Very developed benign prostatic hyperplasia, which no longer responds to medical treatment, must be treated. Prostatic enucleation by holmium laser or HoLEP (Holmium Laser enucleation of the Prostate) is a surgical technique for the treatment of prostate adenoma. This technique consists of the dissection of the prostatic adenoma causing the urinary obstruction by means of a laser fiber for its subsequent morcellation and evacuation. The procedure is performed transurethrally.
When is it necessary?
Prostatic adenoma surgery is indicated in those patients who do not respond to medical treatment for prostatic hyperplasia, patients with urethral catheter with failed removal attempts and patients with bladder lithiasis (stones in the bladder) and prostate adenoma.
Application of the HoLEP technique
The surgery is performed transurethrally (through the urinary tract), so it does not require an abdominal incision. Urology specialists normally perform it under epidural anesthesia, although in selected cases general anesthesia is required.
Advantages of the HoLEP technique over other techniques
It avoids the incision of the abdominal wall in this way the pain and postoperative discomfort suffered after HoLEP are lower than after open surgery and as there is no surgical wound there is no risk of infection.
The excellent coagulation capacity of the holmium laser predisposes to a shorter hospital stay, less urethral catheter time and less likelihood of needing a transfusion.
HoLEP has the ability to be performed on patients of different prostate sizes. It is especially indicated in patients with high prostate volumes.
Allows treatment of bladder stones (if present) in the same procedure.
Duration of the procedure
The duration of the procedure will depend on the prostate volume and the characteristics of the prostate. The average duration is 60-90 minutes.