How the HoLEP Procedure Helps Alleviate Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH), a condition in which the prostate is enlarged and causes symptoms, including frequent urination and an inability to fully empty the bladder, affects more than half of men between the ages of 51 and 60. That figure climbs to 70% for men 60 to 69 and 80% for those over age 70.
The cause of BPH is not fully known, but it is believed to be linked to the exposure of prostate cells to a hormone called dihydrotestosterone in aging men. Additional symptoms of BPH include difficulty starting urination, weak urinary stream, increased urinary urgency, and increased urination at night.
If lifestyle changes (reducing daily consumption of fluids, especially before bed, and other steps) and medication (including those that relax muscles in the bladder and urethra) do not help, surgery is an option.
Among several types of surgery, Yale Medicine offers a minimally invasive procedure called holmium laser enucleation of the prostate (HoLEP), which uses a high-powered laser to remove excess prostate tissue that’s blocking urine flow.
“HoLEP is the new gold standard in the surgical treatment of BPH,” says Jason Lee, MD, a Yale Medicine urologist. “It’s safe. It’s effective, and it can be used for any size prostate. I would recommend HoLEP if you're looking for the most durable and permanent fix.”
With HoLEP, a laser removes excess prostate tissue surrounding the urethra by separating the tissue from the organ. “You can think of it as removing all the fruit inside an orange. So the orange peel is intact, but it will be a lot easier to urinate and the symptoms of BPH will resolve,” says Daniel Kellner, MD, a Yale Medicine urologist.
Patients receive general anesthesia for the surgery, and can return home the same day or the next day.
“Patients come back to see us and say it’s life-changing,” Dr. Kellner says. “I’ve treated many patients with different types of urologic surgeries and nothing compares to HoLEP in terms of improving quality of life.”
Learn more about HoLEP in the video above.
