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HoLEP

HoLEP
In brief

HoLEP (holmium laser enucleation of the prostate) is a minimally invasive operation for benign prostatic enlargement in which the tissue blocking the flow of urine is removed with a laser through the urethra. No skin incision is made, and it can be used for both small and large prostates.

The prostate can grow with age and press on the urethra. Patients usually come in because they need to pass urine often, get up at night to pass urine, have a weak stream or feel that the bladder has not emptied fully. When medication is no longer enough, surgery is discussed.

How Is HoLEP Performed?

A thin camera system is passed through the urethra. The enlarged prostate tissue is separated from its capsule with a holmium laser (enucleation) and pushed into the bladder. There it is broken up with a special instrument and removed, then sent for pathological examination.

Who Is It Suitable For?

  • Patients whose symptoms continue despite medication
  • People with recurrent urinary tract infections, bladder stones or urinary retention
  • Patients who have been advised to have open surgery because their prostate is large
  • People taking blood-thinning medication (after assessment by the doctor)

Advantages

There is no incision in the abdomen or skin, and the risk of bleeding is low. The catheter usually stays in for a short time and the hospital stay is short. Because most of the enlarged tissue is removed, the chance of needing another operation in the future is also low.

After Surgery

In the first weeks there may be burning when passing urine, frequent urination or temporary leakage; these symptoms usually ease over time. Semen passing back into the bladder during ejaculation (retrograde ejaculation) is common after this operation. Possible effects are discussed in detail at the consultation before surgery. For advice on the recovery period, see the article What to keep in mind after HoLEP surgery.

Frequently asked questions

How long does HoLEP surgery take?
The time depends largely on the size of the prostate. After the examination and imaging, you will be told how long your operation is expected to take.
Can the prostate grow again after HoLEP?
Because the enlarged tissue is removed right down to the capsule, a further operation is rarely needed. Even so, regular check-ups are recommended.
When can I go back to work after HoLEP?
People with desk jobs can usually return to work fairly soon. For heavy physical work the period is longer and is confirmed at the follow-up visit.
How long does the catheter stay in after HoLEP?
The catheter usually stays in for a short time and is removed once the urine has cleared. How long depends on the size of the prostate and how recovery goes after surgery.
What tests are done before HoLEP surgery?
In addition to the examination, urine analysis, PSA and blood tests, an ultrasound and a urine flow test may be requested. Which ones are needed is decided at the first consultation.

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