HoLEP Treatment

What is HoLEP Treatment?

HoLEP (Holmium Laser Enucleation of the Prostate) is the most modern and successful treatment method currently used for Benign Prostatic Hyperplasia (BPH). In HoLEP, the prostate is enucleated using a holmium laser, meaning that the prostate’s inner tissue is removed with laser technology. Over the past 10 years, HoLEP has become a widely preferred method for treating prostate enlargement, yielding very positive outcomes. The term “HoLEP” refers to the removal of prostate adenoma using a holmium laser. Generally, the incidence of BPH increases with age, with symptoms appearing in approximately 50% of men in their 60s and in 90% of men in their 80s.

Which Patients Are Suitable for HoLEP Surgery?

HoLEP is suitable for all patients with prostate disease for whom surgical intervention is being considered. Since the HoLEP method can be applied regardless of prostate size, it is not dependent on the dimensions of the prostate. Whether the prostate is enlarged or not, HoLEP can be performed based on the patient’s needs and the urologist’s assessment.

What Are the Features of HoLEP Surgery?

The main features of HoLEP surgery can be summarized as follows:

• Since the HoLEP method uses a laser to separate tissue rather than burning it with electrical energy, patients do not experience a burning sensation (dysuria) when the catheter is removed.
• HoLEP offers advantages such as low bleeding risk, short hospital stay, and rapid recovery, enabling patients to return to normal life as early as 24 hours after the procedure.
• The thermal effect of the HoLEP laser on healthy tissue is less than 0.4 mm, which helps preserve the nerve bundles surrounding the prostate that regulate sexual function. Therefore, postoperative erectile dysfunction is not expected.
• Since the resected tissue in HoLEP does not develop thermal defects, pathologists can examine the tissue more easily, reducing the likelihood of missing potential malignant formations.

With HoLEP technology, complete removal of the prostate tissue results in a very low risk of recurrence.

When Is HoLEP Surgery Indicated?

HoLEP surgery is recommended and performed in cases of BPH when there is no significant improvement with medical treatment. It is indicated when:

• The patient experiences significant symptoms and complaints,
• The patient must use a catheter to void,
• There is residual urine in the bladder after voiding,
• Recurring issues such as persistent infections, bleeding, stone formation, and involvement of the upper urinary tract occur.

How Is Prostate Surgery Performed with HoLEP Technology?

The widespread use of laser technology in urology has paved the way for HoLEP. In this procedure, the enlarged prostate tissue is accessed through the urethra and separated from its capsule using the HoLEP technique. The enucleated prostate tissue, which is pushed into the bladder, is then morcellated into small pieces and removed. Thanks to the holmium laser, the adenoma is completely removed from the prostate capsule, and there is minimal risk of regrowth. The excised tissue is sent for pathological examination to rule out malignancy. With the laser’s ability to control bleeding, patients lose less blood during the procedure. HoLEP is also a suitable option for patients with heart or lung conditions who are on blood-thinning medications. Due to its consistently positive outcomes, HoLEP has gained increasing popularity in the treatment of prostate enlargement.

What Are the Advantages of HoLEP Technology?

The advantages of HoLEP technology, which has revolutionized prostate treatment, include:

• Because the prostate tissue is removed with a holmium laser, the risk of recurrence is extremely low compared to other methods.
• The laser’s hemostatic properties make it easier to control bleeding during the procedure, allowing even patients on blood thinners (antiplatelets/anticoagulants) to safely undergo the surgery.
• HoLEP can be performed on prostates of all sizes, independent of the degree of enlargement.
• When performed by experienced surgeons, there is minimal risk of damage to the nerves responsible for erection.
• Patients often experience a rapid return to normal activities, with many describing the feeling as a return to their 30s.