HoLEP – Enucleation of prostate
HoLEP is an alternative treatment to TURP and seeks to resolve the problems associated with bladder outflow obstruction by relieving and improving the flow through the urethra, caused by Benign Prostatic Hyperplasia (BPH), which is the non-malignant enlargement of the prostate. A telescopic laser is used to cut away the obstructing prostate tissue where it is passed to the bladder and cut into smaller chunks before removal.
Who can have HoLEP treatment?
HoLEP can be performed on men of any age with urinary outflow obstruction caused by an enlarged prostate. Although the procedure can be performed on any size prostate, it is recommended mainly to men with large prostates (over 60mls in size) and can be used by men with bleeding disorders or those who take medication to thin the blood.
Advantages of HoLEP
- Suitable for any size prostate
- Less bleeding compared to other prostate surgeries
- More tissue removed
- Can be used by men who suffer from blood disorders
- Likelihood of requiring further surgery is very low
- Side effects of HoLEP
- Blood in urine after the operation, but this is entirely normal
- Clots are sometimes passed 10-14 days after the operation
- Ejaculation can cease (occurs in 75% of men) which will reduced future fertility
- Temporary and mild burning or frequency to urinate after the procedure
Before the procedure, you will be given a general anaesthetic to numb any pain. The bladder will be inspected with a small telescope followed by a holmium laser fibre inserted down the length of the telescope. Prostate tissue is pushed into the bladder where it is sucked up by a specialist instrument and inspected for any cancerous cells. A catheter is placed into the bladder to drain the urine and a sterile saline fluid passed through in order to dilute any blood in the urine. The catheter is usually left in place for approximately 24 hours before being removed as and when you are discharged from Baddow Hospital.
After the procedure, it is very common to experience some bleeding from the prostate area but this usually clears within approximately 12 hours. You are advised to drink as much fluid as possible within this time to help dilute the urine and avoid potential blood clots.
When you first pass urine, it may come more frequently than normal and it may be slightly painful. As a large amount of prostate tissue has been removed with the laser, there may be a short period of loss of urinary control until the pelvic floor muscles have recovered and strengthened again.