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HoLEP

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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. 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

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.

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.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Who Is a Candidate?

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.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • CompCare (Comprehensive Behavioral Care)
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry Vista Medicare HMO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Global Health Claims Services
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana HUMx
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care