Holmium laser enucleation of the prostate (HoLEP)

A holmium laser enucleation of the prostate (HoLEP) is a procedure where a small telescope affixed with a laser is inserted into the urethra and is used to burn off excess tissue on the prostate gland.

Learn more about HoLEP at King Edward VII’s Hospital

Why would I need a HoLEP?

If you have an enlarged prostate, which can often happen as you age, it can put pressure on your urethra. This added pressure can make it harder for you to urinate, lessen the flow of your urine, or cause problems with emptying your bladder.

When should you speak to your specialist about a HoLEP?

If you have been experiencing difficulties or irregularities with your urination, you should speak to your GP and they might recommend that you undergo a HoLEP.

How is a HoLEP performed?

A HoLEP can be performed under either a general or a spinal anaesthetic and it usually takes one to two hours.

During the procedure, the surgeon will insert a telescope that is affixed with a laser into your urethra. They will then burn off the excess tissue from your prostate gland using the laser and remove them.

What is the recovery for a HoLEP?

The recovery from a HoLEP can depend on a variety of factors, and you should discuss this with your surgeon.

Many patients who undergo a HoLEP have a catheter inserted, which is generally removed the next day.

You should avoid strenuous activities for about a week after your procedure.

You and your surgeon will discuss your plan for recovery prior to your HoLEP.

Are there any risks/complications associated with a HoLEP?

As with any medical procedure, it is possible for risks or complications to arise. It is best that you speak with your specialist or surgeon about how best to avoid any adverse reactions.

Some complications that have been associated with the procedure are:

• Erectile dysfunction
• Inability to ejaculate
• Reduction in fertility
• Needing to pass urine more often and having sudden urges to pass urine
• Urinary tract infections
• Excessive bleeding
• Need for long-term use of a catheter
• Re-occurrence of an enlarged prostate
• An injured urethra

How can I prepare for a HoLEP?

Prior to your HoLEP, you should discuss the preparations you should make with your surgeon, as they can vary depending on the person.

Are there alternatives for a HoLEP?

There are some options that you might consider rather than undergoing a HoLEP, including:

• Medications – however these will not offer a permanent solution
• Transurethral resection of the prostate (TURP)
• Laser prostatectomy – a laser is used to remove parts of the prostate
• Traditional prostatectomy – this is generally done if your prostate is too large to be removed via laser surgery or a TURP
• A permanent catheter
• Prostatic stent – your urethra is widened by inserting a tube
• Prostate arterial embolisation – in this procedure, prostate arteries are blocked, reducing blood flow

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