The HoLEP technique—known in specialist fields as Holmium Laser Enucleation of the Prostate—is an endoscopic urological procedure used to treat Benign Prostatic Hyperplasia (BPH) or an enlarged prostate.

It is indicated for prostates of any volume exceeding 30 milliliters and serves as the clinical gold standard for significantly enlarged prostates over 80 milliliters.

We discussed this procedure with Dr. Claudio Perugia, a urology specialist at Arsbiomedica who focuses on treating BPH using advanced laser prostate surgery.

What Does the HoLEP Technique Involve?

Clinical guidelines establish HoLEP as a primary treatment option alongside traditional open surgery for significantly enlarged prostates.

To visualize the process, imagine the prostate as an orange or mandarin, consisting of the central fruit inside an outer peel. The objective of a deobstructive procedure is to remove the inner fruit while leaving the outer peel intact.

Using a Holmium laser, the HoLEP technique enables complete enucleation—essentially shelling out the entire core of the fruit while preserving the outer capsule.

What Are the Benefits of the Holmium Laser?

The Holmium laser is a highly versatile tool that excels at both tissue enucleation and hemostasis (blood loss prevention).

Patients often mistake laser treatment for a technique that simply vaporizes prostatic tissue. However, HoLEP uses the laser to enucleate—or core out—the central portion of the “orange” while leaving the outer capsule untouched.

The laser’s exceptional hemostatic effect results in a significantly lower risk of bleeding compared to standard resection methods. By operating along the natural boundary between the adenoma (the inner fruit) and the capsule (the outer peel), surgeons work within an area that has fewer blood vessels than the surrounding tissue layers.

What Are the Key Advantages of HoLEP?

In terms of hospital stay, HoLEP is comparable to other endoscopic procedures, typically requiring a stay of two to three days. The urinary catheter is usually removed on the first or second post-operative day, and the patient is discharged the following day once spontaneous urination is restored.

The Urology Center at Arsbiomedica Clinic guides patients through every phase of care—from the initial consultation to selecting the most suitable treatment using advanced diagnostic tools. Following surgery, patients recover in a comfortable environment with dedicated support from our urologists and healthcare specialists until full recovery is achieved.