Holmium Laser Prostate Surgery in Delhi, India

Holmium laser prostate surgery (HoLEP) is a procedure that is most often used to treat BPH. BPH is a condition that causes an enlarged prostate, resulting in compression of the urethra, preventing urine from passing through. 

The procedure is minimally invasive, employing a laser beam to remove excess tissue from the prostate, and relieve symptoms. It carries lower risks compared to traditional methods for treating BPH.

Before undergoing surgery, the doctor will explain the steps of the procedure. This will ensure the patient is fully prepared and well-informed. After the consultation, the doctor may recommend discontinuing certain medications, such as blood thinners, at least a week before surgery. Antibiotics and painkillers will also be prescribed to fight off any bacterial infections and alleviate any pain symptoms. 

Before surgery, the doctor will also order the following tests to determine if HoLEP is the right procedure: 

• PSA Test: A PSA (prostate-specific antigen) test measures the levels of PSA in the body. High levels of PSA may indicate the presence of prostate cancer.
• Urinalysis: A urinalysis will be conducted prior to the surgery to assess the urine for any indicators of infection or abnormalities, including the presence of blood or unusual substances. The test is essential to confirm the urinary tract is free from complications before proceeding with surgery.
• Imaging Tests: Imaging procedures such as a CT scan or transrectal ultrasonography will be performed to assist the doctor in estimating the size of the prostate.
• Cystoscopy: Cystoscopy is the procedure done to examine the urethra, prostate, and bladder to check for obstructions, infections, or cancer.

The procedure typically involves administering either general or spinal anaesthesia to ensure patient comfort. The surgeon uses a specialised instrument called a resectoscope, which is carefully inserted through the urethra to reach the prostate. A Holmium laser is used to remove the excess prostate tissue causing the obstruction. Depending on the case, the removed tissue may either be flushed out or collected for further analysis if necessary.

Post-operative care following the procedure typically involves a brief hospital stay, usually not exceeding 24 hours, for monitoring purposes. A temporary catheter may be inserted to assist with urination during the initial healing phase. Mild discomfort, minimal bleeding, or a slight burning sensation during urination are common, and typically resolve within a few days.

Most patients experience noticeable improvements in urinary flow and symptom relief within the first week following surgery. The recovery process is generally quicker compared to traditional surgical methods, with many individuals returning to regular routines within two weeks.

Following are some of the advantages of HoLEP surgery:

• Minimally Invasive: This advanced treatment requires no external incisions, offering a less invasive alternative to traditional surgeries.
• Shorter recovery: Due to its minimally invasive nature, recovery time is significantly shorter compared to traditional surgical options.
• Improved urinary function: With excess prostate tissue removed, the urethra is no longer compressed and begins functioning normally. 
• Safe for large prostates: The procedure is effective for removing significant amounts of prostate tissue without requiring skin incisions.

As with any surgery, HoLEP carries certain risks, including but not limited to:

• Infection: As with any surgical procedure, there is a risk of infection, though this is generally rare with proper post-operative care.
• Urinary incontinence: A small percentage of patients may develop temporary urinary incontinence, which typically resolves within a few months but may persist in rare cases. 
• Injury: There is a potential risk of injury to surrounding structures, such as the prostate, urethra, or bladder, though such complications are uncommon.
• Temporary bleeding: Mild bleeding during urination is common in the first few days after surgery and usually resolves without intervention.

Will Holmium Laser Prostate Surgery affect sexual function?

The Holmium Laser Prostate Surgery is designed to address prostate enlargement problems with minimal impact on sexual function. Although rare, some men may experience retrograde ejaculation, where semen enters the bladder instead of being expelled through the penis.

How long will it take before I can go back to work or resume normal activities after the procedure?

Most patients can resume light activities, including returning to work, within 1–2 weeks after the procedure. However, heavy lifting and strenuous exercise should be avoided for 4-6 weeks to promote proper recovery.

Is Holmium Laser Prostate Surgery appropriate for those who are suffering from other ailments as well?

Yes, this procedure is generally safe for patients with other medical conditions, such as diabetes or heart disease, as it is minimally invasive and results in minimal blood loss. 

Will I need a catheter after surgery, and for how long?

In most cases, a catheter is used post-surgery to assist with urination and allow the urinary tract to heal. It is typically removed within a span of one or two days, though this may vary depending on the patient's recovery.

Can this surgery be repeated if symptoms return in the future?

Holmium Laser Prostate Surgery can be repeated if necessary, although this is rare. The procedure typically provides long-term relief, with most patients experiencing significant improvement in their symptoms. However, if symptoms do return, the doctor will assess the situation and recommend the most appropriate treatment based on the individual case.

Reviewed by Dr. Vimal Dassi, Senior Director - Urology, Uro-oncology, Kidney Transplant, Robotic Surgery, on 09 December 2025