Treatments for Benıng prostatıc hyperplasıa (BPH)

Your prostate gland sits around your urethra (waterpipe) as it leaves the bladder, and when it enlarges, it may block the urine flow. Rezūm Water Vapor Therapy is a non-surgical treatment that uses the natural energy stored in water vapour, or steam, to remove excess prostate tissue pressing on the urethra.

WHAT DOES THE REZUM PROCEDURE INVOLVE?

The Rezūm procedure involves steam injections into your prostate. The steam injections can be put into the prostate tissue surrounding the urethra (lateral lobes) and any prostate tissue that extends into the bladder (median lobe). The number of injections needed depends 

on the size of your prostate. Following the procedure, we usually put a temporary catheter in your bladder to avoid retention risk. This catheter is removed after a few days. Over the subsequent weeks, the prostate resorbs (shrinks) due to the steam injection, which opens up the water pipe to allow improved urinary flow and bladder emptying. 

The Rezum treatment is revolutionary for patients with health problems that can't risk surgery or elderly patients that don't want surgery since it's done under local anaesthesia. The procedure takes about 10 minutes from start to finish, even in the largest prostates. Patients can usually go home the same or the following day. Compared to other treatment methods with a longer recovery time, patients return to their daily lives faster after Rezum. Another patient group suitable for the Rezum is young men with prostate enlargement. While these patients often encounter sexual problems such as retrograde ejaculation when treated with classical methods, the probability of sexual side effects after Rezum is only about 1%.

The main benefits of this procedure, compared with other surgical treatments for prostate enlargement, are: 

• A short stay in the hospital (usually a day case)
• an earlier return to normal activities; 
• a minimally invasive procedure 
• Provides noticeable symptom improvement within three weeks & maximum benefit in 2 to 3 months 
• sexual side-effects such as retrograde (dry) ejaculation or erectile
  dysfunction (impotence) is rare. 

Starting from £3,000

 In men with BPH, the prostate gland is not cancerous but has become enlarged. An enlarged prostate can result in several urinary tract symptoms, such as frequent urination, inability to urinate, difficulty starting urination, or loss of bladder control.

HOW DOES HOLEP WORK?

Under general anaesthesia, the patient is laid on his back with his legs raised during the procedure. A surgical instrument called a resectoscope is inserted through the urethra. This instrument has a camera that allows Dr Burak to view the internal structure of the prostate gland. Next, the laser is inserted into the resectoscope. The laser energy is then used to "enucleate" the enlarged prostate tissue. The laser vaporizes the incision line, instantly sealing the blood vessels. The tissue that is removed goes into the bladder. The laser is then removed from the resectoscope and replaced by a morcellator. This device suctions away the tissue that was deposited in the bladder. When this is complete, the resectoscope is removed, and a urinary catheter is put in place.

The prostate is approached internally (endoscopically), through the urethra, without any cuts on the skin. The Holmium laser is used to peel out the obstructive core of the prostate. In HoLEP, the laser cuts and removes the fat prostate tissue blocking the urine flow. This leads to maximal relief of prostate obstruction. 

WHAT ARE THE ADVANTAGES?

Although there are many types of BPH surgeries available, HoLEP offers a unique advantage in being able to remove a large amount of tissue without any incisions on the body, even in very large prostates, while decreasing the risk of bleeding and providing tissue for pathology (to look for cancer). This decreases the need for blood transfusions during surgery, minimizes the time of stay in the hospital to one or two days, and reduces the risk of needing repeat treatment. 

WHAT ARE THE SIDE EFFECTS?

The most common side effects include:

• Temporary burning and bleeding during urination. Some blood may be seen in the urine for weeks after surgery. This is usually not an indication of anything serious, only a part of the healing process.
• Inability to control urine flow is expected in all patients immediately after surgery, and they should wear pads for the first few days/weeks. The urge incontinence risk can depend on several factors, including age, prostate size, symptoms, and other medical problems.
• Retrograde ejaculation or "backwards ejaculation." In 75 per cent of cases, the patient will not see any fluid during ejaculation during sexual activity after surgery.

HOW IS HOLEP DIFFERENT FROM LASER ABLATION?

Laser ablation thoroughly vaporizes the tissue. It is helpful for small areas that need to be removed. But when the prostate has more tissue pressing on the urethra, it's unrealistic to ablate all of it. That's where the holmium laser can cut it away.

Starting from £4,000