HoLEP (Holmium Laser Enucleation of Prostate)
Complete holmium laser enucleation of the prostatic adenoma for any prostate size — the lowest retreatment rate of any endoscopic BPH procedure, equivalent to open surgery transurethrally.
What is HoLEP (Holmium Laser Enucleation of Prostate)?
HoLEP uses a holmium laser to enucleate the entire prostatic adenoma from its surgical capsule, mimicking open prostatectomy but performed entirely transurethrally. The enucleated tissue is pushed into the bladder and morcellated before evacuation. HoLEP is size-independent — treating prostates of any size — and produces the most durable results of all endoscopic BPH treatments. The retreatment rate is under 1% at five years, the lowest of any endoscopic technique. All enucleated tissue is recovered for histological analysis, providing equivalent oncological information to open prostatectomy.
How the Procedure Works
Scope & Landmarks
Laser resectoscope introduced transurethrally; prostate size, lobar anatomy, and verumontanum assessed; verumontanum marks inferior enucleation limit.
Mucosal Incisions
Three holmium laser incisions at 5, 7, and 12 o'clock create entry points for the enucleation plane between adenoma and surgical capsule.
Lobe Enucleation
Each lobe systematically enucleated from the surgical capsule using holmium laser energy; all adenoma tissue floated free into the bladder.
Morcellation
Enucleated adenoma morcellated inside the bladder under direct vision and evacuated through the working channel; all tissue sent for histology.
Haemostasis & Catheter
Capsule inspected; bleeding points coagulated; urethral catheter placed and removed at 24–48 hours once urine clears satisfactorily.
Outcomes
Who Needs This Treatment?
- →Men with very large prostates over 80–100 g where TURP has practical limitations and open surgery would otherwise be required.
- →Patients on anticoagulation therapy who cannot safely stop medication for BPH surgery.
- →Those who want the most durable long-term result with the lowest retreatment rate of any endoscopic BPH procedure.
- →Men in urinary retention caused by BPH, including those catheter-dependent for months or years.
- →Patients who have previously undergone TURP and have regrown obstructing adenoma requiring definitive re-treatment.
- →Younger men with BPH who want a single procedure expected to last the rest of their life without retreatment.
"HoLEP is the most durable endoscopic treatment for BPH we have. By removing the entire adenoma transurethrally, we achieve open surgery results without any incision — regardless of prostate size. It offers our patients a genuine long-term solution."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
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