Dr. Ömer Aydın

Benign enlargement of the prostate is a common condition with advancing age. Complaints usually occur with frequent urination, waking up at night, weakening of the urine stream, and the feeling that the bladder is not fully emptied.

In the evaluation, first the severity of the complaints is questioned. Urinalysis, ultrasound and urine flow rate measurement are performed when necessary. Examination and blood tests are also requested to rule out prostate cancer.

For mild complaints, monitoring and lifestyle recommendations may be sufficient. If complaints affect daily life, drug treatment is started. Surgery is considered if there is no response to medication, recurrent infection, bladder stones, inability to urinate, or kidney functions are affected.

HoLEP describes the separation of enlarged prostate tissue from its capsule and its entire removal using a holmium laser. The procedure is performed through the urinary tract. There is no incision in the abdominal area.

While the tissue is scraped piece by piece in the classical endoscopic method, in this method the tissue causing the obstruction is separated layer by layer. For this reason, it is especially evaluated in cases where the prostate is significantly enlarged.

The choice of method is made according to the volume of the prostate, the patient's bleeding risk, the blood thinners used and the accompanying diseases. Pre-operative preparation is completed with urine culture, blood tests and imaging. The expected benefits and possible side effects are discussed in detail with the patient.

The tissue lining the inner surface of the bladder may change its structure in the face of long-term irritation. Squamous metaplasia is one of these changes and is often accompanied by conditions such as chronic inflammation, stones or long-term catheter use.

Such findings are often noticed during cystoscopy and identified by pathological examination of the sample. Not every metaplasia turns into a malignant process. However, some of them require monitoring.

The decision is made according to the type of finding, its extent and whether the underlying cause of irritation can be eliminated. During follow-up, urinalysis, imaging and cystoscopy are planned when necessary. Quitting smoking is one of the prominent suggestions in this process.