Holep Surgery Turkey

What is the meaning of Holep?

It is the abbreviation of prostate enucleation (holmium laser enucleation of the prostate) procedure performed with holmium laser (removal by carving out the outer sphere, capsule).

Later, with the developing technology, the abbreviations Thulep with thulium laser and Thuflep with thulium fiber laser were added to the terminology.

What is Holep operation?

It is a surgical method performed using holmium and thulium laser for benign prostate enlargement. The aim is to widen the channel (urethra) that passes through the prostate and provides urine flow.

While the outer capsule of the prostate is preserved, the round adenoma tissue inside is removed as a whole like a ball with the help of laser (enucleation process) and aspirated by breaking it into small pieces with special tools in the bladder.

How is Holep surgery performed?

Holep surgery is performed with special instruments with cameras inserted from the tip of the penis. There is no incision. Prostate tissues are removed with holmium and thulium lasers specialized for this procedure.

How long does Holep procedure take?

The duration of these surgeries varies depending on the prostate volume. It usually varies between 30 minutes and 180 minutes.

How many days should I stay in the hospital after Holep?

After laser prostate surgery, a 1-2 night stay is usually sufficient. One of the most important advantages of Holep and Thulep surgeries is the short hospital stay and catheterization time. Therefore, it provides rapid recovery.

Advantages of Holep prostate surgery

• Fast recovery
• No erectyl dysfunction side effects
• Low probability of prostate recurrence
• Safer in patients using blood thinners
• Minimal bleeding
• Very rare development of urinary incontinence (<%1)
• Applicability to every prostate volume

Does HoLEP remove the entire prostate?

In this method, compared to TUR-P surgery, the majority of the adenoma tissue blocking the urinary tract of the prostate is removed. However, by leaving the prostate capsule untouched, urinary incontinence and erectile dysfunction are prevented.

Urinary incontinence after Holep surgery

The probability of permanent urinary incontinence after laser prostate enlargement surgery is less than 1%. Generally, mild urinary incontinence due to sudden urges that may last for a few days will heal on its own.

Holep surgery side effects

As I frequently mentioned above, contrary to popular belief, side effects are very few in Holep and Thulep surgeries. Burning urine is expected for a few days after the surgery. Occasionally, pinkish particles and particles may be seen in the urine. Sometimes there may be mild urinary incontinence for a few days.

Persistent urinary incontinence is a very rare condition (<1%). Impairment of erection is not expected. As with other endoscopic prostate surgeries, some semen may escape into the bladder (retrograde ejaculation). This condition occurs in 20% of cases and has no medical risk. There is no obstacle for these patients to have children.

Is Holep a major surgery?

Laser prostate surgeries can be easily performed with spinal anesthesia and are generally low-risk surgeries because bleeding control is very good.

Does Holep affect sexual life?

Erectile dysfunction is not expected after laser prostate surgery. Especially since thulium laser (THULEP and THUFLEP surgery) distributes energy to the surrounding tissues with a depth of 0.2 mm, the nerves that provide erection are not damaged.

Recovery after Holep procedure

1-2 days after laser prostate surgery, patients can easily carry out their daily activities. For work requiring heavy activity, 2 weeks is recommended.

Is there a pathology result in Holep surgery?

Pathological examination of patients who have undergone prostate surgery by enucleation with Holep and Thulep is also routinely performed. However, the old method, green-light laser, did not allow pathological examination because the prostate tissues evaporated.

Holep or Tur-P?

In enucleation surgeries for prostate enlargement performed with holmium and thulium laser, the probability of recurrence is low as the adenoma tissue of the prostate is removed anatomically better. The probability of recurrence of prostate enlargement is higher in TUR-P surgery.

Again, since the energy dissipation applied to the surrounding tissues by laser is less, the possibility of urinary incontinence is less in HOLEP and THULEP surgeries than in TUR-P, and there is no erectile dysfunction. These laser enucleation methods can be applied for any prostate volume. However, TUR-P is generally not preferred over 80 cc. In addition, minimal bleeding, fast recovery time, and less catheterization (1-2 days) are the advantages of Holep and Thulep over TUR-P.

Hospitals that perform Holep surgery in Turkey

Prostate surgery performed with Thulium or Holimium Laser was performed by Assoc. Prof. Dr. Arif Demirbaş at Doruk Nilüfer Hospital.

Holep surgery cost Turkey

The price of this surgery varies depending on the equipment of the surgeon who will perform this procedure, his interest and experience in this surgery, prostate volüme and the equipment and comfort conditions of the hospital.