Holmium Laser Enucleation of Prostate (HoLEP)

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Who is suitable for HoLEP?

What are the advantages of HoLEP?

How is HoLEP performed?

What to expect after HoLEP?

HoLEP outcomes

Are you suitable for HoLEP?

INTRODUCTION

Holmium Laser Enucleation of Prostate (HoLEP) is a safe, modern and definitive surgical treatment for benign prostatic hypertrophy (BPH). This is an alternative to the traditional TURP surgery.
Doctors Shekib Shahbaz and Tony de Sousa of Melbourne Urology Centre have access to Lumenis MOSES high powered holmium laser to perform this procedure safely and effectively. They offer a personalized service and can discuss your options including suitability for this treatment.

Who is suitable for HoLEP?

  • Those experiencing moderate to severe symptoms of enlarged prostate (BPH)
    • Weak stream of urine
    • Incomplete emptying of the bladder
    • Stop and start when urinating
    • Straining to begin urination
    • An increased need to urinate
    • Interrupted sleep because of the need to urinate
    • Complications of enlarged prostate
  • Those who want an alternative option to TURP for management of their BPH
  • Those who have enlarged prostate symptoms and have failed minimally-invasive treatment options
  • Those whose prostate anatomy is not appropriate for other treatment options
  • Those who have failed medical therapy, don’t want to take medication or have had side effects
  • Those who want to improve their quality of life to what it was before BPH symptoms

What are the advantages of HoLEP?

HoLEP is a definitive surgical treatment for enlarged prostate (BPH) for the relief of bothersome urinary symptoms:

  • Very effective treatment option, even for very large prostates
  • Durable improvement in urinary symptoms with low revision rates
  • Quick recovery with minimal bleeding and recovery time after surgery
  • Eliminates the need for lifelong use of medications

How is HoLEP performed?

  • This procedure is performed under general (or spinal) anaesthesia
  • It involves the use of a small telescope (cystoscopy) and a high powered holmium laser
  • The enlarged obstructing lobes of the prostate are ‘shelled out’ (enucleated) and then removed, creating an open prostatic urethra
  • It can take anywhere from 20 minutes up to four hours depending on the size of the prostate
  • Most patients can be discharged 1-2 days following surgery

What to expect after HoLEP?

  • Most of the recovery is done at home and in most cases ‘light’ normal activities can be resumed as soon as 3-5 days post procedure
  • Complete recovery can take up to 4 weeks during which time strenuous activity should be avoided
  • The most common side effects include discomfort or burning with urination, blood in the urine, urgent need to urinate and/or difficulty controlling this urge. Most of these symptoms generally subside within the first two weeks following procedure

HoLEP outcomes

  • Most patients will notice an immediate improvement in their urinary flow, pressure and bladder emptying
  • Bladder symptoms of urinary frequency, urgency and nocturia (getting up at night to pass urine) tend to take longer (up to 3 months) to improve

Are you suitable for HoLEP?

Melbourne Urology Centre offers HoLEP treatment in Melbourne to local and interstate patients. Your case will be thoroughly evaluated including discussion of other appropriate management options. We offer a full range of surgical options for enlarged prostate (BPH), including:

Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa

 

The British Association of urological Surgeons, (2018), Holmium Laser Enucleation of the Prostate (HOLEP): Procedure Information, [https://www.ouh.nhs.uk/urology/services/documents/holep.pdf], accessed 26/02/21.

Aho, T. F., (2013), Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery, Therapeutic Advances in Urology, 5(5), [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763780/], accessed 26/02/21.

Das, A. K., Teplitsky, S., Humphreys, M. R., (2019), holmium laser enucleation of the prostate (HoLEP): a review and update, Canadian Journal of Urology, 26(4), [[https://pubmed.ncbi.nlm.nih.gov/31481144/], accessed 26/02/21.

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