By increasing in size, the prostate compresses the urethra and thereby impedes the escape of urine: this is what occurs in benign prostatic hyperplasia, also known as prostatic adenoma, one of the most common conditions in men, second only to high blood pressure. In fact, it affects 50% of men in the 51-60 age group and 90% in the 81-90 age group. When it becomes symptomatic, in about half of the cases, it compromises the patient’s quality of life and mandates treatment.
If drug therapy is not sufficient, innovative intervention methods, based on the use of lasers such as Thulium and Holmium, allow minimally invasive endoscopic removal of even large adenomas, reducing the duration of the postoperative course, blood loss, and catheterization days. Particularly interesting is the experience in the field of the Circolo Hospital in Varese (ASST of the Seven Lakes), which boasts a case history of more than 700 operations conducted using the ThuLEP technique (Prostate Enucleation by Thulium Laser) and is a center of excellence and reference point for cutting-edge laser imaging.
“In men, surgery for benign prostatic hyperplasia, after cataract surgery, is the most common- explains Dr. Giovanni Saredi, Head of Urology at the Varese Hospital and scientific leader of the course-. the indication for surgery is related not so much to the size of the adenoma as to the actual impact the condition has on the patient’s daily life. Men of full working age, with an active lifestyle, are potential candidates, especially for laser surgery, which, compared with traditional surgery, allows for fewer days of hospitalization and catheterization, as well as lower bleeding risks. Today in Varese, when we perform a prostate enucleation, we are able to remove the catheter from the patient the day after the operation and discharge him or her the day after that again-a total of 3 days versus 4-6 days for traditional methods. Even individuals on anticoagulant therapy or those with heart disease may benefit from laser surgery, given the lower blood loss involved.”.
Thanks to the provision of both the Tulio Cyber TM 200 Watt Laser (which offers the maneuverability needed to operate any adenoma, regardless of size) and the Holmium Cyber Ho 105 Watt (which also allows bladder stones to be crushed), at Circolo Hospital Urology all patients with benign prostatic hyperplasia can only be treated endoscopically. Indeed, many patients come to Varese, including from other regions, and cases often involve particularly large adenomas that in other facilities would be operated on with open surgery. Three to four surgeries are performed each week, totaling about 150 in a year.
