Welcome to Tobias Bothmann - benign prostatic surgery

The following pages give an overview to endosurgery for benign prostatic hyperplasia, especially the Holmium Laser Enucleation of the Prostata (HoLEP). Laser therapy for the treatment of benign prostate enlargement has been a proven, modern surgical method for more than 20 years. I am head of the laser surgical department at the Humboldt-Klinikum, Berlin. We offer the Holmium-Laser-Enucleation of the Prostate (HoLEP).

The following pages show necessary information about this method. Appointments can be scheduled online, alternative dates can be agreed at any time by e-mail. If you are not sure whether to book an appointment or not, feel free to contact Dr. Bothmann directly by e-mail at info@endo-uroberlin.com.

Yours sincerely
Dr. Tobias Bothmann

The enlarged Prostate

During the course of life our body is changing. This is also due to the urinary bladder and the prostate. Safts in the hormone-balance and the aging process lead to a change in the prostatic anatomy: it becomes larger. We call it the benign enlargement of the prostate - the benign prostatic hyperplasia (BPH). This will your bladder emptying.

The resulting complaints - the „lower urinary tract symptoms (LUTS) - are a frequent cause of discomfort, frustration and a reduced quality of life for those affected and their partners.

Therapy Strategies

There are various conservative as well as surgical treatment strategies. If your medication is no longer successful, your urologist will talk to you about the surgical options. The principle of every intervention is the removal of constricting prostate tissue in order to allow urination again.

A distinction is made between open surgery through the abdominal wall and transurethral (uretha = urethra) surgery through the urethra.

Open surgery, known as adenoma enucleation, means to remove the adenoma through an incision in the abdomen. This intervention is usually performed for prostates larger than 100 ml. The indication also depends on the preference of the treating hospital. This procedure is very invasive and is becoming less important due to the increasing spread of HoLEP (holmium laser enucleation of the prostate (see below)).

Image above: healthy prostate, below: prostate with BPH

The endoscopic operations via the urethra can be divided in vaporizing and tissue removing procedures.

Vaporising the adenoma means to „melt down“ the tissue by means of thermal energy (e.g. „Green Light Laser“). These procedures are typically gentle but usually effective with a delay.

The classical prostate operation through the urethra is peeling the adenoma with an electric loop (TURP - transurethral resection of the prostate). During this procedure we gain prostate „chips“. In the end of the operation, those chips are rinsed out via the urethra.

Over time treatmentt options with different laser systems have developed enabling the prostate to be enucleated through the urethra. In this case the prostate adenoma is released from the prostate capsule - i.e. peeling like an orange from inside. One speaks of enucleation.

Holmium laser enucleation of the prostate (HoLEP)
Health magazine "rbb Praxis" from December 5th, 2018

The procedure that we offer is the Holmium Laser Enucleation of the Prostate (HoLEP). You find an illustrated description in the following broadcast from the health magazine “rbb Praxis”, dated December 5, 2018.

On the following pages you will find all the information you need about this method. The easiest way if you have any questions or to make an appointment: You can make an appointment for a consultation online. Alternative appointments can be arranged at any time by email: info@endo-uroberlin.com