HoLEP (Holmium Laser Enucleation of the Prostate) is an outpatient  minimally invasive surgical procedure that uses a laser to remove a significant prostate tissue that's blocking urine flow, known as benign prostatic hyperplasia (BPH), offering an alternative to traditional prostate surgery with a shorter recovery time. 

 

A surgeon inserts a small telescope-like instrument (resectoscope) through the urethra (the tube that carries urine out of the body). A holmium laser is then passed through the resectoscope to cut and remove the excess prostate tissue that's obstructing urine flow. The tissue is then pushed into the bladder and removed using a suctioning device. A catheter is inserted for overnight drainage. 

 

HoLEP may be a good option for men with an enlarged prostate who are experiencing symptoms like frequent urination, difficulty starting urination, or a weak urine stream, and who haven't found relief with medication or other treatments. 

 

Benefits:

Minimally invasive, meaning no incisions are needed. 

Potentially faster recovery time compared to traditional prostate surgery. Low risk of bleeding and blood transfusions. Better long-term outcomes than other BPH surgeries with a re-treatment of 1% at 20 years. Comparatively, re-treatment rates with TURP, Greenlight, and Aquablation are 10% at 10 years, and Urolift and Rezum are >20% at 5 years. 

 

Risks:

Like any surgery, HoLEP carries potential risks, including bleeding, infection, and temporary urinary incontinence. There's also a risk of injury to the prostate, urethra, bladder, or ureters, and risk with 1-3 hours of anesthesia. 

 

Recovery:

Most patients can go home the same day as their surgery. 

A catheter is typically used for 1 day to help with urination. You should be able to get back to your normal activities within a few weeks.