In the U.S., a surprisingly high number of men have an enlarged prostate or benign prostatic hyperplasia (BPH):
- 50% of men over age 50
- 70% of men age 60-69
- 80% of men age 70+
If you’re among them, the University of Miami Health System has answers. <
What is HoLEP?
UHealth has one of the few urologists in the U.S. offering a minimally invasive treatment for BPH. This treatment, holmium laser enucleation of the prostate (HoLEP) provides long lasting relief for urinary problems from BPH. HoLEP is also safer and easier on the patients who have failed prior traditional BPH treatment, transurethral resection of the prostate (TURP).
UHealth urologist and surgeon Dr. Hemendra Shah has performed more than 1,600 HoLEP procedures since 2003 and has trained many other urologists in this technique. He has written extensively on urologic topics for peer-reviewed journals and earned multiple awards for presentations at various internal conferences.
How is HoLEP better?
HoLEP offers a quick, effective return to normal urinary function. Compared to the other surgical treatment modality, HoLEP provides many benefits:
- No incisions
- 1-2 day hospital stay
- 2 week recovery
- Less than 24-hour catheter use in most patients
- Minimal pain and swelling
- Fewer complications
- Protects surrounding healthy tissue
- Long-term relief: least retreatment rate amongst all surgical procedures for BPH
- Lower risk of erectile dysfunction
- Preserves tissue for lab testing – biopsies are superior to other prostate cancer screening methods
- Can be performed on any size prostate gland: It is now considered new size-independent Gold Standard.
- PSA counts generally drop to very low levels after HoLEP
- Covered by most insurance companies
Who is a Candidate for HoLEP?
As men age, their prostate gland may become so large that it interferes with urinary function. This condition, known as benign prostatic hyperplasia (BPH), is especially common among men over 50. While not prostate cancer, it causes the prostate to press on the urethra and create bladder dysfunction. Urinary symptoms and the inability to fully empty your bladder can interfere with your life. In 2000, (most recent data available), BPH accounted for more than 4.4 million office visits, 117,000 ER visits, 105,000 hospitalizations, and 21 to 38 million hours of lost productivity in the U.S.*
HoLEP is a highly effective treatment for BPH. You may be a candidate if you have one or more of the following apply to you:
- Enlarged prostate with bothersome Lower urinary tract symptoms that does not respond to medicines
- Recurrent urine retention, developed swelling on kidney; or developed bladder stones
- Recurrent UTI or recurrent hematuria
- Taking blood thinner medication or have cardiac pacemakers. These co-morbidities increase risk with other procedures.
*Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors J. Kellogg ParsonsCurr Bladder Dysfunction Rep (2010) 5:212–218.
What to Expect
How is HoLEP performed?
The highly precise holenium laser protects the surrounding healthy tissue during the procedure. For this reason, it is widely used by urologic surgeons.
During the procedure, the patient is placed under general anesthesia while the surgeon inserts a telescopic camera through the penis. Using the camera as a guide, the surgeon treats the enlarged prostate tissue with the laser. The capsule surrounding the prostate is left in place. A different instrument is inserted through the camera and is then used to fragment the tissue, which is removed and tested for cancer. Finally, a catheter is placed into the bladder and the surgeon irrigates the bladder with a sterile saline solution to prevent blood clots.
The catheter remains in place overnight and, in most cases, the patient is discharged the next day without a catheter.
Are there side effects?
Side effects of HoLEP are few, but include: risk of infection (present with any procedure) and some blood in the urine for a few days afterwards. While healing, patients may also pass blood clots for one to two weeks. Normal ejaculation stops after HoLEP for most patients because the semen flows back into the bladder instead of through the penis. Though not harmful, this reduces fertility.
In most cases, it does not affect erectile function or continence. Some patients even experience improved sexual function after HoLEP.
Why Choose UHealth?
Comprehensive, leading-edge care. As world leaders in urology care, our physicians use the latest technologies and techniques to treat urologic disorders, male incontinence, and prostate disease. Combining the latest research and least invasive procedures, we help you feel better and recover quicker. Our team of expert urologists personalize your treatment plan so you experience the very best results.
Innovative, expert urology care at the Desai Sethi Urology Institute. Our team of urology experts delivers advanced care for all urologic conditions. We use the latest research and the least invasive procedures to help you feel better and recover more quickly. Our experienced urologists design a personalized treatment plan to give you the best possible results.
University-based medicine. As an academic medical system, our commitment to groundbreaking research helps us develop new, effective procedures that improve quality of life for people with urologic conditions. Your doctors are also respected educators who lecture on urology topics throughout the world.
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