Division of Urologic Surgery
The Division of Urologic Surgery, part of the Department of Surgery, offers exceptional patient care, research programs, and education and training opportunities.
Holmium Laser Enucleation of the Prostate (HoLEP) Surgery
Laser prostate surgery for enlarged prostate
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HoLEP Surgery for Benign Prostatic Hyperplasia (BPH)
Beth Israel Deaconess Medical Center (BIDMC) offers holmium laser enucleation of the prostate (HoLEP) as a minimally invasive treatment option for benign prostatic hyperplasia (BPH).
Understanding the HoLEP Procedure
If you have BPH and other prostate treatment options, like medications, are not enough to control your symptoms, your prostate care team may suggest HoLEP. This is a newer alternative to the more invasive transurethral resection of the prostate (TURP) surgery.
HoLEP surgery decreases the pressure on your urethra (tube through which urine exits the body) that the enlarged prostate causes. Your Division of Urologic Surgery care team will help determine which treatment option is the best choice for you.
HoLEP surgery is for men with any size prostate and any of these conditions:
- You have bothersome urinary symptoms due to BPH.
- You have had past procedures that have not fixed the BPH (in some cases).
- You have a weak bladder and BPH.
- You have a blocked flow of urine due to prostate cancer (HoLEP surgery is not a treatment for prostate cancer).
- You need treatment for BPH again.
- You also need surgery for bladder stones, upper urinary tract stones or other urinary problems.
Benefits of HoLEP surgery include:
- Patients do not typically need treatment for BPH again.
- You may only need a urinary catheter (tube in the bladder) for a short time after surgery.
- The surgery can be done with less risk of bleeding even if the patient is taking an anticoagulant (blood thinner) medication. This is because a laser is used.
- The recovery time is shorter than other BPH surgeries. Most patients can resume physical activities such as exercise one week after surgery.
What to Expect During Laser Prostate Surgery
You will be under general anesthesia (fully asleep) for this procedure. Your urologist completes the HoLEP surgery through a small tube-like scope instrument that they insert through your penis. They don’t need to make any incisions (cuts) in your skin.
Your urologist uses a laser tool to remove the inside tissue of your prostate. This leaves the outer shell of the prostate intact. This is like hollowing out the juicy part of an orange and leaving the peel.
They use another device (morcellator) to break up the shelled-out tissue and remove it from your bladder. This way, you will not pass any tissue through your urine. Your urologist will send part of the removed tissue to pathology for lab review.
HoLEP surgery may take anywhere from 45 minutes to three hours, depending on the size of your prostate.
Recovery After Prostate Surgery
In most cases, you won’t need to stay overnight in the hospital. You should be able to go home the day of your surgery with a catheter in your bladder. If your urine color is light and does not have too much blood in it, your care team can remove the catheter before you leave the hospital. If you do need to go home with a catheter, we will remove it in the urology clinic in one or two days. You can expect to return to normal activities roughly two weeks after your surgery.
