The prostate is a gland about the size of a walnut that is only present in men. It is located just below the bladder and surrounds the urethra, the tube through which urine flows from the bladder and out through the penis.
One of the main functions of the prostate gland is to produce prostatic fluid, one of the components of semen.
The prostate starts enlarging slowly after the age of 40 and by the age of 70 almost one in every three men have significant symptoms requiring treatment. The enlarged prostate causes compression of urethra.
- A Weak Or Intermittent Stream Of Urine
- Hesitancy, Or Difficulty In Starting To Pass Urine
- The Need For Frequent Trips To The Toilet, Including Having To Get Up Several
Times In The Night - the need to pass urine urgently
- a feeling that the bladder isn't empty after urination
- inability to pass urine completely (retention)
- repeated urine infection or formation of stone in bladder
At Panchal Urology Centre, our aim is to understand your bothering symptoms, make an accurate diagnosis by detailed examination and necessary tests including Ultrasound and Urine Flow test (Uroflowmetry) and use international scoring system (IPSS). This along with your other medical problems and personal and social circumstances will help us in suggesting the best option of treatment. We would also like to ensure that the prostate enlargement is age-related (benign) only and not due to cancer.
At Panchal Urology Centre, we offer Holmium Laser Prostatectomy, the operation aimed to remove the central part of prostate gland which enlarges due to ageing and causes pressure on the urine passage (urethra).
The procedure is performed with a special endoscope passed through the urethra. With the help of Holmium Laser, the central part of prostate is separated from the surrounding fibrous covering (capsule) and pushed into urinary bladder. Then it is cut by a special machine (Morcellator) into smaller pieces and sucked out of the body and sent for biopsy.
This technique was developed by Peter Gilling (New Zealand) and is being carried out successfully in the US, UK and Europe over last 5 years with excellent results, but the high level of expertise required for this technique has resulted in being available only in selected centres in the world.
We are introducing this exclusive treatment and only because:
- Dr Panchal gained 2 years (2007 – 2009) of specialised training and experience in various laser treatments at world-renowned hospitals; Frimley Park Hospital – Surrey, Guys and St Thomas Hospital – London and Cambridge University Hospital with the leaders; Tevito Aho (UK) and Peter Gilling (New Zealand)
- We use high power Lumenis Powersuite 100w Holmium laser machine - the world best machine for prostate enucleation combined with Lumenis Morsellator- the best device to remove the enucleated prostate from the bladder.
HoLEP does not cost so much more than TURP - the traditional operation.
- Only 1 Day Hospitalisation
- Catheter is removed within 24 hours compared to 48-72 hours in TURP
- Much lower blood loss during and after surgery compared to TURP
- Removes complete adenoma (enlarged part of prostate) as compared to TURP/ other laser procedures so almost no need for another surgery in future
- Tissue obtained for histology (important to diagnose cancer) which is not possible with other laser treatments
- Best and sustained improvement in symptoms and flow rates as compared to TURP/ other laser procedures
- No risk of TURP syndrome - a serious complication of TURP
- Safer in patients on anticoagulants, aspirin and with heart valves and coronary stents compared to TURP
Commonly early problem is controlled with medicines to relax prostate muscles or reduce the size. Medication is required on a long term basis, otherwise symptoms and problems would recur. Generally the improvement in symptoms and urine flow is significantly less with medicines than with surgery.
But when the symptoms progress, fail to respond to medicines or complicated with retention, stones or repeated infections, surgery is required to remove part of prostate to open urine passage.
This is the standard technique for the removal of enlarged prostate gland. In this technique, telescope is passed from urethra and small pieces of prostate are cut with the help of electric current passed through a metal loop. All pieces are washed out from the bladder.
After being trained in the UK, Dr. Panchal introduced TURP in Ahmedabad in 1988 and have performed over 4000 TURP surgeries with gratifying results. He has trained many urologists and surgeons over the years.
We shall continue to offer TURP to patients who prefer this technique, as we have over the years.
