Prostate Enucleation HoLEP

High efficiency, low risk, painless surgery and fast recovery - these are the biggest advantages of HoLEP enucleation, a modern method of prostate surgery.


The  proper name of this procedure is HoLEP laser enucleation or holmium laser prostate surgery, because the surgery uses a holmium laser. The procedure is most often performed on men who have been diagnosed with benign prostatic hyperplasia or less frequently in those suffering from prostate cancer. The purpose of this procedure is to reduce the volume of the prostate gland. Thanks to this, the discomfort associated with its hypertrophy disappears, because the tissue that blocks the flow of urine is removed. In all cases, the removed tissue is sent back to the laboratory for histopathological examination, and in the case of cancer detection, further therapy is implemented.


What are the indications for treatment?

It is worth considering the HoLEP method if you suffer from benign prostatic hyperplasia. Symptoms of this condition include weak urine flow, intermittent urine flow, bladder retention, frequent and urgent need to urinate, and getting up to use the toilet at night (nocturia). HoLEP enucleation will make these issues stop and eliminate the need for lifetime medication for benign prostatic hyperplasia. HoLEP will also help in the case of urolithiasis or recurrent urinary tract infections. It is used in cases of urinary retention that require a catheter to remain in the bladder. It can also be used in patients taking who cannot undergo a transurethral resection of the prostate due to the necessity for chronic treatment with anticoagulant medication.


What effects does the innovative HoLEP method bring?

There are articles in the scientific press confirming the advantage of this method over others in terms of patient safety and comfort. The first such procedures in Poland were performed on men who suffered from prostate hyperplasia for a period of 5 to 10 years and were only treated pharmacologically. Why is this method so innovative? Its main advantages are that - unlike older methods - it allows the hypertrophied adenoma of the prostate to be removed completely and allows for rapid recovery after surgery, it also has a very high effectiveness of 98%. Let's take a closer look at how the procedure is performed.


What to expect before the HoLEP procedure?

When considering undergoing this surgery, you should first go to a urological consultation. To qualify the patient for surgery, the doctor will need the results of prostate imaging (ultrasound with the assessment of retention after urination, TRUS or magnetic resonance imaging) and a PSA concentration result. Uroflowmetry (urinary tract flow tests) is also often performed. During the consultation, the urologist will also examine the prostate and provide a list of diagnostic tests required for anesthesiological qualifications.


What does prostate surgery look like with the HoLEP method?

HoLEP is a minimally-invasive method. Such a procedure is not like an old-fashioned operation with scalpel in hand. In this case, the tissue is removed with a laser. Before the beginning of the procedure, the patient undergoes lumbar ("from the waist down") anesthesia, so there is no need to be afraid of pain. Then a special device, called a resectoscope, is inserted into the urethra. It provides control over what is happening in the urethra and bladder by projecting an image to a digital monitor. The device is then inserted into the bladder and the part of the urethra, that is surrounded by the prostate gland. Then, using a fiber laser, the urologist extracts the adenoma from the remaining tissue, and cuts it into pieces using a morecelator and removes the tissue of the gland through the urethra. The outer part of the urethra within the prostate gland remains intact.


What to expect after a HoLEP treatment?

After the procedure, the patient will have to briefly have a catheter, which is removed in the morning the next day after surgery. It may take up to three days at most, but normally after spending one night in hospital, the patient is discharged home. You should not be afraid of the impact of the procedure on sexual activity. It should look the same as before surgery if the Patient did not suffer from erectile dysfunction prior to the procedure. There are studies that show that after this operation, the quality of erection in 8% of patients even improves. You can safely return to sexual activity 3-4 weeks after the procedure.


Why is the HoLEP method recommended by urologists?

The HoLEP method is recommended due to how safe it is, because it causes only a minimal risk of bleeding, allows the safe treatment of even very large adenomas, after the procedure the catheter is usually removed quickly and convalescence proceeds efficiently. This method also guarantees a better urodynamic effect, which means better urine flow and greater comfort when urinating.


How can I make an appointment for the procedure?

In order to consult and determine the legitimacy of the procedure, please contact us using the free online consultation. We will be happy to examine your medical history and answer all questions.

To arrange the treatment, please contact the Patient coordination department at: + 48 606 994 372 or by email:

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See also

Laparoscopic Radical Prostatectomy

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Prostate multiparameter magnetic resonance imaging (PI-RADSv2.1)

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