What is an Enlarged Prostate?
An enlarged prostate, or benign prostatic hyperplasia (BPH) is a common condition that affects one out of 3 men over 60. The prostate is situated around the urethra, and when it gets bigger, it can obstruct the urine flow, which leads to such unpleasant symptoms as frequent urination, difficulty starting, and a weak urine stream. In advanced cases, surgery may be required if medications are not effective. For very large prostates, we choose between endoscopic enucleation and robotics.
When lifestyle changes or medication are ineffective in the management of these symptoms, a surgical procedure is recommended.
Endoscopic Enucleation Surgery for Enlarged Prostate
Enucleation surgery can be a good option for BPH as it is a minimally invasive procedure. HoLEP / ThuLEP / BipolEP are common laser procedures.
How Enucleation Surgery Works
In HoLEP, a laser beam is directed at the enlarged prostate tissues via a thin fiber which is introduced through the urethra. The laser separates the enlarged prostate from its surrounding capsule and removes tissue like a big ball. The same can be done by using other lasers or specialized currents, thus, opening up the urinary passage.
Benefits of Enucleation Surgery
- Less Bleeding: Enucleation surgery has the advantage of low blood loss, thus making it a good option for patients on blood-thinning drugs.
- Effective for Large Prostates: Enucleation is designed for larger prostates, being more successful in providing relief for the long term.
Risks of Enucleation Surgery
Enucleation surgery is, in fact, safe; however, some side effects can still occur, such as:
● Burning sensation during urination
● Frequent urination
● Blood in the urine
● Temporary difficulty in urination after surgery.
● Temporary urine leakage.
Generally, those side effects resolve within a few weeks after the procedure.
Robotic Surgery for Enlarged Prostate
Robotic prostatectomy is among the advanced surgical procedures available today. We would consider it in prostates that are too big for endoscopic surgery.
How Robotic Surgery Works
While executing robotic surgery, minor cuts are done in the lower part of the abdomen. The surgeon guides the robotic arms, taking away unnecessary prostate tissue with more accurate control.
Benefits of Robotic Surgery
- Greater Precision: Robotic-assisted surgical procedures assure higher precision directing to lower damage to the surrounding tissues.
- Fewer Complications: In contrast to conventional surgery, robotic surgery is associated with lesser blood loss, infection, and scarring.
- Enhanced Vision: 3D and magnified images significantly increase the accuracy of surgeons while performing a surgery.
- Quicker Recovery: Recovery is faster than traditional open surgery.
Risks of Robotic Surgery
Potential risks include:
● Higher Costs: Robotic surgery costs more mainly due to the high-tech devices used for the procedures.
● Urinary or Sexual Side Effects: Urinary incontinence or erectile dysfunction may happen very rarely, but modern techniques seek to reduce these risks to a minimum.
Endoscopic Enucleation vs. Robotic Surgery: Which is Better?
Both endoscopic enucleation and robotic surgery are good options for enlarged prostates but the decision depends on individual characteristics like the size of the prostate and the patient's general health.
● Endoscopic Enucleation Surgery: Is the first choice for patients with large prostates.
● Robotic Surgery: For prostates that are too large for endoscopic surgery, this method is the ideal one. Recovery may be a bit longer but it offers a very efficient treatment with a minimum of complications.
Recovery After Surgery
Whichever surgical method is chosen, post-operative recovery is a period that patients will have to go through. A catheter may be temporarily inserted. The majority of patients manage to return to their usual activities within a few weeks.
If you are having benign prostatic hyperplasia (BPH) symptoms, both robotic and enucleation are advanced and effective options for treatment. The method to be chosen is determined by various aspects such as the severity of the symptoms, the size of the prostate, and the overall health condition of the patient.
Discussion about surgery options with our Urologists can help you choose the best one for your condition and get a favorable outcome. Surgeries can add to your quality of life by a significant reduction of bothersome symptoms.
