Holmium Laser Enucleation of the Prostate (HoLEP): The Endourologic Alternative to Open Prostatectomy

Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate

“…Similar treatment outcomes have been demonstrated when HoLEP was compared to open prostatectomy for the treatment of large prostates. Surgical time and removed tissue weight were better in open prostatectomy, but duration of catheterization, hospital stay and bleeding were better in HoLEP (9,11,20,21 HoLEP can be performed effectively after about 50 cases, with an outcome comparable to that of experts (12). Their conclusion was based on enucleation efficacy analysis and complication rate.…”

Holmium Laser Enucleation of the Prostate: Modified Technical Aspects

“…The results of HoLEP, as evidenced by PSA data, TRUS, the weight of tissue resected, urodynamic variables and data from many randomized trials, systematic reviews and meta-analyses, confirmed the effectiveness and durability of this technique [2][3][4][5][6][7]. HoLEP reproduces the removal of the whole obstructing adenoma (transitional zone) of the prostate by surgical enucleation, similar to the technique of using the index finger in open prostatectomy.…”

Canadian trend in surgical management of benign prostatic hyperplasia (BPH) and laser therapy from 2007-2008 to 2011-2012

“…7 However, despite excellent long-term durable results independently of prostate size, HoLEP has not gained widespread use among urologists. This limited diffusion is attributed to its technical difficulty and steep learning curve.…”

“…In particular, minimally invasive laser treatments including transurethral holmium laser enucleation of the prostate (HoLEP) and photoselective vaporization of the prostate (PVP) are currently challenging TURP as the first line surgical treatment of choice. [5][6][7][8] After more than decades of decline in BPH surgeries largely represented by TURP, an increased rate of BPH surgeries is observed and is largely driven by the novel laser treatments. In fact in the United States, TURPs represent a minority of all BPH procedures and continues to decline, while GreenLight (AMS, Minnetonka, MN) vaporization of the prostate is the fastest growing modality.…”