The New Gold Standard in Surgical Treatments for BPH
Holmium Laser Enucleation of Prostate (HoLEP)
Mr Pham has been dedicated to providing advanced HoLEP surgery since 2003, bringing over two decades of specialised expertise to patients suffering from enlarged prostates.
What is HoLEP?
HoLEP is a modern, less invasive surgical technique used to treat an enlarged prostate. Unlike traditional surgery, it uses a high-powered laser to remove the obstructing prostate tissue completely, offering a safer alternative with less complications and a faster recovery path for patients.
Why it’s the new gold standard
With over 20 years of clinical evidence, research shows that HoLEP achieves results that are better than or equal to older methods like TURP or open surgery with less bleeding, faster recovery and lower reoperation rates. Its long-term durability and safety profile have made it the preferred clinical choice for surgeons and patients worldwide.
About BPH (Enlarged Prostate)
Benign Prostatic Hyperplasia (BPH) is a natural non-cancerous growth of the prostate gland. It is extremely common as men age, affecting approximately 50% of men in their 50s and up to 90% of men over 80.
Common Symptoms:
- A weak or interrupted urinary stream
- Difficulty starting urination
- Frequent need to urinate, especially at night
- A sudden, strong urge to urinate
- Feeling that the bladder is not completely empty
When is surgery needed?
Surgery is usually considered when lifestyle changes and medications no longer manage symptoms effectively. It becomes essential if complications arise, such as recurrent urinary infections, bladder stones, blood in the urine, or complete inability to pass urine (retention).
Key Advantages of HoLEP
Works for all prostate sizes
HoLEP is versatile and can safely treat very small to very large prostates, often replacing the need for open surgery.
Short hospital stay & quick recovery
Most patients spend only one night in the hospital and return to their normal activities much faster than traditional surgery.
The precision of the laser seals blood vessels as it works, significantly reducing post-operative bleeding.
Lower bleeding risk
Suitable even on blood thinners
Because of its low bleeding risk, HoLEP can be performed on patients who are required to take anticoagulant medications.
Very low retreatment rate
By removing the entire obstructive part of the gland, the chances of the prostate growing back and needing surgery again are minimal.
Tissue available for testing
Unlike some laser methods, HoLEP preserves the removed tissue so it can be sent for a biopsy to ensure no cancer is present.
Main Surgical Options for BPH
TURP (Transurethral Resection)
- The traditional method using an electrical loop to trim away prostate tissue.
- Pro: Well-established and effective for many.
- Con: Higher risk of bleeding; not suitable for severely enlarged prostate; longer hospital stay and recovery time compared to modern laser treatments.
Laser Ablation (example GreenLight)
- Vaporises prostate tissue using high-energy light.
- Pro: Lower bleeding risk than TURP.
- Con: No tissue is preserved for pathology testing; less effective for very large prostates; higher chance of needing repeat surgery.
Suprapubic Open Prostatectomy
- The oldest method, requiring a large incision to remove very large glands.
- Pro: Effective for extremely large prostates.
- Con: Invasive; high risk of significant bleeding; long hospital stay and significant recovery time.
HoLEP (The Modern Choice)
- Enucleates the whole obstructing gland using laser
- Pro: Extremely low risk of significant bleeding; shorter hospital stay; quicker recovery time; lower reoperation rate; suitable for all prostate sizes including extremely enlarged prostates
- Con: Requires specialist surgical expertise.​
HoLEP has been well-studied for over twenty five years. It is proven to be effective and extremely safe with long term durability. It is currently considered a gold standard in surgical treatments for BPH. If you are experiencing symptoms, we invite you to discuss whether HoLEP is the right choice for you with Mr Trung Pham.