Department of Urology

Benign Prostate Enlargement

In about half of all men over the age of sixty, there are complaints of urination, which is most often caused by benign enlargement of the prostate gland. By frequent urination, especially at night, weakened urinary stream or the difficult suppression of urgency, this disease significantly affects the quality of life of the men affected. An emergency situation that forces immediate action is complete urinary retention and impaired kidney function.

Before initiating therapy, the doctor will conduct some examinations to differentiate a malignant lesion of prostate cancer (prostate cancer). If there is no suspicion of prostate cancer, targeted therapy may be initiated depending on the extent of bladder evacuation. Here are drug and surgical treatment options available. Depending on the size of the prostate, various surgical procedures are available, of which standard endoscopic prostate resection through the urethra (TUR prostate, Holmium enucleation of the Prostate HOLEP) or adenoma enucleation via a small lower abdominal incision (Millin-operation) are used. The aim is to remove the obstructive tissue by removing the benign prostate, in order to allow a normal emptying of the bladder and to protect the kidneys from damage.

Treatment

In the treatment of benign prostate enlargement, drug and surgical therapies are available. In any case - always in consultation with the patient - the most appropriate treatment needs to be explained and discussed.

Surgical treatment options of the benign prostate

Transurethral resection of the prostate (TUR-P)

In transurethral resection, the prostate adenoma is scraped across the urethra using an electrical sling. This procedure remains the gold standard for small to medium size prostate glands. The procedure is performed under general anesthesia or spinal cord anesthesia. With the insertion of a catheter into the urinary bladder, which remains for a few days, the operation ends. The patient should expect inpatient hospitalization for a maximum of 3 to 4 days.

Holmium Laser Enucleation of the Prostate (HoLEP)

We also offer the Holmium Laser Enucleation of the Prostate (HoLEP) for the benign prostate enlargement. Here, the prostate size can also be reduced through the urethra.

In this method, the glandular tissue along the prostate capsule is enucleated and then first dropped into the bladder. This makes it possible to operate on an especially low-blooded and well layered basis. For example, taking aspirin 100 does not need to be interrupted for this procedure. The liberated adenoma is downsized and sucked off at surgery with a special instrument within the bladder. It is thus still possible to pathologically evaluate the removed tissue and to examine for the presence of an unexpected prostate carcinoma.

This procedure is now internationally widely recognized. We offer a great experience with this new operation technique.

Open adenoma enucleation of the prostate - Millin OP

Open adenoma enucleation is commonly used on very large prostate adenomas. In this case, the enlarged prostate tissue is removed via a small lower abdominal section. The operative effort and the inpatient hospital stay are comparable to the resection of the prostate through the urethra (TUR-P). Reoperation after years is usually no longer necessary after complete removal of the adenoma. At the same time existing diseases such as bladder stones or bladder diverticulum (protuberances of the bladder muscles), can be treated in one procedure.

Our specialists

Dr. Florian Fuchs, Senior Specialist in Urology, Operative Urology, Endourology, Stone Therapy
Dr. Peter Marian, Medical specialist for Urology, Uro-oncology, Andrology, Coordinator Prostate Center
Prof. Dr. Alexander Karl, Professor and Chair, Department of Urology

Office Hours

To schedule an appointment or if you have questions:
Heike Mylius
Sophia Schottenhammel
Monday to Friday 8:00 - 16.00
Phone +49 (0)89 1797-2603
Fax +49 (0)89 1797-2623
E-Mail: uro@barmherzige-muenchen.de


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