Prostate Surgery with HoLEP (Laser) Method

HOLEP, “Holmium Laser Enucleation of Prostate”, means the removal of the prostate by enucleation by laser.  HoLEP, has been widely used in America and Europe in the last 10 years and it is considered as one of the gold standard methods due to its success in prostate enlargement treatment.

Closed methods such as Tour, Plasmacinetic or Greenlight are used in the treatment of prostate enlargement, but postoperative bleeding and growth in the remaining prostate tissue are sometimes seen in these methods.

HoLEP surgery is performed by entering the patient’s urinary canal, that is, as a closed surgery. Enlarged prostatic adenoma is removed from the capsule of the prostate with a holmium laser and  Since there is no adenoma tissue left behind, regrowth is not observed. The tissues removed are pathologically examined and it is also investigated whether there is cancer tissue.

The patient loses very little blood since bleeding is controlled very well with the laser. HoLEP surgery can be safely performed to patients with heart and lung diseases and patients using blood thinners.

Does it have a harmful effect on sexuality?

The depth at which the Holmium Laser acts on the tissue is 0.4 mm. It is not possible for this laser to penetrate the 6-7 mm thick capsule and damage the nerves related to masculinity, so it has no harmful effect on erection.

Can enlarged prostates also be operated with the HoLEP method?

While prostates up to 80 ml can be operated with TUR or plasmakinetic methods, there is no limit with HoLEP method. It can be applied to prostates of any size up to 100mg, 150mg or even 300 ml.

Does urinary incontinence occur after HoLEP surgery?

Among prostate surgeries, HOLEP surgery is the method that best protects the urine holding muscles called sphincters. The muscles that hold urine are very well visualized, not approached, very well protected. However, if the sphincter that holds urine has become lazy before surgery, temporary urine drips may rarely be seen in some patients after the catheter is withdrawn. These drops improve with medication and exercises, sometimes within a few days and sometimes within a few weeks.  There is no permanent urinary incontinence observed.

How many days is the urinary catheter left in place after HoLEP surgery?

Although this period varies according to the patient’s comorbidities and the size of the prostate, it is generally sufficient to stay catheterized for 1-2 days.

Is it possible to have a child after HoLEP surgery?

YES. Since there is no damage to the seminal ducts, the semen continues to come out, only the semen can go to the urinary bladder and come out from there; in such cases, a child can be conceived through in vitro fertilization.

Does prostate enlargement recur after HoLEP surgery?

NO. Since the prostate is completely removed, it is very rare for it to grow again in the following years.

What are the advantages of HoLEP surgery?

Since the prostate tissue is completely removed in laser enlargement surgery, there is no risk of recurrence of the disease. Since bleeding control can be done very well with laser, this method is quite safe for patients who have to use blood thinners (antiaggregant-coagulant) drugs. Patients are catheterized in as little as 24 hours, with advantages such as lower risk of bleeding, shorter hospitalization and faster recovery. Patients can return to their normal lives quickly. As a result, patients return to their 30s after surgery in their own words.