HoLEP (Holmium Laser Enucleation of the Prostate)

Istanbul

HoLEP (Holmium Laser Enucleation of the Prostate) in Istanbul is available at 2 hospitals in the Voumed network.

HoLEP (Holmium Laser Enucleation of the Prostate) is a minimally invasive laser treatment for an enlarged prostate, a very common condition in older men that can make passing urine difficult. Benign prostatic enlargement narrows the channel through which urine flows, causing symptoms such as a weak stream, frequent urination and getting up at night. HoLEP uses a holmium laser passed through the urethra, with no external cut, to separate the overgrown inner prostate tissue from its outer shell and remove it completely. By taking out the whole obstructing tissue, it offers durable relief and works well even for very large prostates.

On this page

At a glance

Type: minimally invasive laser prostate surgery (enucleation)
Used for: benign (non-cancerous) prostate enlargement causing urinary symptoms
Key benefit: complete removal of obstructing tissue, suitable for all prostate sizes
Anaesthesia: general or spinal anaesthesia, no external incision
Where it is used: leading accredited urology centres abroad

What it is

HoLEP is an endoscopic procedure, meaning it is carried out entirely through the natural urinary passage using a thin telescope and a holmium laser, with no incision on the body. The holmium laser is a precise surgical laser that both cuts tissue and seals small blood vessels as it works, which helps keep bleeding low. In an enlarged prostate, the inner tissue grows and squeezes the urinary channel; HoLEP peels this entire inner tissue away from the prostate's outer capsule, much like removing the segments from inside an orange peel. Because the whole overgrown portion is removed, the result tends to be long-lasting.

How it works

Under general or spinal anaesthesia, a fine telescope is passed along the urethra to the prostate. The holmium laser is used to separate the enlarged inner tissue from the surrounding capsule and push it into the bladder in a few large pieces. A second instrument then breaks these pieces into smaller fragments that are removed through the telescope, so nothing is left behind. The laser seals vessels along the way, keeping blood loss low. A catheter is usually placed for a short time to help the area heal and drain urine, and most patients have it removed and go home within a day or so.

What it treats and who it helps

HoLEP treats benign (non-cancerous) enlargement of the prostate that causes bothersome urinary symptoms or complications, such as difficulty passing urine, incomplete emptying, repeated infections or urinary retention. A key advantage is that it is suitable for prostates of all sizes, including very large glands that were traditionally treated with open surgery. It can also be a good option for men who take blood-thinning medication, because the laser controls bleeding well. A urologist assesses each man's symptoms, prostate size and overall health to decide if HoLEP is the right choice.

Benefits and what to expect

The main benefits are complete and durable relief of obstruction, low bleeding, a short catheter time and hospital stay, and a low chance of needing repeat treatment later. Because the entire overgrown tissue is removed, symptoms typically improve markedly. After the procedure, mild burning when passing urine, urgency or a small amount of blood in the urine can occur for a short time and usually settle. Some men experience temporary leakage that improves with time and pelvic exercises. The care team provides aftercare advice and follow-up to confirm a good recovery.

Frequently asked questions

These answers are general guidance and may vary by provider. Confirm the details with the hospital you choose.

Is HoLEP a major operation?

No external cut is made. HoLEP is performed entirely through the urethra using a telescope and laser, which makes it minimally invasive. It is done under general or spinal anaesthesia, and the catheter time and hospital stay are usually short.

Is it suitable for a very large prostate?

Yes. A major advantage of HoLEP is that it works well for prostates of all sizes, including very large glands that once required open surgery. The whole obstructing tissue is removed regardless of size.

Will I have bleeding?

Bleeding is usually minimal because the holmium laser seals blood vessels as it cuts. This also makes HoLEP a suitable option for many men who take blood-thinning medication, though your specialist will review your individual situation.

How long is the recovery?

Most men stay only a short time in hospital and have the catheter removed within about a day. Mild urinary symptoms can last a little while as healing completes, and the team advises on when to resume normal activities.

Will my symptoms come back?

Because HoLEP removes the entire overgrown inner tissue, the relief is generally long-lasting and the risk of the obstruction returning is low. Routine follow-up confirms that the result is durable.

Does it affect sexual function?

HoLEP relieves urinary obstruction effectively, and many aspects of sexual function are preserved. One common effect is a change in ejaculation, which your specialist explains beforehand so you know what to expect.