Holmium Laser Enucleation of Prostate for Treatment of Enlarged Prostate in New York City
by Dr. Alex Shteynshlyuger, a board-certified urologist, and specialist in the treatment of enlarged prostate, BPH and urinary retention. He is one of the first urologists in the US and NYC to offer Urolift and prostate enucleation, an alternative to traditional TURP as a treatment for enlarged prostate. He is an experienced surgeon who has performed laser enucleation of the prostate with Holmium, ProTouch, and other lasers.
What is HoLEP (Holmium Laser Enucleation of Prostate)?
Prostate enucleation is an effective treatment option for men with symptoms of enlarged prostate. When Holmium laser is used for prostate tissue removal during prostate enucleation procedure, the procedure is called Holmium laser enucleation of prostate abbreviated as HoLEP.
Holmium laser enucleation of the prostate is an effective alternative to bipolar TURP, and holmium laser ablation of prostate.
Men with symptoms of slowing intermittent urine flow, urinary retention, incomplete bladder emptying, frequent urination, and urge to pee as a result of prostate enlargement typically experienced significant improvement in symptoms after the HoLEP procedure.
Prostate enucleation through holmium laser is done through the urethra. The procedure can be done under general anesthesia or epidural anesthesia.
What are the Advantages of HoLEP?
The advantages of Holmium laser enucleation of prostate over holmium laser ablation of the prostate is at larger prostates can be effectively treated with HoLEP.
Holmium laser enucleation advantages over bipolar TURP and TURP include less blood loss, less heat damage to surrounding tissues due to the more precise delivery of energy which may lead to lower chances of sexual side effects associated with monopolar TURP surgery.
Compared to minimally invasive office procedures such as Urolift, and Rezum procedure for BPH, HoLEP achieves a better speed of urine flow (higher Qmax) and greater improvement in urinary symptoms.
What are the Alternatives to Holmium Laser Enucleation of Prostate (HoLEP) and How do they Compare?
Laser enucleation of the prostate (LEP) can be performed with lasers other than the Holmium laser. Other commonly used lasers for laser enucleation of prostate include ProTouch laser, Greenlight laser, Revolix Thulium laser among others. Success rates in improving urinary symptoms are similar among different lasers. While there are some differences among lasers, an experienced urologist can achieve comparable results with different lasers.
For patients with mild to moderate symptoms of enlarged prostate, medical treatment with medications for BPH may be effective. Minimally invasive procedures such as the Urolift stent for BPH and Rezum procedure may be effective. The advantage of holmium laser enucleation of prostate over medical treatment with medication such as Flomax and Proscar as well as minimally invasive procedures such as Urolift and Rezum is that HoLEP achieves a greater improvement in symptoms and effective for men with urinary retention. The trade-off is that recovery is longer after HoLEP than with minimally invasive treatment options and unejaculation is common after the procedure. Modified HoLEP procedure in an effort to preserve ejaculatory function is possible but may not always be successful.
Recovery after HoLEP
While patients are able to resume most regular activities within a week after holmium laser enucleation of the prostate, some urinary symptoms improve immediately after surgery, while other symptoms take 2-3 months to improve.
After HoLEP, men I advised to refrain from sexual activity and ejaculation for 4-6 weeks after the procedure.
What are the Risks of HoLEP?
Risks of all the past similar to risks of other surgical procedures for the large prostate. Common risks include UTI, bleeding, blood clot formations in the bladder and urinary retention. Rare risks include injury to the urethra, urethral stricture, bladder injury and injury to adjacent organs. As with any surgery requires anesthesia, anesthetic risks including pneumonia, DVT, PE and heart attacks are related to underlying patient’s health. Modern anesthesia is very good and millions of men, even very elderly and very sick, undergo major surgeries safely throughout the United States.
Why Choose New York Urology Specialists for Treatment of Urinary Retention Caused by Enlarged Prostate?
- All treatment is performed by a Board certified urologist experienced in treating men with symptoms of BPH using medical therapy, minimally invasive therapies, lasers and open surgery.
- We are one of the few practices in the region to offer a full range of options for treatment of BPH.
- We offer BPH treatment options under local anesthesia which avoids the risks, costs and recovery from general anesthesia. Most men are able to return to office work and other normal activities the next day.
- Extensive Experience: Hundreds of men treated successfully using medical therapy, Urolift, lasers for BPH (Holmium, Thulium, Evolve , Greenlight lasers), Bipolar TURP, traditional TURP, open suprapubic prostatectomy, robotic suprapubic prostatectomy for BPH.
- We treat men with BPH who have heart problems (hypertension, CAD, CHF), renal failure (ESRD) on hemodialysis, men on blood thinners such as aspirin, Lovenox, Coumadin (Warfarin), apixaban, rivaroxaban (Xarelto).
When it comes to experience and innovation – New York Urology Specialists are a step ahead. Better Science Means Better Care. We specialize in minimally invasive highly effective treatment for symptoms of enlarged prostate and BPH. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.
Medicare and major insurances accepted. We offer affordable rates and financing options.
Schedule an Appointment with Dr. Shteynshlyuger:
Dr. Alex Shteynshlyuger is a fellowship trained board certified urologist with expertise in evaluation and treatment of urinary problems in men. He uses modern effective and proven treatment methods including prostate enucleation and Urolift for BPH. He is highly recommended by top primary care physicians in the New York area.
He has successfully performed hundreds of prostate procedures in adults. Urolift procedures are performed in the office under local anesthesia, in a surgical center and affiliated hospitals under anesthesia.
We offer affordable, highest-quality urology care with or without insurance. Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.