Holmium Laser Enucleation of Prostate (HoLEP) is used in the management of enlarged prostate. In this, Holmium laser is used to remove the obstructive tissue and also to seal the blood vessels.
In this procedure, a resectoscope is inserted into the urethra through penis. Then a 550 micron fibre attached to the 100 watt Holmium laser machine is passed through it, which enucleates the excessive prostatic tissue. The enucleated gland is then pushed into the bladder, which is then shred into smaller pieces and sucked out using a device called Morcellator. The procedure takes around 15-90 minutes, depending upon the size of the prostate gland. HoLEP is almost bloodless as the laser beam seals the blood vessels also. At the end of the surgery, a catheter is inserted to keep the bladder empty. The catheter is usually kept for 24–48 hours. After the catheter removal, patient is discharged.