HoLEP Surgery | Laser Treatment for Prostate

HoLEP surgery or Holmium Laser Enucleation of the Prostate is a common surgical procedure that is performed by the best urologists in India. Get the most advanced treatment for Benign Prostate Enlargement (BPH) in India at Pristyn Care.

HoLEP surgery or Holmium Laser Enucleation of the Prostate is a common surgical ... Read More

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What is HoLEP?

HoLEP or Holmium Laser Enucleation of the Prostate in a minimally invasive surgical procedure that is often performed to reduce urinary symptoms caused by Benign Prostate Hyperplasia (BPH) or commonly known as an enlarged prostate. In a HoLEP surgery, entire sections of the prostate gland are removed to ease symptoms of BPH.

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Best healthcare centre for HoLEP surgery in India

Pristyn Care is one of the leading surgical healthcare providers in India. It has tie-ups with some of the best hospitals in India and boasts a team of highly experienced urologists with years of experience in performing successful HoLEP procedures without any complications or major side effects.

Pristyn Care provides other auxiliary services to its patients such as complete insurance and hospital documentation support, affordable no-cost EMI options and a cab facility to all its patients for pick up and drop off from the hospital at the day of surgery. They also provide all their patients with complimentary meals during hospitalisation.

Diagnosis for BPH

Prior to the surgery, your urologist will likely ask you about your medical and surgical history and perform a series of simple tests and diagnostics to not only assess your overall health but also uncover any medical conditions you may have that could require extra precautions either during surgery or during recovery. Some diagnostic tests for BPH include:

Digital rectal examination: A digital rectal examination is a simple test which your urologist will likely perform to diagnose your BPH. For the test, the urologist will insert a gloved finger into your rectum and physically feel the prostate gland to determine its size and shape.
Transrectal ultrasound: This test allows your urologist to visualise and assess the exact size and shape of your prostate gland. A transrectal ultrasound is also more accurate than a physical examination.
Cystoscopy: Cystoscopy is a test that is performed by a urologist to examine the lining of your bladder and urethra using a thin camera called a cystoscope. This cystoscope will be inserted through the opening on the tip of your penis and passed through your urethra to reach the bladder. Once in place, your urologist can examine its lining.
Urodynamics: Your surgeon may perform some tests to evaluate the functioning of your bladder and urethra.
Prostate-specific Antigen (PSA) test: A PSA blood test is one of the most reliable markers for prostate enlargement. If the PSA levels in your blood are determined to be more than 2.5 ng/mL, you are likely to have some degree of prostate enlargement.

What happens during a HoLEP surgery

A HoLEP surgery is a minimally invasive procedure that takes around 2-3 hours to complete. HoLEP is typically performed under general anaesthesia meaning you will be asleep throughout the procedure but depending on your overall health and preference, your surgeon may use spinal anaesthesia meaning, you will remain conscious during the procedure but parts of your body become numb.

Similar to TURP surgery, HoLEP surgery uses a modified resectoscope which will be inserted through the opening at the tip of your penis and passed through your urethra to reach the prostate gland. Once the resectoscope is in place, the surgeon will use a laser to enucleate the enlarged prostate tissue from the outer shell of the prostate gland and seal up any blood vessels. The tissue that is removed deposits in the bladder that will be later be suctioned out with the help of a device called morcellator. Once the tissue removal is complete, the surgeon will remove the resectoscope and you will be taken to a recovery area for postoperative observation and evaluation.

After the procedure, there might be slight swelling in the urethra that could cause difficulty urinating. In such a case, your urologist may need to place a catheter inside your urethra to allow urine to pass. Once the swelling has subsided and you are able to urinate on your own, the catheter will be removed.

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How to prepare for a HoLEP surgery?

Prior to surgery, your urologist will likely recommend some necessary precautions and temporary changes in your lifestyle to minimise chances of complications either during or after surgery as much as possible. If you are undergoing a HoLEP surgery, make sure to follow the measures laid out by your urologist as strictly as possible. You should also make some preparations before surgery such as:

Before surgery, it is important to inform your urologist about your entire medical and surgical history. If you have some pre-existing medical conditions such as diabetes or hypertension, make sure to inform your doctor about them.
It is important to disclose all information about any medications or supplements you take to your urologist. Certain medications such as ibuprofen, warfarin or aspirin can cause your blood to be thinner. Taking them before surgery can significantly increase the chances of excessive bleeding during surgery.
Fast for at least 6-8 hours before surgery especially if your HoLEP surgery is being carried out under general anaesthesia.
Make sure to have an empty bowel before arriving at the hospital for surgery. If you have difficulty in performing bowel movement, you may need an enema to relieve your bowels completely.
Your urologist may recommend you to wear loose and comfortable clothes before coming to the hospital for surgery.

What are the risks associated with HoLEP surgery?

While complications of any kind after a HoLEP surgery are very rare, like any other surgery, they can still happen. Some complications that are associated with HoLEP are:

Injury to bladder or urethra
Infection
BPH recurrence
Erectile dysfunction
Retrograde ejaculation
Complications associated with anaesthesia

After your HoLEP surgery, if you exhibit symptoms such as blood or pus in the urine, nausea and dizziness, it is advised to contact your healthcare provider as soon as possible.

When is HoLEP required?

A HoLEP is usually recommended for patients suffering from serious urinary symptoms which are having a considerable impact on their daily lives. Some conditions for which a HoLEP may be required include:

Nocturia or the frequent urge to urinate at night
Slow urine stream
Inability to start urinating easily
Pain while urinating
Urinary retention
Leakage of urine or urinary incontinence

What are the benefits of a HoLEP surgery?

The benefits of undergoing a HoLEP surgery are:

A HoLEP procedure is minimally invasive in nature and hence, recovery time is fast as well.
Minimal bleeding
Low rate of BPH recurrence
A HoLEP surgery can remove a large amount of prostate tissue without any major incision being made on the body or the prostate gland.
Low chance of complications

FAQs on HoLEP Surgery

How long does it take to recover from a HoLEP surgery?

Recovery period after HoLEP surgery depends from person to person. However in most cases, a patient needs at least 1-2 weeks of rest after surgery.

Can the prostate gland grow back after surgery?

The prostate is likely to continue to grow in size even after a surgery. However, the growth rate is so minimal that most patients do not require another BPH treatment.

How much of the prostate is removed during a HoLEP surgery?

During the surgery, your surgeon will only remove the parts of your prostate that cause blockage in the urethra. Your prostate gland can work normally after the surgery.

What are the side-effects of a HoLEP surgery?

After a HoLEP surgery, some side-effects are to expected such as:

Temporary bleeding
Burning sensation while urinating
Temporary urinary incontinence
Blood in urine

Is HoLEP an outpatient procedure?

Hospitalisation period after a HoLEP surgery usually depends on the severity of your prostate enlargement. While in most cases, HoLEP requires at least 1 day of hospital stay, in some cases, you do not require hospitalisation.