HoLEP Procedure

An enlarged prostate can have a significant effect on your quality of life and urinary health. Our team of experts at the Orlando Health Medical Group Urology offers the most innovative treatments for your condition.

Our multidisciplinary team includes one of the few physicians in the southeast United States offering holmium laser enucleation of the prostate (HoLEP). This minimally invasive treatment uses precision laser technology to remove prostate tissue obstructing your urethra and causing urinary complications.

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What is HoLEP?

Holmium laser enucleation of the prostate (HoLEP) is minimally invasive surgery designed to treat an enlarged prostate, also known as benign prostatic hyperplasia (BPH). The condition affects about half of men between the age of 51 and 60, though severity can vary greatly. As the prostate grows, it can affect your ability to urinate. HoLEP uses cutting edge laser to remove excess tissue.

During the procedure, a thin laser fiber instrument is threaded through your urethra to reach the prostate. Once there, laser energy is used to carve away sections of the prostate, which are removed through the urethra. The procedure takes about one to two hours and is done under general anesthesia.

Benefits of HoLEP

The surgery provides a minimally invasive option for men who are considering a simple prostatectomy, which uses an abdominal incision to reach and remove the part of the prostate causing the blockage. HoLEP has a lower risk of complications, with less bleeding and faster recovery times.

The procedure also benefits men taking blood thinners, which makes them vulnerable to excessive bleeding during procedures like the transurethral resection of the prostate (TURP), which removes the core of the prostate gland.

HoLEP also offers shorter hospital stays and a low retreatment rate: less than 1 percent.

Steps Before HoLEP Surgery

There are several steps before your HoLEP procedure, starting with a thorough physical examination and exploration of your medical history. Your doctor will assess the condition of your prostate and its impact on your life. This could include an exam to evaluate how much urine is left in your bladder after you pee. Lab tests may include a urinalysis and a PSA (prostate-specific antigen) test to look for signs of cancer.

Among the tests:

  • Computed tomography (CT) scan, MRI or transrectal ultrasound may be used to gauge the size of your prostate.
  • Cystoscopy uses a tiny camera to peer inside your urethra, prostate and bladder to look for signs of cancer, infection or blockage.
  • A urodynamics test measures how well your bladder is working and evaluates the potential benefits of removing prostate tissue. The test is performed by inserting a catheter – equipped with pressure sensors – into your bladder.
Who Is a Candidate?

If you have BPH and are a surgery candidate, this treatment may be right for you. It is particularly beneficial for men who are taking blood thinners. Among the symptoms of BPH:

  • Difficulty peeing
  • Frequent infections in your urinary tract
  • Blood in your urine
  • Bladder stones
  • Kidney problems
HoLEP Therapy Compared to Other BPH Treatments

One of the biggest advantages of HoLEP versus some other surgical options is its ability to remove a large amount of prostate tissue. Other methods, including the TURP, remove only the amount of tissue needed to restore urine flow. This can leave behind tissue that can grow back over time and, potentially, lead to a recurrence of the condition. HoLEP has a lower retreatment rate compared to other procedures.