About this page. This is a plain English summary of holmium laser treatment for an enlarged prostate. It does not replace medical advice from your own doctor or specialist.
For full information and references, please read the detailed page.
What is HoLEP?
HoLEP stands for Holmium Laser Enucleation of the Prostate. It is a way of treating an enlarged prostate (BPH) using a laser. The procedure is done from inside the urine tube. There are no cuts on the outside of the body.
How does it work?
The prostate has an outer shell (the capsule) and an inner part (the adenoma). When the prostate grows with age, it is the inner part that grows the most and squeezes the urine tube.
In HoLEP, a small camera is passed through the urine tube. A laser fibre is then used to gently separate the inner part of the prostate from the outer shell, like peeling an orange from inside. The freed tissue is pushed into the bladder, then broken into small pieces and removed.
Because the surgeon works along the natural plane between the inner part and the shell, the inside of the prostate channel becomes wider, and the outer shell stays in place.
Why is it sometimes preferred?
- It can be used on prostates of almost any size, including very large prostates that might otherwise need open surgery.
- The laser cuts and seals at the same time, which usually means less bleeding.
- The procedure uses a saltwater solution (saline) for irrigation. Saline is the same fluid used in an intravenous drip, so absorbing some of it is generally not a problem.
- Studies have reported good long-term symptom relief. The full references are listed on the detailed page.
What is the procedure like?
HoLEP is done in hospital under a general or spinal anaesthetic. The length of the procedure depends on the size of the prostate.
After the procedure, a urinary catheter is needed for a short period while the prostate channel settles. Most people stay in hospital for a short time. Light blood in the urine is normal in the first weeks of recovery.
Dr Kooner's experience
Dr Kooner has been performing holmium laser treatment for BPH for over 20 years and has completed over 3,000 holmium laser procedures. He continues to use this technique for patients with moderate to severe symptoms, and for very large prostates where it has particular advantages.
Important things to know
- HoLEP has a steep learning curve for surgeons. It is best done in a centre where it is performed regularly.
- As with any prostate procedure, there are possible side effects. These include changes to ejaculation (most men do not ejaculate forwards after HoLEP), temporary urinary urgency, mild burning when passing urine, and short-term incontinence as the bladder retrains.
- There is a small risk of bleeding, infection, urinary retention, or scar tissue forming inside the urine tube over time.
- HoLEP is not always the right choice for every man. Other BPH options may suit your case better.
What you can do next
- Read the full detailed page for full information and references.
- Short version overview of enlarged prostate (BPH) and the full menu of treatments.
- Request a second opinion on a treatment plan.
- Call 02 8382 6980 to make an appointment.