It is a type of endoscopic prostate surgery used in the treatment of prostate enlargement using new generation laser devices (holmium laser, thulium laser, thulium fiber laser).
Since the holmium laser was first developed, these surgeries are generally called HOLEP surgery among the people. THULEP and THUFLEP are new generation laser systems developed after holmium laser and they work with the same basic logic in prostate surgery.
It is the process of separating the prostate tissue, which makes urine flow difficult by means of laser energy with the help of optical magnifiers and camera, by entering from the tip of the penis, from its capsule as if opening a tunnel.
This procedure is also called prostate enucleation. Then, this large prostate piece or pieces sent into the bladder are separated into small tissues with the help of a device called a morcellator and taken out with a special vacuum system and directed for pathological examination.
With the new generation laser devices in benign prostate enlargement surgeries, both rapid recovery, better urinary flow and less side effects are aimed.
Since the holmium laser device was first used for the prostate enucleation method with this laser, 'holmium laser enucleation prostatectomy' was named HOLEP. Later, thulium and thulium fiber lasers were also developed and the same surgical model gave very successful results with these latest technology laser devices. These are also abbreviated as THULEP and THUFLEP.
Scientific studies show that these three laser systems do not have obvious advantages over each other. However, since the thulium fiber laser (THUFLEP) device is known to damage tissue at a maximum depth of 0.2 mm during surgery, it is thought to have fewer sexual side effects and less urinary burning side effects after surgery. This distance is 0.4 mm for the holmium laser.
Laser devices are the new generation in the treatment of benign prostate hypertrophy, as well as the latest technology THULIUM FIBER LASER (THUFLEP) and REZUM devices.
The most important reasons why laser prostate surgeries are more preferred today are; better results and less risk.
Like Thuflep and Holep, the most important determinant of the duration of laser surgery of the prostate is the prostate volume. These surgeries are usually performed between 15 minutes and 2 hours.
After laser prostate surgery, our patients can be discharged within 1-2 days.
After these operations, the probe is usually removed between 1 and 3 days, depending on the size of the prostate. Therefore, the time to return to normal life is very short.
In benign prostate surgeries performed with holmium and thulium fiber laser systems, more tissue can be removed by separating from the capsule with the same anatomical logic as in open prostate surgery.
For this reason, laser prostate surgeries are the endoscopic prostate enlargement surgeries with the lowest probability of recurrence.
Side effects in prostate enlargement surgeries performed with laser are less common than classical TUR and open prostate surgeries. Bleeding, especially after surgery, is less in Thuflep and Holep surgeries.
Contrary to what is thought, the probability of prostatic enlargement surgeries to impair erection is low (1-2%). Especially in surgeries performed with thulium fiber laser, this rate is close to zero. It is also known that sexual performance will increase after prostate enlargement surgeries, if prostate enlargement has greatly affected the quality of life.
The side effect of erectile dysfunction occurs mostly after prostate cancer surgery. After laser prostate surgeries, some semen may be ejaculated backwards tı the bladder (retrograde ejaculation).
Permanent urinary incontinence is less than 1% after surgeries performed with both holmium, thulium and thulium fiber lasers. However, post-operative temporary and minor urinary incontinence may last from a few days to a few weeks and usually resolves with exercise and medication.
It tries to overcome the resistance in front of the bladder due to prostate enlargement. The bladder loses its ability to contract after a while, and even if the resistance in front of it is removed (in the case of delayed prostate surgery),it cannot provide sufficient urinary excretion, and as a result, urinary tract stones, recurrent complicated urinary tract infections and kidney failure may occur.
After about 3-4 weeks after laser prostate surgery, it is okay to have sexual intercourse.
Thulium fiber laser prostate surgery (THUFLEP),one of the latest technology laser systems in prostate surgery, is performed by Associate Professor Arif Demirbaş at Bursa Doruk Nilüfer Hospital which is one of the comfortable and high quality hospital.
One of the most important questions in the minds of patients who are candidates for prostate surgery is the comments of those who have had this surgery before. For the comments of some patients who have had prostate surgery with Thulium laser in Turkish; Testimonials
Laser prostate surgeries applied in the treatment of benign prostate enlargement vary according to the device used, the infrastructure of the hospital, the factors of the surgeon and the patient, and most importantly, the prostate volume. Laser prostatectomy costs range 3000 to 6000 USD