HoLEP (Holmium Laser Enucleation of the prostate)

Holmium Laser Enucleation of the prostate (HoLEP) is a modern alternative to the standard Transurethral Resection of the Prostate (TURP) procedure for bladder outflow obstruction due to BPH.

It requires a short period of hospitalisation and an anaesthetic. A catheter is also needed for 1-2 days until the urine clears. Patients are advised to take life quietly and to avoid straining or heavy lifting for four weeks after the surgery.

Who is it suitable for?

HoLEP can be performed on men of any age with urinary outflow obstruction caused by an enlarged prostate. It is particularly indicated in men with large prostates (over 60mls in size) and men on medications to thin the blood (such as warfarin, aspirin or clopidogrel).

Advantages of HoLEP:

  • There is no upper size limit of prostate that can be dis-obstructed – traditionally men with prostates over 100ml in size needed major open surgery
  • There is often less bleeding than after a TURP
  • Shorter period of hospitalisation than after TURP (at 1-2 days)
  • The chance of recurrence requiring further surgery is very low
  • Unlike greenlight laser operations, large quantities of prostate tissue are sent for pathological analysis
  • The PSA generally drops to very low levels after HoLEP operations

Disadvantages of HoLEP:

  • The procedure takes slightly longer than a TURP and requires specialist training.

What to expect after the procedure?

  • Erectile function is normaly not disrupted, but after the surgery men have the ”retrograde ejaculation”.
  • Normaly there is no urinary incontinence after the surgery.
  • A specific rehabilitation is not required, but there are certain restrictions for the postoperative period that are going to be explained to the patient individually depending on situation and prostate volume.

 

How much does it cost?

HoLEP surgery costs EUR 3500.00, plus pre-operation health tests 150.00 EUR.

Visa help, meet&greet and transfers are included.