HoLEP Surgery

Prostate Surgery with HoLEP (Laser) Method

HOLEP, “Holmium Laser Enucleation of Prostate”, means the removal of the prostate by disintegration by enucleating with a Laser. HoLEP has been widely used in the last 10 years in America and Europe and is considered one of the gold-standard treatments due to its success in prostate enlargement treatment.

Closed methods such as Tur, plasma kinetics or Greenlight are used to treat prostate enlargement, but bleeding after surgery and growth of the remaining prostate tissue are occasionally observed in these methods.

HoLEP surgery is performed by entering through the patient's urinary canal, that is, closed. A prostatic adenoma grown with a holmium laser is removed by separating it from the prostate capsule. Since no adenoma tissue is left behind, regrowth is also not observed. The tissues taken are pathologically examined, and it is also investigated whether there is cancer tissue.

The patient loses very little blood because the haemorrhages are controlled very well with the laser. HoLEP surgery can be safely performed in patients with heart and lung diseases and patients using blood thinners.

Does it have a harmful effect on sexuality?

The depth at which the Holmium Laser acts on the tissue is 0.4 mm. It is not possible for this laser to pass through the 6-7 mm thick capsule and damage the nerves related to masculinity, so there is no harmful effect on erection.

Can large prostates also be operated with the HoLEP method?

While only prostates up to 80 ml can be operated with TUR or plasma kinetic methods, there is no limit in the HoLEP method, it can be applied to prostates of any size up to 100mg, 150mg, or even 300 ml.

Is urinary incontinence possible after HoLEP surgery?

Among prostate surgeries, HOLEP surgery is the method that best protects the urine-retaining muscles called sphincter. Urinary-holding muscles can be seen very well, not approached, and very well protected. However, if the urinary-holding sphincter becomes sluggish before the surgery, temporary urinary drips may be seen in some patients after the catheter is removed. These drips improve with medication and exercises, sometimes in a few days, sometimes in a few weeks.  Permanent urinary incontinence is not observed.

How many days does the urinary catheter remain after HoLEP surgery?

Although this period varies according to the patient's comorbidities and prostate size, it may be sufficient to stay with the catheter for 1-2 days in general.

Is it possible to have a child after HoLEP surgery?

YES, because there is no damage to the semen ducts, semen continues to come, only semen can go to the urinary bladder and come out from there. In such cases, it is possible to have a child using the IVF method.

Does prostate enlargement recur after HoLEP surgery?

No, because the prostate has been completely removed, regrowth in later years is very rare.

What are the advantages of HoLEP surgery?

In laser prostate enlargement surgery, there is no risk of recurrence of the disease, since the prostate tissue is completely removed. This method is quite safe for patients who have to use blood thinners (antiaggregant-coagulant) drugs, since laser bleeding control can be performed very well. With advantages such as lower bleeding risk, shorter hospitalization time and faster recovery process, patients get rid of their probes in just 24 hours and can return to their normal lives quickly. As a result, patients, according to their own statements, return to their 30s after surgery.