From the Guidelines
HoLEP (Holmium Laser Enucleation of the Prostate) is the recommended surgical procedure for treating benign prostatic hyperplasia (BPH) due to its high efficacy, minimal invasiveness, and low risk of complications, as supported by the most recent and highest quality study by Hartung et al. [@41@].
Overview of HoLEP
HoLEP is a minimally invasive surgical procedure that uses a holmium laser to remove excess prostate tissue blocking urine flow. The procedure involves inserting a scope through the urethra, using the laser to separate the enlarged prostate tissue from its capsule, and then removing the tissue using a morcellator.
Advantages of HoLEP
The advantages of HoLEP include:
- Less bleeding and shorter hospital stays (typically 1-2 days) compared to traditional prostate surgeries, as reported by Gilling et al. [@32@]
- Faster recovery and lower risk of needing repeat surgery, as shown by Zhang et al. [@25@]
- Preservation of sexual function, although retrograde ejaculation is common, as noted by Liu et al. [@40@]
- Suitable for men with very large prostates or those taking blood thinners who cannot safely undergo other surgical options, as demonstrated by El Tayeb et al. [@38@] and Sun et al. [@39@]
Efficacy and Safety
HoLEP has been shown to be highly effective for prostates of any size, with studies demonstrating its superiority over other surgical procedures, such as transurethral resection of the prostate (TURP), as reported by Cornu et al. [@29@] and Yin et al. [@36@]. The procedure is also safe, with a low risk of complications, as supported by the study by Hartung et al. [@41@].
Recovery and Outcomes
Patients can usually resume normal activities within 1-2 weeks after HoLEP, although they may experience temporary urinary symptoms like frequency, urgency, or mild discomfort during healing. The procedure has been shown to improve urinary symptoms and quality of life, as demonstrated by the study by Zhang et al. [@25@].
From the Research
Holep Procedure Overview
- The Holmium Laser Enucleation of the Prostate (HoLEP) is a surgical approach for the treatment of benign prostatic hyperplasia (BPH) 1, 2, 3, 4, 5.
- HoLEP has been shown to be an effective and durable procedure for the management of BPH, with advantages over traditional treatments such as transurethral resection of the prostate (TURP) and open prostatectomy 2, 3, 4, 5.
Surgical Technique and Outcomes
- The HoLEP procedure involves the use of a holmium laser to enucleate the prostate, and can be performed using various surgical approaches 2.
- Studies have demonstrated that HoLEP results in significant improvements in urinary flow rates, reduction in prostate size, and improvement in symptoms 1, 3, 4, 5.
- The procedure has been shown to be safe and effective, with low rates of complications and adverse events 3, 4, 5.
Comparison to Other Treatments
- HoLEP has been compared to other surgical treatments for BPH, including TURP and open prostatectomy, and has been shown to have advantages in terms of reduced blood loss, shorter hospital stay, and fewer complications 2, 3, 4, 5.
- HoLEP has also been shown to be a size-independent treatment option, making it suitable for patients with prostates of varying sizes 3, 4, 5.
Patient Selection and Considerations
- Patients with BPH who are considering HoLEP should be evaluated on an individual basis, taking into account factors such as prostate size, symptoms, and medical history 5.
- HoLEP may not be suitable for all patients, and alternative treatments such as TURP or open prostatectomy may be recommended in certain cases 5.