Laser Prostate HOLEP Surgery



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laser Prostate HOLEP SurgeryFirst slide
laser Prostate HOLEP Surgery

Holmium Laser Enucleation of the Prostate (HOLEP)

Holmium Laser Enucleation of the prostate (HOLEP) is a modern alternative to the standard Transurethral Resection of the Prostate (TURP) procedure for bladder outflow obstruction due to BPH.It requires a short period of hospitalisation and an anaesthetic. A catheter (a tube which drains the bladder) is also needed for few days until the urine clears.Patients are advised to take life quietly and to avoid straining or heavy lifting for four weeks after the surgery.

Who is it suitable for?

HOLEP can be performed on men of any age with urinary outflow obstruction caused by an enlarged prostate. It is necessarily indicated in men with large prostates (over 60mls in size) and men on medications to thin the blood such as warfarin,aspirin or clopidogrel.


What are the advantages of HOLEP?

  • There is no upper size limit of prostate that can be dis-obstructed traditionally men with prostates over 100ml in size needed major open surgery.
  • There is often less bleeding than after a TURP.
  • Discharge is often quicker than after TURP at 1-2 days.
  • The chance of recurrence requiring further surgery is very low.
  • Unlike greenlight laser operations,large quantities of prostate tissue are sent for pathological analysis
  • The PSA generally drops to very low levels after HOLEP operations.

What are the disadvantages of HOLEP?

The procedure takes slightly longer than a TURP and requires specialist training.
Apart from this and the risk of infection that accompanies any operation or invasive procedure,the only significant side-effect is the near certainty that normal ejaculation will cease.This is because the contraction that occurs during orgasm may not completely block the entrance to the bladder once some tissue has been removed,and the semen will flow back into the bladder (retrograde or dry ejaculation) rather than out through the penis.This is not harmful,but it does mean that future fertility is greatly reduced.The procedure does not generally affect erectile function or continence,although the urinary symptoms may take a few weeks to settle down afterwards.

Where is it done?

Dr.M.Gopichand consults with patients at The kidney urology andrology clinics both at clinic at kothapeta and also at KIMS HOSPITAL and undertakes the procedure at KIMS HOSPITAL.Dr.M.Gopichand has personally carried out over 50 of these procedures.He is a faculty member of the urological society of india and also guide and teacher for national board for superspeciality training nad also trains other surgeons.

How much does it cost?

If you are paying for your treatment yourself,the cost of the procedure will be in the region of Rs 1.25000.If you have health insurance,you can expect this operation to be covered although some companies/policies do not pay the full amount of the surgeons or anaesthetist fees.We recommend that you discuss the potential shortfall with us before deciding to go ahead.

How can I make an appointment?

Dr.M.Gopichand is available on weekdays mornings in KIMS HOSPITAL and Evenings at Clinic.Please telephone our Patient Liaison team for an appointment on 8985325177 or mail to urologyhyd@gmail.com.