HoLEP: The 'Life-Changing' Prostate Treatment That Preserves Sexual Function

Men who suffer from benign prostatic hyperplasia can return to regular activities within a few days after the Holmium Laser Enucleation of the Prostate (HoLEP).

Related Rivers, Benue, other states with highest numbers of HIV patients in Nigeria Lagos govt taking drastic steps to tackle brain drain in health sector – Commissioner One in five children in Africa under-vaccinated — WHO

As men get older, many will experience urination issues due to an enlarged prostate. The result is a common condition known as Benign Prostatic Hyperplasia (BPH).

A larger-than-normal prostate puts pressure on the urethra, which can result in painful symptoms like difficulties starting to urinate, increased frequency of nighttime urine, and an urgent or frequent desire to urinate.

Additional symptoms include the difficulty to fully empty the bladder, dribbling at the conclusion of urination, or a weak or intermittent urine stream. Your quality of life may suffer as a result, particularly if you have to get up multiple times during the night to urinate.

Drugs and surgery are two ways to treat BPH. Drugs are often the first line of treatment. They relax the prostate muscles, allowing urine to more easily flow but when stopped, the results stop as well. What is more, with the urination issues, there may also be other issues affecting sexual function.

HoLEP is one procedure to treat the obstruction of urine flow due to an enlarged prostate without it affecting sexual function.

The American Urological Association and the European Association of Urology both recommend HoLEP as the best option for prostates that are more than 80 to 100g in size.

In Nigeria, Kelina Specialist Hospital in Lagos State, which focuses on minimally invasive procedures, has achieved an important landmark in treating prostate cancer. The facility recently celebrated performing its 500th HoLEP procedure for BPH over the past six years.

HoLEP employs laser technology to eliminate the prostate gland when it impedes urinary flow or poses a risk to overall health, particularly affecting the kidneys.

"Within 24 hours following the procedure, the patient is mobile and active, and can start eating on the very same day of the operation. This method stands out as the most suitable option for removing the prostate in such cases when contrasted with alternative techniques," explained Dr. Celsus Undie, who serves as the Medical Director at Kelina Hospital.

During a recent media discussion held in Lagos, Undie, a consulting urologic surgeon, revealed that Kelina Hospital has conducted 6,000 surgeries since opening its doors. These procedures include advanced techniques such as keyhole surgery for prostate cancer, HoLEP, robotic-assisted operations, and less-invasive methods for treating kidney stones.

As he stated, the hospital carries out more than 100 prostate operations annually, encompassing both non-cancerous and cancerous cases.

He stated, "Our commitment is to excellence, innovation, and patient-focused care. This drive pushes us continually beyond limits and sets fresh benchmarks in surgical procedures. In April 2025, Kelina Hospital will reach an important landmark with the completion of six thousand (6,000) surgeries from its start."

In April 2025, Kelina Hospital will reach a significant achievement by completing 500 Holmium Laser Enucleation of the Prostate (HoLEP) procedures over a span of six years. Kelina Hospital holds the distinction of being the pioneer institution to perform HoLEP surgery in Nigeria, which began towards the close of 2018. The procedure is specifically utilized for treating an enlarged prostate that impedes urinary flow.

Underie, who spent a decade as the Chief of Urology at the National Hospital before transitioning to Kelina Hospital, shared insights into the benefits of Holmium Laser Enucleation of Prostate (HoLEP) compared to traditional open prostatectomies and transurethral resection of the prostate (TURP). The latter procedures involve less invasiveness when addressing an enlarged prostate.

Compared to TURP or open prostate surgery, HoLEP offers advantages such as reduced blood loss, shorter duration of catheterization, decreased hospital stay, quicker recovery, and an earlier return to work for patients.

“The American Urological Association and the European Association of Urology both recommend HoLEP as the best for prostates that are more than 100g in size, which is what we see a lot in this country,” he said.

Dr. Undie noted that although urinary catheterization, which involves draining the bladder using a flexible tube known as a catheter, provides just a short-term remedy for collecting urine.

As he puts it, "Safety is a concern here. Whenever we encounter patients in the hospital who have had a catheter for over a week, testing their urine will reveal an infection every time. Therefore, if passing urine requires reliance on a catheter, why make such a fuss about having one’s prostate removed?"

If they choose not to undergo surgery and their catheter dislodges, making it impossible for them to insert a new one, you'll need to replace it yourself. Ultimately, these individuals should receive surgical intervention. Therefore, catheters ought not to remain in place for extended periods. Additionally, bear in mind that the penis has functions beyond urination for males; it also plays a role in reproduction.

Furthermore, Dr. Undie confirmed that it is a misunderstanding to believe that the testicles are removed during prostate enlargement surgery.

Removing the testicles is solely recommended for prostate cancers that have metastasized. Prostate cancer relies on testosterone to grow. Therefore, if the condition is detected at an early stage, there is absolutely no need to undergo this procedure.

“In the 54 prostate cancer surgeries we performed last year, all patients maintained normal urinary control, and many experienced normal erections,” Dr Undie said.

Undie also dispelled a common misconception, stating that "There is no scientific evidence to suggest that frequent sexual activity prevents prostate cancer."

He guaranteed that HoLEP will not stop men from becoming fathers.

We will eliminate the portion of the prostate causing significant obstruction to urine flow; he will continue to experience erections and typical ejaculation. If the complete prostatic adenoma is removed, normal ejaculation might be impacted.

"Despite having an erection without ejaculation, they could still father children through IVF since the sperm cells can be extracted from their urine," explained Dr. Undie.

The urologist noted that the advanced medical services at Kelina Hospital have reduced the necessity for Nigerians and people from neighboring countries to seek prostate treatments abroad. This has helped retain healthcare spending within the local economy and attracted international patients as well.

Nigerians ought to be motivated to seek medical care within their own country. It is saddening to observe individuals traveling overseas for common surgeries such as appendix removal, hernia fixation, fatty tumor extraction, or prostate sampling—procedures generally lasting under an hour.

"Traveling 12 hours for these small operations doesn’t just reflect badly on us; it also puts patients at undue risk. Multiple patients have come back from abroad experiencing issues, even post-prostate biopsies resulting in infections," he stated.

Dr. Vincent Obiwuru, an anesthesia and critical care specialist, stated that HoLEP is highly beneficial for patients with significant underlying health issues, as they previously needed to travel overseas to receive optimal treatment for their prostate condition.

"Minimally invasive procedures such as HoLEP allow patients to spend less time in the hospital and recover more quickly. The number of complications is also significantly reduced. Therefore, these are key advantages for anyone looking to improve healthcare in Africa," he noted.

Dr. Bertin Njinou, a distinguished robotic surgeon from France who is also licensed to practice in Nigeria and certified by the American Medical Council, stated that HoLEP represents the future of enlarged prostate treatments in Africa due to its numerous verified benefits.

According to Njinou, compared to other conventional and more invasive surgeries, HoLEP is marked by lower risks, shorter hospital stays, faster recovery times, and less problems like bleeding and blood transfusions.

“Now, the advantage of the HoLEP over these other methods is that the patient is already eating on the day of surgery and is up and doing by the next day,” Njinou explained.

Dr. Njinou additionally stated an uptick in prostate cancer instances and emphasized the significance of early identification via Prostate-Specific Antigen (PSA) blood tests beginning at age 40 for every man.

He indicated that the primary risk factors for prostate enlargement and prostate cancer include being African American, having obesity, and possessing a familial history of prostate cancer.

He mentioned that individuals can lower their chances of developing prostate cancer by including foods such as broccoli, cucumbers, garlic, green tea, and cooked tomatoes in their diet.

The Head of Corporate Relations at Kelina Hospital, Omada Idoko, also commented that as part of their policy, the hospital regularly sends its employees overseas for training sessions. This ensures they can continually offer top-notch medical care to local patients.

Over the years, the hospital has worked alongside surgeons from around the globe, provided these doctors hold a valid Nigerian surgical license.

We are exceptionally pleased to have Dr. Bertin Njinou join us, as we anticipate bringing aboard additional top-tier robotic surgeons in 2025," stated Idoko. "Dr. Njinou oversees the African Urological Training Center at IRCAD in Kigali, Rwanda, where numerous Nigerian urologists have received valuable training.

Provided by Syndigate Media Inc. ( Syndigate.info ).