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Diabetes and Benign Enlarged Prostate


Benign enlarged prostate is common in persons over the age of 60 years.Incomplete emptying of bladder, reduced urine flow, urinary frequency are common symptoms. Diabetics in particular are prone to reduced contraction of bladder wall and this leads to inefficient emptying of urine from the bladder. Ultimately these patients can retain more urine and develop overflow urinary incontinence, By this time bladder power of contraction is lost and surgery at that stage will not give good result.

Endoscopic Laser prostate surgery (Holmium Laser Enucleation of Prostate) HOLEP is advised early in Diabetics with residual urine to get good results after surgery. HOLEP  is the most advanced technique in the treatment of Benign enlarged prostate.

It offers many advantages to the patient

  1. painless procedure
  2. No blood loss
  3. large size glands can also be done safely. Traditional TUR prostate surgery is unsafe and can cause severe bleeding.
  4. Very safe in cardiac patients, elderly and those taking blood thinners
  5. Smooth recovery
  6. Patient can return home early and return to work early

How is the procedure done?

  • Procedure is done through natural passage ( Urethra),
  • There is no cutting
  • Entirely endoscopy procedure

How is the procedure done?

The patient is fully assessed earlier by relevant investigations to confirm the diagnosis and the need for surgery. Their fitness is assessed with help from physician, cardiologist and Anesthetist. patient is admitted on the previous evening or in the early morning before surgery Endoscopy is passed to check the urethra, Bladder and Prostate. Special instrument called Resectoscope is passed which has a channel to pass laser fiber. Most powerful 100 watts Holmium laser is used. Prostate lobes are  enucleated and the prostate is broken into small pieces using a morcellator. A catheter is placed to drain the urine and is usually removed 24 hours later

What to expect after surgery?

Initially urinary frequency, urgency can be present and usually settles in a few weeks. A small percentage of patients may experience mild stress leak which settles in two weeks. Patients can take care of themselves and can go for a short walk and enjoy normal diet

Laser Prostate Surgery

100 Watt Holmium Laser machine

Morcellator

Removed prostate chips

Authored By Dr. N. Anandan

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About Dr. N. Anandan

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Dr. N. Anandan is a senior consultant at Kauvery hospital and Apollo spectra hospitals in Chennai

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