Prostate enucleation by HoLEP and TUR-P for benign prostatic enlargement

If bladder emptying is incomplete due to the size of the prostate and this can no longer be successfully treated with drug therapy, HoLEP or TUR-P is recommended. It is worth mentioning that after the operation, no more medication needs to be taken for bladder emptying. The time at which surgery is indicated must be carefully considered. As a rule, benign prostatic enlargement is treated in the event of complications of bladder emptying (urinary retention, bladder stones, frequent urinary tract infections). However, it should be borne in mind that after HoLEP or TUR-P, the changes in the bladder muscle, which often lead to an increased urge to urinate, only regress slowly, and therefore the procedure should not be delayed for too long. Compared with TUR-P, HoLEP is better suited for pronounced enlargements. Tissue removal is very good.

HoLEP is a minimally invasive surgical procedure performed via the urethra. The prostate tissue is detached from the prostate capsule with the holmium laser and pushed into the urinary bladder. There, the removed prostate tissue is morcellated and removed from the bladder. The tissue is examined histologically in order to detect any malignant cells of the prostate. At the end of the operation, a bladder catheter is inserted, which can usually be removed on the 2nd day after the operation. As a rule, patients are discharged from inpatient treatment on the 3rd day after the operation.

TUR-P is a minimally invasive surgical procedure performed via the urethra. The prostate tissue is removed with an electric loop from the inside out to near the prostate capsule. The tissue is examined histologically in order to detect any malignant cells of the prostate. At the end of the operation, a bladder catheter is inserted, which can usually be removed on the 2nd day after the operation. As a rule, patients are discharged from inpatient treatment on the 3rd day after the operation.

In the case of a very large prostate, especially in combination with concomitant conditions such as bladder stones or bladder diverticula, robot-assisted da Vinci enucleation of the prostate or open surgery may also be possible. The question of the best surgical method for benign prostatic enlargement can only be determined on an individual basis in consultation with the patient.

Prostate enucleation can be performed using various procedures such as holmium laser enucleation of the prostate (HoLEP) or transurethral resection of the prostate (TUR-P). At the Goldstadt Private Clinic, the procedure begins with a thorough preliminary examination. The patient is then operated on under general or spinal anaesthesia, and the excess tissue is removed using a laser or resection instrument. After the procedure, the patient is monitored in the clinic to ensure a quick recovery.

Prostate resection or enucleation becomes necessary when patients suffer from a significant impairment of urine flow due to an enlarged prostate. Typical symptoms are frequent urination, urination at night, a weak urine stream and incomplete bladder emptying. The specialists at the Goldstadt Private Clinic assess each case individually and decide together with the patient on the best treatment option.

The terms "enucleation" and "resection" of the prostate refer to two different surgical procedures for the treatment of benign prostatic enlargement.

Enucleation (holmium laser enucleation of the prostate, HoLEP):

In enucleation, excess prostate tissue is removed with a holmium laser. The laser enables precise separation of the tissue, which is then moved into the bladder and aspirated from there. This procedure is characterised by high precision and a low risk of bleeding and is particularly suitable for larger prostate volumes.

Resection (transurethral resection of the prostate, TUR-P):

In resection, the excess prostate tissue is removed with an electric loop that is inserted through the urethra. This method is widespread and is often used for small to medium-sized prostate enlargements. It is known for its effectiveness in relieving symptoms such as urinary retention.

Both methods, enucleation and resection, are performed at the Goldstadt Private Clinic by experienced urologists to ensure optimal treatment for patients.

Find out more about our urology specialists here.

Prostate enucleations and resections at the Goldstadt Private Clinic are performed by experienced urologists. One of the leading experts in this field is Prof. Dr. med. Sven Lahme, specialist in urology and medical director of the Goldstadt Private Clinic. Prof. Dr. Lahme has many years of experience and extensive expertise in the use of state-of-the-art surgical techniques such as holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TUR-P). His expertise and commitment to excellent medical care ensure that patients receive the best possible treatment.

You can find further information about Prof. Dr. med. Sven Lahme here.

At the Goldstadt Private Clinic, two main methods are used for prostate enucleation: holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TUR-P). Both procedures have proven to be effective and offer different advantages depending on the individual needs of the patient.

As with any surgical procedure, there are risks associated with prostate enucleation, but these are minimised by careful planning of the procedure. Possible complications include bleeding, infections, temporary incontinence and sexual dysfunction. Patients are informed in detail about the risks during the informative consultation. The treating urologists take all necessary precautions to minimise them.