling or inability to completely empty the bladder with a new procedure at Lehigh Valley Health Network (LVHN) that can offer significant advantages over standard care.

Called holmium laser enucleation of the prostate (HoLEP), the procedure addresses issues that arise when the walnut-sized prostate gland develops a condition common among older men called benign prostatic hyperplasia (BPH). The noncancerous BPH impinges the urethra, the tube that channels urine from the bladder, and restricts urine flow.

HoLEP advantages

While medication can sometimes relieve BPH’s squeeze on the urethra, many men require a surgical solution. Standard therapy has been transurethral resection of the prostate (TURP), a minimally invasive procedure in which a small instrument called a resectoscope is inserted into the urethra to trim away excess prostate tissue. Severely enlarged prostates may be treated with a more invasive open surgery called simple prostatectomy that removes larger amounts of the obstructive gland. Prostatectomy is associated with longer hospital stays and higher risks of complications and bleeding.

In the HoLEP procedure, surgeons enter the urethra with a laser that removes large amounts of the prostate and pushes the tissue into the bladder, where it’s removed with an instrument called a morcellator.

“You get the same results as with open prostatectomy but go home after about 10 hours instead of needing an overnight hospital stay,” says urologic surgeon Jim Johannes, MD, with LVPG Urology–1250 Cedar Crest. “Many urologists believe this approach will become the new standard of care for BPH, but it requires specialized equipment and training.” LVHN alone offers HoLEP locally.

An ideal candidate

HoLEP is especially useful for prostates that are too large for TURP to treat effectively. This was the case with 75-year-old Gary Fitch of Tannersville. Prostate-specific antigen (PSA) test results and symptoms had long indicated Fitch had BPH. He took medication but put off surgery. “Having this kind of procedure is not something you really look forward to,” Fitch says. Eventually, his prostate grew so large that he became completely unable to urinate. A urine-draining catheter offered a short-term solution, but it was clear Fitch’s problem needed a more definitive

Johannes performed a HoLEP procedure on Fitch in June 2017. “I showed up for surgery around 7 a.m., and by about 3 p.m., they said I could go home,” Fitch says. “The results are absolutely amazing.” Issues with flow, control and pain have vanished. “By every objective, measurable outcome, he’s doing fantastic,” Johannes says. “He’s peeing better than a 20-year-old.”

To refer a patient for HoLEP or other urology treatments, call 888-402-LVHN.