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Holmium Laser Enucleation of the Prostate (HoLEP)

Laser surgery is frequently being used because of its minimally invasive properties and faster recovery times. The Holmium laser system is beneficial over other types of laser systems because it has a shallower penetration depth, meaning that there is less damage to the surrounding healthy tissue. Additionally it is highly absorbed by water meaning that the energy is reduced when working in a wet environment and this further reduces the damage to the surrounding tissue.

The Holmium laser system can be used for a number of different surgical procedures, including enucleation (BPH) of the prostate (HoLEP).

Holmium Laser Enucleation (BPH) of the Prostate (HoLEP)

BPH is the non-malignant enlargement of the prostate.  It is traditionally treated by transurethral resection of the prostate (TURP); however, several minimally invasive techniques have been developed as a replacement due to the increased morbidity associated with TURP.  The holmium laser is the only laser technique recommended for the treatment of BPH in the UK by NICE (the National Institute for Health and Clinical Excellence), who provide national guidance and advice to improve health and social care.

Use of the holmium laser was developed in order to provide safer and more effective surgical treatment for BPH.  The main benefits of using this system over TURP include:

Fewer complications

  • Less bleeding during & after the procedure
  • Less need for blood transfusion
  • Reduced risk of dilutional hyponatremia (TUR Syndrome) as normal saline solution is used for irrigation during the procedure and this is physiological

Quicker Recovery

  • Reduced length of catheter use post-operatively
  • Reduced hospital stay – usually the patient can go home after 1-2 days

Wider Indications

  • Suitable for men with prostates of any size; as opposed to TURP which is only safe for men with prostates weighing 100g or less
  • Can be used to treat men who have bleeding disorders or are on blood thinners, such as Aspirin, clopidogrel and warfarin
  • Bladder stones can be fragmented and removed simultaneously

Improved Security

  • Far less chance of recurrence/needing repeat surgery due to the full anatomical enucleation of the prostate gland.
  • Improved clarity regarding PSA levels as post-operatively PSA levels usually fall to under 2ng/ml

Mr Ben Challacombe is a Consultant Urological Surgeon who has carried out over 200 HoLEP procedures (enucleation of the prostate using the Holmium laser) for BPH on men with urinary symptoms or in urinary retention.  He is a faculty member of the British Association of Urological Surgeons where he teaches on courses about the use of this system and he has also mentored and taught other surgeons in these techniques.

If you would like more information about this surgery or to book an appointment, please contact us on 020 3813 2508.