“HoLEP brings together the comfort of the transurethral approach, the efficacy of open surgery and the safety of laser technology”
Prostate enucleation with holmium laser (HoLEP) is a surgical technique for the treatment of benign prostatic hyperplasia (BPH) first described in 1998 in New Zealand by Peter Gilling. At present, its realization is recognized and recommended by the main international urological guides, although due to its technological requirements and its great technical complexity, it is only carried out in highly specialized centers.
HoLEP is the most versatile technique. HoLEP can be used in any scenario of BPH, because it is the only one capable of operating any prostate size. The reason that several surgical techniques have coexisted for decades is that none has been able to treat all patients suffering from this pathology, especially when it comes to large prostates.
With the arrival of HoLEP, this problem has finally been solved, combining the comfort of the transurethral approach, the efficacy of open surgery and the safety of laser technology.
The surgery with HoLEP needs a high degree of specialization. Really, the only two reasons why there is not only HoLEP currently in the urological world are two. On the one hand, the great technological requirements it requires, which are not available to all centers. On the other hand, it is extremely demanding from the technical point of view, being one of the most difficult urological operations to perform safely and effectively in all cases. The latter is the fundamental limiter, since many centers have the holmium laser apparatus to treat urinary stones, but they do not perform HoLEP because they do not have a trained urologist: “There are many machines, but few experts”