Prostate & Urinary Procedures
Holmium Laser Enucleation of the Prostate (HoLEP)
A gold-standard laser treatment for an enlarged prostate. HoLEP offers a long-term solution for men of all prostate sizes, providing excellent long term results.
Key takeaways
- A gold-standard laser treatment for an enlarged prostate. HoLEP offers a long-term solution for men of all prostate sizes, providing excellent long term results.
- Specialty: Prostate & Urinary Procedures
60–90
Typical procedure timemin
Day case
Often home the same day
No
No external cutsscars
Treatment Overview
About Holmium Laser Enucleation of the Prostate (HoLEP)
HoLEP is a highly effective, minimally invasive procedure used to treat an enlarged prostate (also known as BPH). While older methods like TURP involves scraping away pieces of the prostate, HoLEP uses a precision Holmium laser to gently 'peel' away the blocking tissue from the surrounding capsule—much like removing the fruit from an orange.
The removed tissue is then safely vacuumed out of the bladder using a specialised tool. Because HoLEP allows your specialist to remove more of the obstructing tissue than almost any other method, it is widely considered the 'gold standard' for providing long-lasting relief from urinary symptoms.
Safety Information
Benefits, Risks & Side Effects
01
Benefits
HoLEP is unique because it works for prostates of any size—even very large ones that would otherwise require major open surgery.The benefits include:
Faster Recovery: Most men are back on their feet much sooner than with traditional surgery.
Shorter Catheter Time: The tube used to drain your bladder is usually removed within 24 hours.
Built to Last: HoLEP has the lowest 'redo' rate of any prostate surgery, meaning it is likely the only procedure you will ever need.
02
Risks
While HoLEP is highly effective and follows best-practice clinical standards, it is important to understand the potential risks involved. We categorize these complications by frequency to help you make an informed decision.
🟢 Common (More than 1 in 10 patients)
Hospital-Acquired Infection: There is a general risk (4–6%) of acquiring an infection such as MRSA during a hospital stay.
🔴 Rare (Between 1 in 50 and 1 in 250 patients)
Unrelieved Symptoms: The treatment may occasionally fail to completely relieve all of your urinary symptoms.
Severe Bleeding: A rare risk of bleeding that is significant enough to require a blood transfusion or a second operation.
General Medical Issues: Rare complications related to anesthesia or the heart, such as blood clots (DVT/PE), chest infections, or stroke.
03
Side Effects
To help you prepare for your recovery, we use the following traffic light system to outline common after-effects. Many of these are self-limiting or temporary reactions that settle as the prostate cavity heals.
🟢 Common (More than 1 in 10 patients)
Temporary Urinary Symptoms: Almost all patients experience temporary mild burning, light bleeding, and frequent urination. Overactive bladder symptoms (frequency and urgency) can take up to three months to fully settle.
Retrograde Ejaculation: In 9 out of 10 patients (90%), no semen is produced during orgasm because it passes backward into the bladder on ejaculation. This is safe and harmless.
Ongoing Mild Discoloration: Between 1 in 2 and 1 in 10 patients will see continuing blood in their urine for several days after surgery.
Delayed Secondary Bleeding: Around 1 in 5 patients (20%) may experience brief bleeding 2 to 3 weeks after going home as scabs separate from the healing prostate cavity.
Temporary Loss of Control: Between 1 in 10 and 1 in 50 patients experience a short-term loss of urinary control (incontinence), which typically improves with targeted pelvic floor exercises.
What We Treat
How Holmium Laser Enucleation of the Prostate (HoLEP) Can Help You
This treatment is effective for a wide range of health needs. Select a condition below to learn more about how we can support your recovery and improve your daily well-being.
Patient Journey
What to Expect
A step-by-step guide through your Holmium Laser Enucleation of the Prostate (HoLEP) journey—from preparation and what happens during the procedure to recovery and aftercare.
01/ 03
Before Procedure
To prepare, you will have a few simple tests including a flow rate test and an ultrasound to measure your prostate size. We will ask you to complete a symptom score and will scan your bladder after your flow test to see how well you empty your bladder. Your specialist will check if you are taking any blood-thinning medications. Before the day of surgery, you'll have routine blood tests and a urine check to ensure you don’t have an infection.
You'll typically need to fast (no food or water) for a few hours if you are having any form of sedation or anaesthetic.
02/ 03
During Procedure
The procedure is performed under a general anaesthetic (so you are asleep) or a spinal anaesthetic (so you are numb from the waist down).
A thin telescope is passed through the penis—there are no external cuts or stitches.
The laser separates the enlarged tissue from the outer shell of the prostate.
A 'morcellator' then clears the tissue from the bladder. The surgery usually takes between 60 and 90 minutes depending on the size of your prostate.
03/ 03
After Procedure
You will wake up with a catheter in place to help your bladder drain. You will either be discharged home the same day or you may stay in hospital for one night and have the catheter removed the next morning(this is called a 'Trial Without Catheter' or TWOC).
Once you are peeing comfortably, you can go home. We recommend avoiding heavy lifting or strenuous exercise for about 4 weeks to allow the internal area to heal fully. You should drink plenty of water during the first few days to keep your system clear.
You will then be seen in the clinic several weeks later to check your symptoms and see how well you pass urine with a flow test, and you will have a bladder scan to check how well you empty your bladder.
Specialists
Specialists for Holmium Laser Enucleation of the Prostate (HoLEP)
Leading experts for this treatment. View profiles to see clinical backgrounds and current availability.
Our Commitment
Care you can trust
Every treatment is delivered to the same standard: senior consultants, a personalised plan, and the safety of an accredited private hospital behind you.
Consultant-Led Excellence
Receive evidence-based treatments delivered by senior NHS consultants in a professional, specialist setting.
Personalised Care Plans
Your consultant will design a bespoke treatment plan tailored to your specific health goals and lifestyle.
Hospital-Grade Safety
We operate within leading private hospitals, adhering to strict CQC safety and technology standards.
A Heritage of Trust
Our partners bring decades of NHS and private experience, successfully managing thousands of patient cases.
Trusted Resources
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Patient Guidance
Frequently Asked Questions
Common questions about this treatment and what to expect.
3 questions
For many men, yes. While TURP is effective for smaller prostates, HoLEP can treat prostates of any size and removes a larger volume of obstructing tissue. Studies show that HoLEP has a lower risk of bleeding, a shorter hospital stay, and a much lower chance that you will ever need a second operation in the future.
Reviewed 2 Mar 2026
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HoLEP does not typically cause erectile dysfunction; in fact, many men find their sexual confidence improves when their urinary symptoms are gone. However, the majority of men (around 80%) will experience 'Retrograde Ejaculation.' This means that during orgasm, the semen travels into the bladder instead of out of the penis. It is not harmful, but it does mean you may be unable to father children naturally.
Reviewed 2 Mar 2026
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Most men experience some 'urgency' leakage immediately after the catheter is removed as the bladder muscle adjusts. Genuine 'stress' incontinence (leaking when coughing or sneezing) occurs in about 5-10% of men but usually resolves within a few weeks as the pelvic floor muscles strengthen. Permanent incontinence is extremely rare (less than 1%).
Reviewed 2 Mar 2026
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