Holmium Laser Prostate Surgery, widely known as HoLEP (Holmium Laser Enucleation of the Prostate), has become one of the most advanced and reliable treatments for men suffering from Benign Prostatic Hyperplasia (BPH) or enlarged prostate. Across India, especially in Kerala, thousands of men experience urinary symptoms due to prostate enlargement as they age, and many find that medications do not provide long-lasting relief.
With modern urological centres in Kerala adopting cutting-edge laser technology, HoLEP has emerged as a gold-standard procedure. It offers precision, safety, faster recovery, and long-term results unmatched by older surgical techniques. Centres like SDC Prostate Centre are bringing this globally trusted treatment within reach for patients seeking effective prostate care.
This detailed blog walks through everything a patient or caretaker needs to understand about Holmium Laser Prostate Surgery — from symptoms to recovery.
Understanding Enlarged Prostate (BPH): A Growing Concern With Age
As men grow older, the prostate gland naturally increases in size. When this growth becomes excessive, it compresses the urethra — the tube that carries urine from the bladder — leading to troublesome urinary symptoms.
Common Symptoms of Enlarged Prostate Include:
Difficulty starting urination
Weak or interrupted urine flow
Frequent urination, especially at night
Urgency or inability to hold urine
Feeling that the bladder is not fully empty
Dribbling after urination
Occasional urinary retention
Recurrent urinary infections
While medicines can help initially, many men eventually require a procedural solution when symptoms progress. This is where Holmium Laser Surgery becomes a highly effective choice.
What is Holmium Laser Prostate Surgery (HoLEP)?
HoLEP is a minimally invasive laser-based procedure used to remove enlarged prostate tissue and re-establish smooth urinary flow. Unlike traditional open surgeries or older endoscopic techniques, HoLEP uses Holmium laser energy to precisely separate and remove obstructing prostate tissue without any external incisions.
How HoLEP Works — Step by Step
A thin instrument (resectoscope) is inserted through the urethra.
The surgeon uses Holmium laser energy to gently peel out the enlarged tissue from the prostate capsule.
These tissue fragments are deposited into the bladder.
A device called a morcellator is used to suction out the tissue.
The removed tissue is often sent for pathological examination.
Since the technique removes the entire enlarged portion of the prostate, HoLEP is considered a complete and lasting treatment for BPH.
Why HoLEP is Preferred Over Traditional Procedures
1. No External Cuts or Stitches
The entire surgery is performed through the natural urinary passage, making it completely incision-free.
2. Very Low Bleeding Risk
The Holmium laser seals blood vessels instantly while cutting, which makes this procedure safe even for elderly patients or those on blood thinners.
3. Suitable for Small, Medium, and Very Large Prostates
Unlike TURP, which is limited by prostate size, HoLEP can treat even extremely large prostates with ease.
4. Faster Recovery and Shorter Hospital Stay
Most patients return home within 24–48 hours and resume normal activities earlier than with conventional surgery.
5. Long-Term, Durable Results
Since the obstructing tissue is fully removed, recurrence is rare, and symptom relief is long-lasting.
6. Tissue Available for Lab Testing
The prostate tissue removed can be examined for any unexpected conditions, offering added diagnostic reassurance.
Who Needs Holmium Laser Prostate Surgery?
HoLEP is ideal for men who:
Have moderate to severe urinary symptoms
Do not find relief with medications
Have very large prostate glands
Suffer from urinary retention
Experience recurrent UTIs caused by obstruction
Want a minimally invasive and long-lasting solution
Even men with medical comorbidities like diabetes, hypertension, or cardiac issues often tolerate HoLEP better than older surgical approaches.
What to Expect During the Procedure
Before Surgery
A detailed evaluation including blood tests, urine tests, ultrasound, and flow studies
A consultation to understand the prostate size and severity of symptoms
Instructions on fasting and medication adjustments if necessary
During Surgery
Performed under spinal or general anesthesia
Typically lasts 60–120 minutes depending on prostate size
No incision or skin cuts
Catheter is placed temporarily after the procedure
After Surgery
Mild burning during urination may occur for a few days
Some patients notice blood-tinged urine initially
Catheter is usually removed the next day
Urinary flow improves dramatically within 24–48 hours
Recovery After HoLEP: What Patients Should Know
1. Hospital Stay
Most patients go home within 1–2 days.
2. Returning to Activities
Light activities: 2–3 days
Driving: 1 week
Heavy work: 2–3 weeks
Sexual activity: After 3–4 weeks
3. Common Temporary Side Effects
These usually settle in the first few weeks:
Mild incontinence (improves with pelvic exercises)
Burning during urination
Blood in urine
Increased frequency or urgency
4. Long-Term Outlook
Patients enjoy:
Stronger urine flow
Reduced nighttime urination
Better bladder emptying
Improved quality of life
HoLEP is one of the very few procedures proven to maintain excellent outcomes even after 10–15 years.
Why Kerala Is a Growing Hub for HoLEP Surgery
Kerala has emerged as a major destination for advanced urological treatments due to:
State-of-the-art healthcare infrastructure
Experienced urologists skilled in laser procedures
Higher standards of post-operative patient care
Affordable treatment packages compared to other regions
Centres specialising exclusively in prostate care
Hospitals and dedicated prostate centres here offer internationally comparable care, making Kerala an excellent choice for patients from India and abroad.
Why Choose a Centre Like SDC Prostate Centre for HoLEP?
Centres specializing in prostate treatment, such as SDC Prostate Centre, bring unique advantages:
Dedicated prostate care experts
Advanced Holmium laser technology
Emphasis on minimally invasive procedures
Individualized patient counselling and follow-up
Rapid recovery programs designed for elderly patients
High success rates and excellent functional outcomes
A focused centre ensures that patients receive precise diagnosis, the right procedure, and excellent recovery support.
Conclusion
Holmium Laser Prostate Surgery (HoLEP) has transformed the way enlarged prostate is treated. With no external cuts, low complications, quick recovery, and long-lasting results, it stands out as one of the safest and most effective options for men experiencing urinary symptoms due to BPH.
For patients in Kerala, especially those seeking advanced yet patient-friendly treatment, HoLEP offers a life-changing solution. With experienced urologists and specialized centres like SDC Prostate Centre, patients can expect world-class care and lasting relief from urinary obstruction.
FAQ
No, the procedure itself is not painful because it is performed under either general or spinal anesthesia. Most patients experience only mild burning or discomfort during urination for a few days after surgery, which gradually settles as healing progresses.
Most patients can go home within 24–48 hours after the procedure. The hospital stay is significantly shorter compared to traditional surgeries such as TURP or open prostatectomy.
Yes, a catheter is usually placed at the end of the procedure to allow proper drainage. In most cases, it is removed the next day once the surgeon confirms that urine is clear enough and the bladder is functioning well.
Patients typically return to light activities within 2–3 days, resume driving in about a week, and can get back to normal routines within 2–3 weeks. Heavy lifting and strenuous exercise should be avoided for a few weeks to support proper healing.
HoLEP does not affect the ability to have an erection or sexual pleasure. However, some men may experience retrograde ejaculation, a harmless condition where semen flows into the bladder during orgasm instead of exiting through the penis. This does not affect overall sexual satisfaction.
Yes. One of the biggest advantages of HoLEP is that it is effective for prostates of any size, including extremely large glands that are otherwise difficult to treat with conventional procedures. This makes it a preferred option for men with advanced BPH.
