Dr. Christofer DelgadoPreciso Urología

Signature procedure

HoLEP

Holmium laser enucleation of the prostate

If you struggle to urinate, wake up several times a night or feel your bladder never fully empties, the most common cause is benign prostate enlargement. HoLEP offers a lasting solution, with no incisions.

Holmium laser equipment during prostate surgery

What is HoLEP?

It is an endoscopic procedure performed through the urethra, with no cuts in the skin. Using holmium laser energy, the tissue blocking the flow of urine (the adenoma) is completely separated from the prostate capsule, following its natural anatomical plane.

The freed tissue is moved into the bladder, where it is broken up and removed. All of it is sent to pathology, so it can be analyzed to rule out other conditions.

Benefits

01

No incisions

Everything is done endoscopically.

02

Any size

Works even for very large prostates that used to require open surgery.

03

Less bleeding

The laser seals tissue as it works, reducing the risk of bleeding.

04

Fast recovery

The catheter is usually removed within 24 to 48 hours and the hospital stay is short.

05

Lasting results

Because all obstructing tissue is removed, the need for repeat surgery is very low.

06

Tissue analysis

Complete tissue is obtained for pathology.

Who is a candidate?

Whether HoLEP is right for you is always decided in consultation, after a complete evaluation.

  • Men with moderate or severe urinary symptoms that do not improve with medication.
  • Patients with urinary retention or who depend on a catheter.
  • Recurrent urinary infections, bladder stones or bleeding from the prostate.
  • Kidney function affected by obstruction.
  • Large prostates where other techniques have limitations.

The process, step by step

  1. 01

    Evaluation

    Medical history, examination, PSA, ultrasound and, when needed, uroflowmetry.

  2. 02

    Planning

    Pre-operative tests and anesthesia assessment. We go over expectations and questions together.

  3. 03

    Surgery

    Under regional or general anesthesia. Duration depends on the size of the prostate.

  4. 04

    Recovery

    Early catheter removal, quick discharge and a gradual return to your activities.

What you should know

  • Retrograde ejaculation is common: semen flows into the bladder instead of out. It is not harmful, but you should know about it.
  • During the first weeks there may be urgency or mild leakage, which usually improves progressively.
  • Results vary from person to person. We will discuss your case clearly before deciding.

Frequently asked questions

Is HoLEP painful?

The surgery is done under anesthesia. Afterwards, discomfort is usually mild and controlled with common pain relievers. With no skin incisions, pain is lower than with open surgery.

How long will I stay in the hospital?

In most cases, one to two days. It depends on the size of the prostate and your overall health.

How is it different from TURP?

TURP removes the prostate in small pieces and has size limits. HoLEP removes the entire obstructing tissue along its anatomical plane, which is associated with less bleeding, less catheter time and fewer repeat procedures, especially in large prostates.

Does it affect erections?

Erectile function is generally preserved. Retrograde ejaculation, however, is common. We will discuss it in detail during your evaluation.

Is it covered by my insurance?

Many policies cover it. We work with several insurers; message us and we will guide you.

Book your visit

Do you have prostate symptoms?

Book an evaluation to find out whether HoLEP is an option for you.