The latest generation minimally invasive operations for the reduction of the enlarged prostate were performed by the Urology team of the Policlinico.
The Urology of Polyclinic of Abano Terme (Padua) performed for the first time in the world two holmium laser reduction of enlarged prostate (HoLEP)using only thelocal anesthesia it’s a light sedation. The team coordinated by Daniel Romagnolidepartment manager, used the catheter Schelin, a latest generation device which allows the anesthetic drug to be injected directly into the organ to be operated on. The patients were operated on last Thursday and discharged on Saturday.
This new technique involves the introduction of a small silicone probe, similar to a normal bladder catheter, into the prostate of the fully awake patient. The device has a slim retractable needle through which it is possible to instill small doses of anesthetic in the prostate tissue, guaranteeing the anesthesia of the affected organ. This system has already been used successfully during procedures Summaryminimally invasive treatment with water vapor of theBPHwhich is used in case of enlargement of the organ up to 80-100 cubic centimeters in volume.
“Never before – comments Romagnoli – has this revolutionary catheter been applied to holmium laser procedures, which guarantee an almost permanent resolution of the symptoms linked to prostatic hypertrophy”. According to both European (European Association Of Urology, EAU) and American (American Urological Association, AUA) guidelines, the holmium laser represents the method of choice (gold standard) for the minimally invasive treatment of any prostate volume”.
And again: “In the two cases performed, the effectiveness was such as to allow the procedures to be performed with the sole addition of a slight sedation, without therefore having to resort to types of anesthesia, such as spinal or general anesthesia with intubation, which are usually used on that occasion, but which are much heavier and more demanding for the patients. The Urology Department of the Abano Polyclinic therefore confirms its mission, based on the treatment of prostatic hypertrophy and other urological pathologies with cutting-edge techniques”.
The pathology – Benign prostatic hypertrophy (BPH) affects 80% of men over 50 and manifests itself with the volumetric increase of the prostate, the gland through which the urethra passes, the duct that carries urine from the bladder to the external. When the prostate enlarges, urine output is obstructed, resulting in urination problems and stagnation and an increased risk of infection.
The disease is progressive, gets worse over time and, if not properly treated, can cause permanent damage to the bladder and upper urinary tract. “The enlargement of the prostate gland should neither be underestimated nor overlooked. The patient must undergo regular check-ups and agree with the trusted specialist on the most suitable drug or surgical therapy for his case”, Romagnoli specifies.
The minimally invasive methods in detail – These are two minimally invasive non-obstructive methods that employ latest generation technologies for the treatment of enlarged prostate. The use of the holmium laser has revolutionized endoscopic urological surgery, both as regards the treatment of urinary calculi (endoscopic laser lithotripsy operations for kidney and ureteral calculi) and the treatment of benign prostatic hypertrophy.
“This technology – continues Romagnoli – is used in the event of significant prostate symptoms and volumes and allows patients to be operated on endoscopically and without cuts”. Among the advantages of this method, recognized worldwide as the most effective and safe, there is a reduction in blood loss, intra- and peri-operative complications, bladder catheter use times and hospitalization.
“The only drawback of this method – adds the specialist – is the fact that the ejaculation becomes internal, without however altering in any way either the orgasm or the erection”. For patients with prostates up to 80-100 cubic centimeters in volume and who do not want to give up ejaculation, the Rezum treatment is available, a latest generation technology that allows a minimally invasive treatment that can be performed in day surgery.
“This operation exploits thermal energy in the form of water vapor – explains the urologist – which is injected through the urethra into the prostate by means of a probe of very few millimeters in diameter, all in ten minutes at most. There are many advantages for the patient: hospitalization in the morning and discharge in the afternoon, speed of execution and maintenance of ejaculation”.
Nurse Times editorial team
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