Holmium Laser Enucleation of the Prostate HoLEP

What is HoLEP?

Holmium Laser Enucleation of the Prostate or HoLEP is a minimally invasive treatment to alleviate symptoms due to the prostate. Men can pass urine with a faster flow and less frequently after recovery. A HoLEP is a modern alternative to the standard Transurethral Resection of the Prostate (TURP), carried for bladder outflow obstruction caused by prostate enlargement.

The HoLEP procedure is suitable for men of any ages whose symptoms are due to a large prostate and can be used even if using medication that thins the blood.

With the use of a tiny telescope-like instrument, a high powered laser will carefully remove the excess prostate tissue obstructing the urethra. The residual pieces of the urethra are removed and analysed for any potentially cancerous changes.

After the excess tissue is removed, the surgeon will insert a catheter which is usually removed the following morning.

The procedure can be carried under general anaesthetic or regional (spinal) anaesthetic should you wish to remain awake.

What are the benefits of this procedure?

  • Allows you to leave the hospital within 12-24 hours of the surgery
  • Reduced recovery time
  • Little blood loss
  • It can treat any size prostate
  • Immediately faster urine flow

What are the potential risks?

Any procedure has a risk of potential complications.  When undergoing HoLEP the risks are:

  • Feeling the need to urinate frequently which may take several months to settle
  • Urinary infection
  • Retrograde ejaculation
  • Erectile dysfunction
  • Bleeding
  • Self-catheterisation if the bladder muscle does not work
  • Prostate regrowth after many years
  • Deep-vein thrombosis
  • Injury of the urethra

Your consultant urologist will be able to inform you on the potential complications of the procedure based on your situation.

What are the alternatives to this procedure?

If you suffer from an enlarged prostate or benign prostate dysplasia, there are several treatment options available, depending on the intensity of your symptoms:

How quick will I recover?

The operation should be painless, however you might feel some discomfort from the catheter. Some men may experience bladder spams or contractions the because of the catheter rubbing inside the bladder. Due to these spasms, an urgent feeling to urinate might appear.

In the first 10 to 14 days there might be a mild burning feeling when trying to pass the urine. This will pass once the urethra will heal from the surgery and the catheter will be removed. You will be able to go home once you will be able to pass urine more comfortably. 

Your consultant urologist or nurse will be able to advise on the proper care once at home and what pelvic floor exercises you can perform to improve your bladder control.

Want to look at other treatments? or find it on the A-Z list.