Ces Urol 2023, 27(4):236-242 | DOI: 10.48095/cccu2023030

Holmium laser enucleation of the prostate (HoLEP)

Pavel Tolinger, Aleš Petřík

Urologické oddělení, Nemocnice České Budějovice, a. s.

Tolinger P., Petřík A. Holmium laser enucleation of prostate (HoLEP). For nearly a century, methods limited by the size of the prostate have been established as the gold standard of surgery for benign prostatic hyperplasia (BPH). For glands over 80g open prostatectomy (OP) and for smaller ones transurethral prostatectomy (TURP). Despite their indisputable effect, they bring a high rate of morbidity. The technological development of the 90s of the 20th century enabled new surgical procedures of which Holmium laser enucleation of the prostate (HoLEP) is established as a size-independent method. We try to provide an overview of the development of the method, alternative procedures and new technological possibilities. At the same time we bring a comparison of various parameters with standard procedures up to now. More and more literary sources consider HoLEP to be an effective, safe and long-term effective method of surgical treatment of BPH. Based on this, it is gradually replacing TURP and OP as the new method of choice in the guidelines. HoLEP should be considered as the number one option when planning prostate surgery regardless of prostate size. It can also be offered to patients with a higher risk of bleeding, after a biopsy or after previous procedures on the prostate. The development of technologies promises further speed-up and better safety profile of the procedure which is becoming the new gold standard in BHP surgery.

Keywords: HoLEP, lower urinary tract symptoms, benign prostatic hyperplasia, TURP, open prostatectomy.

Received: September 18, 2023; Revised: October 9, 2023; Accepted: October 13, 2023; Prepublished online: October 13, 2023; Published: December 19, 2023