Professor Aurel MESSAS is one of the pioneers of minimally invasive surgery in urology, mastering a number of innovative surgical techniques, including laparoscopic and robotic surgery, scarless endoscopic laser surgery and scarless extracorporeal lithotripsy.


Paris American Hospital

Prof. Dr. DAHER

Bellevue Clinic Dakar


Prostate adenoma is a benign non-cancerous pathology corresponding to an increase in prostate volume. Its cause may be linked to a change in male hormone production due to age. Around 80% of men aged 50 and over suffer from this disease.

How do I know if I have prostate adenoma? prostate adenoma?

  • I often feel the
    urgent need to urinate
    (also called pollakiuria)
  • I wake up at night to pee
  • I have difficulty urinating
  • I have sexual dysfunctions

If you experience one or more of these symptoms, make an appointment with a urologist to begin your diagnosis, which consists of a questionnaire about your symptoms and an ultrasound scan.

To prevent the adenoma from becoming too large and causing further symptoms, prostate adenoma resection can be performed endoscopically or by laser.

Prostate cancer is the most common cancer in men. On average, 1 in 8 men is affected before the age of 75. It is caused by the presence of numerous small cancer cells that multiply day by day within the prostate.

This cancer is manifested by frequent urges to urinate, difficulty emptying the bladder, a reduction in the size or strength of the urine stream, urinary incontinence (leakage of urine) or an ejaculatory stream that becomes less strong than before.

When a patient suffers from one or more of these symptoms, his or her doctor will carry out the following tests to confirm or rule out the presence of cancerous cells in the prostate: a clinical examination, a blood test, an ultrasound scan of the prostate and a biopsy.

Urinary lithiasis, also known as renal colic (or kidney stones), is a recurrent pathology caused by an obstacle (frequently a kidney stone behaving like a small pebble) blocking the flow of urine from the kidney to the bladder. Between 5% and 10% of the population suffer from this pathology. This segment comprises people aged between 20 and 60, 3 quarters of whom are men.

Kidney colic is characterized by severe pain in the lower back or abdomen, blood and/or pus in the urine, difficulty urinating, painful and/or burning sensations when urinating, and fever. In case of infection, you may also experience chills, nausea, vomiting and fever.

Kidney stones can also be asymptomatic. In this case, the pathology is usually detected by a blood or urine test, an ultrasound scan or an abdominal CT scan.

To avoid repeated attacks of nephritic colic, and if the kidney stone does not evacuate on its own, a laser procedure(stone fragmentation) can destroy the clots.

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Transperineal biopsy is an innovative diagnostic technique, performed under local anaesthetic, which reduces the risk of nosocomial infection to virtually zero, is painless and precise enough to avoid over-treatment.

This procedure, which is still not very widespread in Europe and is performed by a urologist, requires lengthy, specialized training and very high-tech equipment.
The ultrasound machine used to take this sample merges MRI and ultrasound images. If cancer is suspected, the practitioner will take a targeted sample through the skin of the perineum rather than the rectum ( locoregional ss - outpatient or 1 night).

Introduction of a miniaturized camera through the natural tract (urethra, bladder and ureter) to visualize the stone. Calculus fragmentation is carried out in situ by a laser capable of 400 impacts/sec (increasing its efficiency and the speed of the operation). Fragmented stones can be removed using extraction forceps. (Under GA - 1 or 2 nights).

Introduction of a resector through the natural tract to cut the adenoma into small pieces and remove it. (Under GA - 2 or 3 nights).

The advantage of this technique is that the laser is used transperineally. The adenoma is destroyed and then evacuated via the natural route. The Elesta laser has the advantage of preserving ejaculation. (Under GA - 2 or 3 nights).

Prostatic Artery Embolization (PAE) is an innovative, non-invasive procedure to reach the prostate without surgery through its endovascular approach. It is performed by an outpatient interventional radiologist.

The interventional radiologist inserts a 1.6 mm-diameter catheter into the artery in the wrist or groin. Then, under X-ray control, he directs the catheter to the small arteries supplying the prostate. After checking that the catheter is correctly positioned in the prostatic artery, microscopic particles are injected. These block the blood supply to the prostate arteries. As a result, the prostate receives less blood, shrinks in size and allows urine to pass through more easily.

This procedure is performed without any incisions or scars.

It treats all prostate-related urinary symptoms without affecting the urethra or bladder neck.

The procedure lasts 1h30 on average, with the option of being slightly asleep or not.


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Medical Talent

Un des pionniers de la chirurgie
mini-invasive en urologie en Europe


Il traite les maladies de l’appareil urinaire de l’homme et de la femme mais aussi de l’appareil génital masculin (infections urinaires, troubles urinaires adénome de la prostate, calculs des voies urinaires, cancers de la prostate, de la vessie, du rein, des testicules). 

Le professeur Aurel MESSAS est l’un des pionniers de la chirurgie mini-invasive en urologie, il maîtrise différentes techniques chirurgicales innovantes, comme la chirurgie laparoscopique et robotique, la chirurgie endoscopique sans cicatrice au laser, la lithotritie extra-corporelle sans cicatrice.


Ancien Chef de service d’Urologie – Centre d’Accueil et de soins Hospitaliers de Nanterre – Hôpital Max Fourestier
Ancien Chef de clinique – Hôpital Bichat-Claude Bernard à Paris
Ancien interne des Hôpitaux de Paris
Membre – Comité Scientifique de l’Association Européenne d’Urologie
Président – Comité de l’Association Européenne d’Urologie