High-tech laser prostate reduction operations now being delivered in Northants as a day case

A state-of-the-art laser prostate reduction operation is now being successfully delivered in the county as a day case procedure.

HOLEP, or Holmium Laser Enucleation of the Prostate, is a minimally invasive surgical procedure used to treat difficulties in urination caused by an enlarged prostate.

Northampton General Hospital (NGH) has just delivered its 100^th operation – 15 of which were day cases - and Kettering General Hospital has now delivered its first 16 HOLEP procedures since February. It too will begin to deliver them as day cases once it has delivered its first 20 procedures.

HOLEP involves using a laser to help break-up and remove excess prostate tissue enabling easier urination.

It is considered a significant advance in prostate procedures because it usually improves urination considerably, takes a short time to deliver, and patients can recover from it more quickly, and with less complications, than other common procedures.

Surgeons at the University Hospitals of Northamptonshire – which runs Northampton and Kettering general hospitals – have been working hard to fully establish and deliver the procedure across both Trusts. Northampton is the first hospital in the East Midlands to deliver the procedure as a day case.

The operations, which require specially trained consultants, are being delivered at NGH by consultant urologist, Mr Aakash Pai, and at KGH by consultant urologist, Mr Shady Nafie.

Mr Pai said: “Benign prostate enlargement affects about half of men over 50, and up to 80% of men over 70.

“The symptoms include frequent urination, difficulty starting to pee, a weak stream, and the feeling of incomplete bladder emptying.

“This is because the prostate tissue’s enlargement puts pressure on the urethra, the tube that carries urine from the bladder. 

“While not normally a serious threat to health it can significantly impact on a person’s quality of life and if medications don’t help surgical procedures can become an option.”

Mr Nafie said: “HOLEP is a high-tech, impressive operation that excels in treating larger prostates with less bleeding, faster recovery, and better outcomes compared to other methods.

“It is the new gold standard of treatment for benign prostate enlargement.

“I was determined to offer the procedure at Kettering to make it easier for North Northants patients and I made a successful bid to have some specialist training in Cambridge and Germany so that I could bring it here as soon as possible.

“We are delighted to be offering the procedure now across both of our hospitals for the benefit of our patients.”

Patients have said the new procedure is painless, leads to a quick recovery, and has significantly improved their quality of life.

Retired heating engineer David Leggett, 74, from Northampton, had been suffering from reduced flow and discomfort for some months. He had a procedure to remove stones from his bladder and his surgeon then recommended he go to NGH for a HOLEP procedure to further improve his condition.

He was one of the first patients to have the procedure as a day case at Northampton General Hospital.

Mr Leggett, who is married to Susan and has two children and six grandchildren, said: “I hadn’t been to hospital for 73 years so I was quite nervous but the day case team at NGH looked after me very well.

“The procedure took a couple of hours and I went home on the same day with a catheter in which was removed a week later.

“The difference has been amazing. You could say I previously would have struggled to fill a teacup but now I can put out a forest fire. It has a big difference on my life. I used to worry about being close to a toilet and now I am confident again in going for walks and living life to the full. I am over the moon with the operation. It is a one-stop shop, no side effects and no pain.”

Peter Letts, 73, from Wellingborough, had his HOLEP procedure at KGH in June after being admitted to hospital with urinary retention.

Mr Letts, who is married to Kathleen and has three children and five grandchildren, said: “I don’t remember much about the morning I had it but it was quick and painless. In about a week I was back to normal.

“If you get the chance to have this procedure I would say just do it. It can make a big difference very quickly.”

The average amount of tissue that is removed for HOLEP is five times the amount removed using conventional procedures, hence there is less need for follow-up procedures if prostate tissue regrows.

Mr Nafie said: “Compared to older techniques like TURP and open prostatectomy, HOLEP offers improved outcomes, including less bleeding, shorter catheterization and hospital stays, and a lower risk of a need for a repeat procedure.

“It is a significant advancement over previous surgical procedures particularly in its ability to treat larger prostates with reduced complications and shorter recovery times.

The University Hospitals of Northamptonshire’s Group Medical Director, Mr Hemant Nemade, said: “Essentially this state-of-the-art procedure uses a light beam to peel tissue and hollow out the prostate.

“It can remove more prostate tissue than other procedures for prostate enlargement and help address obstruction of the bladder.

“At Northampton we have now started to deliver some of our HOLEP procedures as a day case through our excellent day surgery unit and we aim to do this at Kettering too soon.”