Benign prostatic hyperplasia (BPH) affects millions of men over the age of 50. Traditionally, surgical treatment has been performed using invasive techniques such as transurethral resection of the prostate (TURP). However, in the last decade, the Holmium Laser Enucleation of the Prostate (HoLEP) technique has gained prominence, offering a less invasive, more effective alternative with reduced recovery times .
In this article, you’ll learn how holmium laser enucleation of the prostate works, its main advantages, clinical indications, technological requirements, and why more and more clinics are adopting this cutting-edge technology.
What is the HoLEP procedure?
HoLEP is a minimally invasive surgical technique that uses a holmium (Ho:YAG) laser to enucleate and remove prostate tissue that causes urinary obstruction, a common feature of BPH.
The procedure involves separating the prostate adenoma from the rest of the gland, breaking it into small pieces, and removing it endoscopically using a morcellator . All of this is done through the urethra, without any external incisions.
Main indications of the procedure
Patients with large prostates (greater than 60-80cc)
Men who do not respond adequately to drug treatment
Cases with urinary retention or recurrent urinary tract infections
Patients on anticoagulants or with comorbidities where a low-bleeding technique is required
Clinical advantages of HoLEP laser versus TURP or open surgery
| Feature | HoLEP | Transurethral resection (TURP) | Open surgery |
|---|---|---|---|
| Technique | Minimally invasive | Invasive | Very invasive |
| Hemorrhage | Very low | Medium/high | High |
| Hospitalization time | 24-48 h | 3-5 days | 5-7 days |
| Probe removal | Before 48 hours | 3-4 days | 5+ days |
| Reinterventions | Infrequent | Frequent long-term | Moderate |
| Recommended prostate size | Any size | Less than 80cc | Greater than 100cc |
How does the Ho:YAG laser work in enucleation?
The holmium laser operates at a wavelength highly absorbed by the water contained in tissues, allowing for clean, precise cuts without charring . This translates into less bleeding, less inflammation, and improved intraoperative visibility.
During enucleation:
The laser is used to separate the adenoma from the capsular plane.
The tissue is pushed into the bladder.
Using a morcellator, the tissue is fragmented and removed in just a few minutes.
Equipment needed to perform HoLEP
High power holmium laser (minimum 100 W)
Reusable or disposable laser fiber
Compatible endoscopic resectoscope
Prostate morcellator
Irrigation system and HD endoscopic camera
At Uroláser.care, we offer sales and rental options for all the equipment needed to implement this technique in your clinic, including technical advice and training for medical staff.
Why are clinics and hospitals adopting HoLEP?
Better long-term clinical outcomes.
Lower reintervention rate compared to other techniques.
Compatible with anticoagulated patients.
It allows treating large prostates without resorting to open surgery.
Reduction in surgical times and hospital stays.
Frequently Asked Questions (FAQ)
How does HoLEP differ from green laser (PVP)?
HoLEP completely removes the prostate adenoma, while the green laser vaporizes only part of the tissue, which can lead to recurrence in some cases.
How long does the procedure take?
Between 60 and 120 minutes, depending on the size of the prostate and the surgeon’s experience.
When can the patient return to normal activities?
Most patients resume light activity within 3-5 days and their full routine within 1-2 weeks.
Can the equipment be rented for specific procedures?
Yes. At Uroláser.care, we offer flexible rental options for centers that don’t yet wish to purchase the equipment.
Conclusion
The HoLEP technique using holmium laser is currently one of the most effective and safe surgical procedures for treating benign prostatic hyperplasia. Thanks to its precision, low risk, and excellent long-term results, it has become the preferred alternative to traditional techniques.
If your clinic wants to incorporate this technology and offer the best in urological surgery, at Uroláser.care we offer all the support, equipment, and experience to make it possible.
👉 Contact us today and request a free consultation.
