What is HoLEP (Holmium Laser Enucleation of the Prostate)?
Benign Prostatic Hyperplasia (BPH, or enlarged prostate) is a common health issue that significantly decreases the quality of life, particularly in men aged 50 and older. It manifests with symptoms such as difficulty urinating, frequent urination, and waking up at night to void. Among the most current and effective treatment options is HoLEP, which stands for Holmium Laser Enucleation of the Prostate.
What Kind of Procedure is HoLEP?
HoLEP is a minimally invasive procedure that involves the complete removal of prostatic tissue using a holmium laser. During the procedure, the enlarged prostate tissue is carefully stripped and separated into the bladder. It is then divided into small pieces using a specialized instrument called a morcellator and removed from the body. This process thoroughly clears the prostate tissue that was obstructing the urinary tract.
When is HoLEP Recommended?
HoLEP is preferred in cases of:
- Moderate to large volume prostatic enlargement (60 grams or more).
- Severe reduction in urine flow and obstructive symptoms.
- When symptoms like frequent and nighttime urination affect the quality of life.
- In patients who have not responded to medication therapy.
- When complications such as retained urine in the bladder and bladder stones have developed.
- For patients seeking a minimally invasive and lower-risk alternative to open surgery.
How is the HoLEP Procedure Performed?
- It is usually performed under spinal or general anesthesia.
- A special endoscope is inserted through the tip of the penis to reach the prostate area.
- The holmium laser is used to detach the enlarged prostate tissue from its capsule and remove it.
- The removed tissue is fragmented by a morcellator and taken out of the body.
- A urinary catheter is typically used for a few days after the procedure, and patients are discharged within 1–2 days.
What are the Advantages of HoLEP?
- It can be applied to all prostate sizes.
- The risk of bleeding is significantly lower compared to open surgery.
- Hospital stay is short, and recovery is fast.
- Provides a permanent and effective correction of urination problems.
- The risk of recurrence is extremely low.
- There is no risk of TUR syndrome.
- It is suitable and safe for patients who use blood thinners.
Potential Risks After HoLEP
- Temporary urinary incontinence (usually resolves within a few weeks).
- Burning and irritation sensation in the urinary tract.
- Rarely, a urinary tract infection.
- Retrograde ejaculation (semen flowing backward into the bladder; this does not affect sexual function but is important for those planning to conceive).
HoLEP is considered a revolutionary method in the surgical treatment of prostate enlargement. With both its effectiveness and the comfort it provides to the patient, it is an ideal option for men seeking relief from prostate problems. It is important to consult a urology specialist for detailed information and to determine if it is suitable for you.