Holmium laser enucleation of the prostate, also known as HoLEP, is a minimally invasive option to treat Benign Prostatic Hyperplasia (BPH or enlarged prostate). HoLEP is a transurethral procedure that uses a laser to remove prostate tissue in order to restore urine flow and eliminate bothersome symptoms. This procedure eliminates the need for surgical incisions and is beneficial for men with any size prostate.
How does HoLEP work?
HoLEP is a surgical procedure that is performed under general anesthesia in a hospital or surgery center. During the procedure the surgeon will feed a resectoscope through the urethra and bladder to the prostate. This instrument is equipped with a light and camera used for viewing. A laser is then inserted through the resectoscope to the prostate. The laser will enucleate (or cut) the overgrown prostate tissue into pieces. During this process, these pieces will be deposited into the bladder. As the laser is cutting, it is also cauterizing the area to seal the vessels and minimize blood loss. The laser will then be removed and replaced with a morcellator tool. This tool suctions the prostate tissue out of the bladder, grinds it into small fragments, and removes it through the urethra. Upon completion, the resectoscope will be removed and replaced with a temporary catheter.
What to expect after surgery
Following surgery, patients may experience minor symptoms that should resolve over time. These symptoms may include:
- Blood in the urine
- Painful urination
- Frequent and/or urgent urination
- A mild burning sensation while urinating
- Urinary incontinence
- Retrograde ejaculation
As with any surgical procedure, there is a chance of infection. Any symptoms related to an infection should be reported to the provider as soon as possible. Symptoms may include fever, chills, sweats, pain, a sensation of heat or an unusual discharge.
Your provider will discuss any physical limitations following surgery. These typically include avoiding strenuous activity, sexual intercourse and heavy lifting.