The Most Effective and Safe Treatment for Benign Prostatic Hyperplasia (BPH)

What is Prostate Enucleation?

Enucleation is widely considered the gold standard for treating benign prostate enlargement (Benign Prostatic Hyperplasia, or BPH) due to its ability to remove all obstructive prostatic tissue responsible for urinary blockage and associated symptoms.

Unlike other approaches such as classic Resection or Aquablation, Enucleation completely removes the enlarged prostatic tissue without damaging the prostate capsule. This results in a more effective and long-lasting unblocking, with a lower risk of recurrence.

This procedure can be performed using different energy sources:

HoLEP (Holmium Laser Enucleation of the Prostate): Enucleation with Holmium laser.

ThuLEP (Thulium Laser Enucleation of the Prostate): Enucleation with Thulium laser.

Bipolar Energy.

Other energy sources (including KTP laser).

This treatment significantly improves quality of life, allowing a rapid return to daily activities.

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Advantages of Prostate Enucleation

Prostate Enucleation is a highly effective minimally invasive procedure that significantly reduces the risk of serious complications compared to other treatment techniques.

Less blood loss and shorter catheterization period;
Lower risk of urinary incontinence and preservation of sexual function;
Minimally invasive (performed through the urethra with no skin incisions);
Shorter hospital stay (24 to 48 hours) and faster return to normal activities;
High efficacy in removing all enlarged prostatic tissue, reducing the risk of recurrence.

How is Prostate Enucleation Performed?

Prostate Enucleation is performed under general or spinal anesthesia, following a highly precise protocol:

1. Endoscopic Access to the Prostate

The procedure is performed endoscopically through the urethra, eliminating the need for incisions. A thin endoscope with a high-definition camera provides a clear view of the prostate and ensures greater control during the procedure.

2. Separation of the Obstructive Prostatic Tissue

Using laser energy (Holmium, Thulium, KTP) or bipolar energy, the enlarged prostatic tissue is carefully separated from the prostate capsule. The central part of the prostate, which compresses the urethra and obstructs urinary flow, is completely removed. This approach eliminates the root cause of symptoms, reduces recurrence risk, and preserves the integrity of the prostate capsule.

3. Tissue Removal

The removed prostatic tissue is fragmented and extracted through the urethra. Unlike vaporization techniques such as PVP (photoselective vaporization with GreenLight laser), this method allows for histological analysis of the extracted tissue.

4. Coagulation and Hemorrhage Control

The energy used cauterizes blood vessels, significantly reducing the risk of bleeding. Bipolar energy, in particular, has superior coagulation capacity compared to laser.

5. Temporary Catheter Placement

At the end of the procedure, a catheter is placed to facilitate urinary drainage and ensure a safe recovery. In most cases, the catheter can be removed the following day or within 48 hours.

Throughout the process, our medical team will provide personalized care to ensure your comfort and confidence at every stage of treatment.

Want to Learn More About Prostate Enucleation for Treating BPH?

Book a consultation at the Instituto da Próstata to learn more about this treatment, its advantages over other approaches, and the steps involved in the procedure.

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Post-Treatment: Recovery After Prostate Enucleation

Recovery after prostate enucleation is quick and well-tolerated, with significant improvements in the first few days. Key aspects include:

Short hospital stay: Most patients are discharged within 24 to 48 hours.
Catheter removal: Typically within 24 to 48 hours post-surgery.
Improved urinary symptoms: Urinary flow improves immediately after catheter removal.
Possible traces of blood in urine: Small traces are normal in the first few days and gradually disappear.
Quick return to normal activities: Depending on individual recovery.
Preservation of erectile function: The risk of erectile dysfunction with this technique is minimal. Most patients retain normal sexual function, though a brief adaptation period may occur.
Retrograde ejaculation: A common effect in about 70% of cases. This does not affect sexual function but prevents semen from being expelled during orgasm. However, a modified technique can increase the chances of preserving antegrade ejaculation.

After the procedure, we provide close follow-up to monitor your progress. Our team is always available to answer your questions and ensure your full recovery and well-being.

Dr José Santos Dias

Clinical Director of the Instituto da Próstata

Bacherlor's Degree from the Faculty of Medicine at the University of Lisbon
Specialist in Urology
Fellow of the European Board of Urology
Autor dos livros "Tudo o que sempre quis saber Sobre Próstata", "Urologia fundamental na Prática Clínica", "Urologia em 10 minutos","Casos Clínicos de Urologia" e "Protocolos de Urgência em Urologia"

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