Very large prostates: holep versus simple prostatectomy versus PAE

Very large prostates: holep versus simple prostatectomy versus PAE

As men age, many will find it necessary to receive treatment for an enlarged prostate. The most common cause of an enlarged prostate is benign prostatic hyperplasia. This condition, also known as BPH, is a generally harmless condition (benign) that occurs in over 50% of men past the age of 60. This condition is non-cancerous and presents as an enlarged prostate that continues to grow over time. Multiple approaches are available for the treatment of this condition, but selecting the right one for you can be daunting. Three common options are HoLEP, simple prostatectomy, and prostatic artery embolization. 

HoLEP, Simple prostatectomy, and PAE

HoLEP is an abbreviation of one of two terms for the same procedure. Known as holmium laser enucleation of the prostate or, alternately, Holmium last prostate surgery, this treatment is used to improve urine flow through the prostate. Its end results are similar to an open surgery approach but are accomplished without the need for creating a large incision. During this procedure, the obstructing tissue is removed from the prostate and then broken down into pieces small enough to remove. It is an effective method of treating prostates that have become significantly enlarged. Another benefit of this procedure is recovery times that are much shorter than those of open surgery.

Simple Prostatectomy

This procedure was the traditional approach to addressing enlarged prostates that developed problematic symptoms. The end goal of this procedure is to remove a portion of the prostate that has been causing urinary issues as a result of BPH. For many years this procedure was performed using an approach called “open surgery .”This approach involved making a large incision in the abdomen of the patient to provide access to the prostate. While this approach is still used, robot-assisted surgery is now the preferred technique when possible.

Robot-assisted simple prostatectomy is performed by making two small incisions, known as ports, in the patient. These ports are then used to insert and guide small surgical tools to the target site. One of these tools is called an endoscope and is a small camera that allows the surgeon to easily view the surgical site. The minimally-invasive nature of this surgical approach means it has shorter recovery times than open surgery and limited risk of complications.

Prostatic Artery Embolization (PAE)

This minimally invasive procedure has become the new gold standard for treating enlarged prostates. It is accomplished in a manner similar to robot-assisted prostatectomy but with different goals. This procedure guides catheters to the portion of the prostate that has become enlarged. Small plastic obstructions are then placed in the arteries feeding the prostate, causing it to shrink over time. There is significantly reduced downtime with this procedure, and it is generally performed outpatient.

Which Is Right For Your Prostate Health?

Now that you know about these three procedures and how they differ, you may be wondering which is right for you. Schedule a visit with your prostate specialist to identify the procedure that will work best with your condition. Together you’ll develop a treatment plan that will effectively reduce the symptoms of enlarged prostate.

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