Holmium laser enucleation of the prostate (HoLEP) is a newer treatment option for patients with a condition called benign prostrate hyperplasia (BPH). As a man gets older, the prostate increases in size and blocks the urine flow causing a voiding dysfunction. BPH is a non-cancerous enlargement of the prostate gland that is commonly found in men over the age of 50.
Mount Sinai is a leader in minimally invasive approaches to treat a variety of urologic conditions, including HoLEP, which uses a specific laser to remove the obstructive prostate tissues and restores normal urine flow. Thanks to advancements in urological surgical technologies, HoLEP has become recognized as a gold standard for treatment of BPH, offering patients reduced operative and recovery time.
Osama Zaytoun, MD
In this Q&A, Osama Zaytoun, MD, a urologist and HoLEP expert at Mount Sinai Doctors – Brooklyn, and, explains what this procedure is and why it is becoming more popular due to its unique benefits for patients.
“HoLEP is the latest cutting-edge surgical technique,” says Dr. Zaytoun, who is also an Assistant Professor of Urology at the Icahn School of Medicine at Mount Sinai. “Our patients come and go the same day and get the best surgical and post-operative care.” Mount Sinai is one of a limited number of hospitals in New York State offering this procedure.
What are the benefits of HoLEP over other BPH treatments?
Compared to traditional surgery, HoLEP (Holmium Laser Enucleation of the Prostate), offers better long-term results and a quicker recovery overall. The procedure takes between 90 minutes and three hours. Patients who undergo HoLEP typically regain their physical functions quickly and can urinate normally. They have a short hospital stay and can return home the same day of the procedure. HoLEP also has no size limitation and therefore allows surgeons to treat patients with different stages of BPH and all prostate sizes.
How do I know if I have an enlarged prostate?
Key symptoms of an enlarged prostate include urinating more frequently and urgently, straining or finding it difficult to urinate, hesitancy or feeling it’s more difficult to urinate, dribbling after urination, and incontinence. Urine retention and the need for urinary catheter may be a complication for neglecting this condition.
Are there any risks associated with HoLEP?
HoLEP is a safe procedure, but as any other surgical procedures it still has a low incidence of complications that is reported to be less than 10 percent. Most of these complications are mild and reversible, or resolve on their own.
What happens during a HoLEP procedure?
During the HoLEP procedure, the surgeon inserts a high-powered laser into the urethra and carves out the obstructive excess tissue of the enlarged prostate. The tissue is further cut into smaller pieces to allow easy removal. This allows the urethra to open more, significantly improving the urine flow and the patient’s ability to void fully. Right after the procedure, a catheter is placed in the bladder to help with urination after the surgery; this is removed after one or two days.
What is the recovery like after a HoLEP procedure?
Recovery is quick and most patients can go back to their normal activities within a week or so after the procedure. A patient might feel mild pain, burning, and discomfort following the procedure, but these symptoms are temporary and will resolve after a few days.
Who is a candidate for HoLEP?
The HoLEP procedure is ideal for men with BPH with bothering symptoms and is especially helpful for those who have very large prostates, for those who have not responded to medication, and those who have had other procedures done that were not effective.
What makes the HoLEP procedure offered at Mount Sinai unique?
HoLEP is an extremely specialized procedure that requires intensive urological training, mentorship, and special equipment. Because of the difficult learning process, there are few urologic surgeons performing the procedure in the United States. Our team has mastered the procedure, and we are excited that we can help.
Please call 212-844-8900 to schedule an appointment.