HoLEP and TURP are two popular surgical treatments for BPH. TURP involves shaving away problematic prostate tissue, while HoLEP separates the tissue from the outer capsule before removing it.

HoLEP vs TURP: Which Enlarged Prostate Surgery Is Better?

Benign Prostatic Hyperplasia (BPH) is a common condition affecting men, especially those above 50. According to Harvard Health, around 50% of men above 60 years are likely to have an enlarged prostate. The percentage jumps to 90% for men above 85.

For decades, TURP (Transurethral Resection of the Prostate) was considered the gold-standard procedure for benign prostatic hyperplasia treatment in Navi Mumbai, but a newer surgery: HoLEP (Holmium Laser Enucleation of the Prostate) has also been gaining popularity lately. Let’s understand each procedure, along with benefits and limitations.

Benign Prostatic Hyperplasia: When Does it Require Surgery?

The prostate gland sits at the base of the bladder. Since it is so closely connected to the male urinary tract, its enlargement can cause a range of urinary symptoms. This mainly happens because an enlarged prostate squeezes the urethra (the tube carrying urine out of your body through the penis).

Initially, you might notice frequent trips to the restroom throughout the day and night, but when the condition progresses, these urinary issues become more bothersome. For example, you might experience a weak stream or a feeling that your bladder is not fully emptied despite urinating frequently.

Over time, the symptoms worsen and the risk of complications, such as bladder stones, recurrent urinary tract infections, acute urinary retention, or impaired kidney function, increases. When medication and conservative treatments are no longer effective, a urologist may discuss surgical procedures.

What is TURP?

During TURP, a urologist inserts a thin instrument that has a heated electrical wire loop at its tip into the urethra. Once it reaches the enlarged prostate, the surgeon gently moves the wire loop to cut away the prostate tissues that block urinary flow.

The tissue is shaved away in tiny pieces, and with the help of irrigation fluid, it is flushed into the bladder. Once done, the tiny tissue chips are suctioned out of the bladder through the resectoscope.

Once the tissue that causes urinary issues is removed, the urethra becomes wider again, and urine can pass freely. The entire procedure takes between 60 and 90 minutes and can be performed with general or spinal anesthesia.

Benefits

A trusted treatment for enlarged prostate
No external incisions needed
Excellent symptom relief
Improved urine flow
Improved overall quality of life

Limitations

Not an appropriate choice of treatment for men with a very large prostate
Requires a hospital stay for 1-3 days
It causes retrograde ejaculation

What is HoLEP?

HoLEP is another minimally invasive BPH surgery, where the enlarged prostate tissue is separated from the capsule and is gently pushed into the bladder. These tissues are then cut into smaller pieces and removed through the same device.

The removed tissue is sent to the lab for further testing, just to rule out prostate cancer. The entire procedure is conducted through the urethra without external incisions. Since the laser seals off blood vessels, there’s considerably less bleeding than in TURP.