PSA (prostate specific antigen) test

Laser Surgery Relieves Enlarged Prostate

Gary Fitch of Tannersville, Pa., knew he had prostate problems. He scored high on PSA (prostate specific antigen) tests as far back as the late 1990s, but biopsies ruled out cancer. His prostate was enlarged, with symptoms to match – like frequent urination and difficulty getting a stream going. Medication helped, but his urologist told Fitch he’d eventually need surgery such as TURP (transurethral resection of the prostate) that would remove excess prostate tissue and relieve pressure on the urethra, which channels urine from the bladder. “I put it off and put it off,” the 75-year-old Fitch says. “Having this kind of procedure is not something you really look forward to.”

In spring 2017, his body forced a decision. “One night I couldn’t go at all,” Fitch says. “I tried my darndest for a day and a half.” A urine-draining catheter offered a short-term solution. It was the endpoint for his condition, known as benign prostatic hyperplasia (BPH).

New option: HoLEP

Fitch’s prostate was now too large for standard TURP. Next standard option: an open prostatectomy surgery that involves a hospital stay and carries risks of complications and bleeding. “At that point, my urologist recommended I see a surgeon at Lehigh Valley Health Network (LVHN) who offered a different procedure that very few surgeons in the U.S. can do,” Fitch says.

Called holmium laser enucleation of the prostate (HoLEP), the minimally invasive procedure removes substantially more prostate tissue with fewer risks and less blood loss than a TURP or open procedure. “You get the same results as with open prostatectomy but go home after about 10 hours instead of staying overnight in the hospital,” says urologic surgeon Jim Johannes, MD, with LVPG Urology. “Many urologists believe this approach will become the new standard of care for BPH, but it requires specialized equipment and training.” LVHN alone offers HoLEP locally.

Remarkable relief

Imaging tests showed Fitch’s prostate had grown four times larger than normal, making him an ideal HoLEP candidate. “I showed up for surgery around 7 a.m., and by about 3 p.m., they said I could go home,” Fitch says. “The results are absolutely amazing.” Issues with flow, control and pain have vanished. “By every objective, measurable outcome, he’s doing fantastic,” Johannes says. “He’s peeing better than a 20-year-old.”

– Richard Laliberte