Understanding Holmium Laser Enucleation of the Prostate

About Benign Prostatic Hyperplasia (BPH)

Your prostate is a walnut-sized gland. It surrounds the urethra just below the bladder. When you have benign prostatic hyperplasia (BPH), your prostate is larger than usual. It can create pressure on your urethra, which can begin to block the flow of urine. This may cause you to have a slow stream of urine or difficulty starting a stream of urine. This also may force your bladder muscle to work harder, and become irritable or weakened. If you have BPH, the muscles of your pelvic floor do not have to work as hard to prevent urine leakage. Not using these muscles can cause them to weaken.

HoLEP Procedure

HoLEP (Holmium laser enucleation of the prostate) surgery is a treatment option for BPH that decreases the pressure on your urethra caused by the enlarged prostate. HoLEP surgery is done through a small tube-like scope instrument inserted through your penis. It does not use incisions through your skin. The inside tissue of your prostate is removed with a laser tool, leaving the outer shell of the prostate intact. This can be compared to hollowing out the juicy part of an orange and leaving the peel. Another device (a morcellator) acts like a small food processor to break up the shelled-out tissue and remove it from your bladder. This way, there is no tissue that will be passed through your urine.

During and After the Procedure

HoLEP surgery may take anywhere from 45 minutes to 3 hours, depending on the size of your prostate. The procedure is done while you are asleep (under anesthesia). The urologist will insert the small telescope instrument through your urethra. A holmium laser will be used through the scope to core out the enlarged prostate tissue. This will make your prostate smaller. Leftover prostate tissue in your bladder will then be removed by the morcellator device and suction. A portion of the tissue will be sent to a pathologist for review.

At Home Care

In most cases, an overnight hospital stay is unnecessary and you will go home the day of your surgery with a catheter in your bladder. In some cases, if your urine color is light and does not include too much blood, the catheter may be removed before you leave the hospital. If you do need to go home with a catheter, it will be removed in the urology clinic the following day. You can expect to return to normal activities roughly three weeks after your surgery.