Dr. Abhay A. Singh of St. Luke’s Center for Urology successfully performed the first-ever Holmium Laser Enucleation of the Prostate (HoLEP) procedure at St. Luke’s on a patient in late April. This represents the first time this minimally invasive treatment–which many experts consider the gold standard treatment of large prostate glands–was offered to patients within the St. Luke’s University Health Network.
Singh said the network offers a variety of medical and surgical options to men with voiding issues, and described the HoLEP procedure as “not only another powerful surgical tool in our arsenal, but also an elegant procedure that has been proven to help many men, including those with very large prostates–some of whom may otherwise have to consider a more invasive surgery. We are excited to offer this surgery to more patients moving forward.”
The HoLEP procedure is a unique, laser-based, endoscopic surgery for voiding dysfunction; a broad term that is used to describe ineffective or inconsistent coordination between the bladder and the urethra. The non-cancerous condition of an enlarged prostate causes dysfunction by preventing urine from emptying effectively, which the procedure addresses by passing a laser into the urethra and carving out tissue. The excess tissue is then ground up and sucked out, clearing a pathway for a significant improvement in the patient’s ability to void completely.
Singh likened the one-and-a-half to three-hour procedure to carving out the inside of an orange while leaving the outer rind intact. In addition to reductions in bleeding/blood loss, the likelihood of regrowth of the prostate and time spent using a catheter, the HoLEP procedure offers physicians the ability to treat any size prostate and allows patients to experience a faster healing time.
Singh’s inaugural patient for the procedure at St. Luke’s was unable to void at all, and had to catheterize himself before the HoLEP procedure was performed. He reported that the patient is recovering well and is now voiding with no difficulty at all.
The capacity to offer this minimally invasive surgery to patients of St. Luke’s helps to address a common condition for men, particularly those over the age of 60, and those with a family history of non-cancerous enlargement of the prostate. While there isn’t much men can do to avoid the condition, Singh noted that those who are diligent about diet and exercise often experience milder symptoms.
Patients Say They Only Wish They’d Had Prostate Procedure Sooner
Having performed a range of voiding dysfunction surgeries for years, including HoLEP, Dr. Singh said a man’s typical response after undergoing the laser prostate-reduction treatment is, “I wish I had done this sooner.”
Many men, he said, “are understandably hesitant or concerned about undergoing surgery and dealing with the risk of side effects. They typically put it off until they really have no choice and that’s when they pull the trigger. Afterward, they feel so much better and realize that they didn’t have to suffer as long as they did.”
Singh, who joined the St. Luke’s University Health Network in 2021, earned his medical degree from UMDNJ-Robert Wood Johnson Medical School and honed his skills in robotic and endourology–a urology subspecialty in which minimally invasive techniques are used–through a fellowship at Thomas Jefferson University Hospital in Philadelphia. He completed a general surgery internship at Walter Reed Army Medical Center in Washington, D.C., followed by a urology residency at Duke University Hospital in Durham, N.C. Following his residency, he served as an active-duty U.S. Army urologist at Fort Benning, Ga., and at Fort Belvoir, Va., where he was named chief of urology.
He specializes in robotic surgeries to treat both cancer (kidney, prostate and bladder) and for reconstructive purposes, as well as endoscopic surgeries that address voiding dysfunction and stones in men and women.
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