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Holmium Laser Enucleation of the Prostate (HoLEP) for BPH

HoLEP is a surgical procedure that uses laser technology to remove the prostate in one piece and then a separate instrument to cut the prostate tissue into smaller fragments that are easily removed.

How it Works

Imagining an orange, a HoLEP would be similar to removing the inside of the orange but leaving behind the peeling. This option is typically used for the largest prostates.

A laser is used to enucleate, or core-out, the majority of prostate tissue. A separate instrument is then used to cut the prostate tissue into smaller fragments that are easily removed.

HoLEP procedure image

Procedure/Recovery

The procedure is typically performed under anesthesia.

  • A catheter is required for at least one night, sometimes longer.
  • Most men will experience ejaculatory dysfunction, specifically retrograde ejaculation (see page 10 of this book for a description).
  • The risk of erectile dysfunction is very low.
  • The procedure requires decreased activity for 2-4 weeks.
  • Blood in the urine is expected for 1-4 weeks, although it may come and go for longer.
  • Burning with urination and/or urinary frequency and urgency may last for a few weeks.
  • This procedure is best for very large prostates, as it removes the most prostate tissue.
  • Prostate tissue is removed and will be checked for cancer by a pathologist.

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