Moses technology: A boon to elderly and high-risk suffering from BPH (enlarged prostate)

By Dr T Manohar

MoLEP(Moses Laser Enucleation of Prostate), is an embodiment of the modern urologic technological revolution, providing a revolutionary approach to solving challenges associated with benign prostatic hyperplasia (BPH) affecting millions of elderly men worldwide. This advanced technique of surgery has revolutionized the landscape of prostatic surgery as it is a new innovative high power (P 120) holmium laser used specifically for kidney stones and BPH treatment. This laser works with the principle of plasma bubbles in bubble technology through pulse modulation. The bubble helps in the microdissection of the tissue to be removed effectively and fragment/dust the stone in question. This is possible because the physics of the holmium laser has been re-framed to suit the treatment.

All lasers work on the principle of a certain wavelength with tissue penetration capability, just enough to target and cut the tissue with minimal or no bleeding. These lasers have 44% higher enucleation efficiency compared to regular holmium pulse.

Traditional treatments, such as transurethral resection of the prostate (TURP) and open prostatectomy, have been used for BPH management. However, MoLEP has brought about a revolutionary change in surgical intervention with profound benefits for patients.

A case of BPH patient with co-morbidities
Prostate problems in men are quite common after the age of 50, as the prostate gland begins to enlarge due to hormonal reasons. The prostate gland in the male body is essential for fertility. It is a small gland resembling the shape and size of a walnut in men that helps in making some of the fluid in semen, which carries sperm from an individual’s testicles when they ejaculate. It tends to get larger as one gets older.

If the prostate gets too large, it can cause several health issues because it surrounds part of the urethra. The enlarged prostate can squeeze the tube, which causes problems when one urinates. Common symptoms of benign prostatic hyperplasia (BPH) include a frequent urge to urinate, the need to get up several times during the night to urinate, blood in the urine or sperm, pain or burning urination, painful ejaculation, frequent pain or stiffness in the lower back, hips, pelvic or rectal area, or upper thighs, and dribbling of urine.

A 92-year-old patient with comorbidities and a two-year history of urinary blockage visited Apollo Sheshadripuram Hospital for consultation. The patient was suffering from a recurrent urinary tract infection, and his quality of life was poor as he was advised to rely on long-term catheterization due to his age and associated surgical risks. However, that caused the patient discomfort and restricted mobility.

Upon evaluation and diagnosis, it was revealed that he had an enlarged prostate with bladder weakness. Therefore, we advised him to undergo a minimally invasive permanent procedure to remove his prostate, which has minimal complications and excellent results. MoLEP procedure was performed on the patient, which was completed in just 35 minutes under general anaesthesia. As a result of the treatment, the patient is now able to pass urine independently, free from the burden of a catheter, significantly improving his quality of life.

This case reflects the incredible benefits of Moses 2.0 technology. It's minimally invasive, reduces blood loss, and displays a high success rate. It ensures no bleeding in surgical procedures, and enhanced accuracy helps doctors to precisely cut out specific tissues and structures without damaging nearby ones.

How is does applications of Moses Technology in BPH Management work?

• Customized Treatment Plans: Moses technology can enable urologists to make tailored treatment plans for every individual. The technology ensures improved results by customising the treatment according to the individual patient’s prostate size and shape and overall health.

• Treatment of Larger Prostates: Some of the traditional surgical methods, especially in cases where a prostate is too big, can be both time-consuming and dangerous. For such situations, Moses 2.0’s accurate control and reduced blood loss make it a suitable alternative.

The Future of Moses Technology in BPH Management
Moses technology, with its credibility, precision, and minimally invasive nature, can make medical professionals feel more at ease with BPH management, knowing that their patients are in safe hands. The ability to address a wider patient demographic also expands the horizons of urological practice, making previously challenging cases more manageable.

Dr T Manohar, Chairman, SCUG: Silicon City Urology Group, Urologist- Endourologist, Laser & Laparoscopic Surgeon, Robotic Surgeon & Renal Transplant Surgeon, Director, Apollo Institute of Renal Sciences

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