Urology · Prostate Enlargement (BPH)
Prostate Enlargement (BPH)
Diagnosis and minimally invasive treatment of benign prostatic hyperplasia. Enucleation techniques preserving continence and, where possible, ejaculation.
Condition Benign prostatic hyperplasia (BPH)
Techniques Bipolar Enucleation · HoLEP · TURP
Hospital stay Day surgery / 24–48h
Anaesthesia Spinal or general
Follow-up PSA + urinary flow at 1–3 months
What is benign prostatic hyperplasia?
Benign prostatic hyperplasia (BPH)
Treatment options
I.
Bipolar Enucleation
BipolEn
Enucleation of the prostatic adenoma with low thermal density bipolar energy. Active sphincter and ejaculation preservation. Original technique developed and published by Prof. Calarco in 2020.
- Immediate continence in all cases
- Ejaculation preservation (61%)
- Hospital stay < 24h
- Re-intervention at 5 years < 2%
Indicato per: First choice for prostate > 60 ml
II.
HoLEP Laser
HoLEP
Laser enucleation with Holmium fibre. International gold standard for large prostatic volumes. Excellent stone-free rate and long-term durability.
- Applicable at any volume
- Long-term durability
- Hospital stay 24–48h
- Minimal bleeding
Indicato per: Prostate of any volume, anticoagulated patients
III.
Pharmacotherapy
Alpha-blockers and 5-alpha-reductase inhibitors. First choice for mild-moderate symptoms. Possible combination with periodic monitoring in the absence of complications.
- Non-invasive
- No hospitalisation
- Outpatient management
- EAU guidelines first line
Indicato per: Mild-moderate BPH without retention
Clinical pathway
-
01
First visit
Medical history, PSA, transrectal ultrasound, uroflowmetry and IPSS score.
-
02
Assessment
Possible cystoscopy or urodynamics. Treatment plan definition.
-
03
Procedure
Spinal anaesthesia. Duration 60–90 min. Catheter removed in 24–48h.
-
04
Discharge
Instructions for diet, hydration and post-operative medication.
-
05
Follow-up
PSA + uroflowmetry at 1 and 3 months. Sexual function assessment.
Frequently asked questions
Will I be incontinent after prostate surgery?
With Prof. Calarco's Bipolar Enucleation technique, 92% of patients are already continent within 24 hours. Full continence is achieved in 98% of cases within 3 months.
Does prostate surgery affect sexual life?
The bipolar technique preserves antegrade ejaculation in 61% of cases — significantly higher than standard techniques. Erectile dysfunction from surgical cause alone is rare with modern minimally invasive approaches.
Can the prostate grow back after surgery?
Enucleation removes the adenoma completely. The probability of re-intervention at 5 years is less than 2%, compared to 10–15% with traditional partial resections.
When can I return to normal activities after prostate surgery?
Most patients are discharged the same day or the following morning. Light daily activities resume in 3–5 days. Intense physical activity and sexual intercourse are possible after 3–4 weeks.