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Holmium Laser Enucleation of the Prostate (HoLEP)

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Minimally Invasive Urology

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Abstract

Holmium laser enucleation of the prostate (HoLEP) is a transurethral procedure optimized for the removal of obstructing adenomatous tissue of the prostate to improve urinary function for men with lower urinary tract symptoms from benign prostate hyperplasia (LUTS/BPH). The procedure was first performed in the United States in 1998 and has since been shown in multiple randomized controlled trials to provide the most durable and sustained improvement in LUTS for men with BPH, independent of bladder health, retention status, prostate size, and anticoagulation status. Critics of HoLEP point to high rates of incontinence, retrograde ejaculation, and a steep learning curve as obstacles to the universal adoption of HoLEP for the surgical management of LUTS/BPH. Appropriate counselling about the transient nature of the associated urinary incontinence and a multimodal approach, including self-directed learning, video review, and mentored operations, can reduce the learning curve and expedite surgical mastery of HoLEP. In this updated chapter, we review the current literature, the step-by-step process and necessary equipment, as well as the complications associated with HoLEP.

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Disclosures

  • T. Large: None

  • Krambeck: Boston Scientific, Consultant; Lumenis, Consultant; Cook Medical, Advisor

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Authors and Affiliations

  1. Department of Urology, Indiana University Methodist Hospital, Indianapolis, IN, USA

    Tim Large & Amy E. Krambeck

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  1. Tim Large
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  2. Amy E. Krambeck
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Correspondence to Amy E. Krambeck .

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Editors and Affiliations

  1. Department of Urology, University of Wisconsin–Madison, Madison, WI, USA

    Sara L. Best

  2. Department of Urology, University of Wisconsin–Madison, Madison, WI, USA

    Stephen Y. Nakada

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Large, T., Krambeck, A.E. (2020). Holmium Laser Enucleation of the Prostate (HoLEP). In: Best, S., Nakada, S. (eds) Minimally Invasive Urology. Springer, Cham. https://doi.org/10.1007/978-3-030-23993-0_15

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  • DOI: https://doi.org/10.1007/978-3-030-23993-0_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-23992-3

  • Online ISBN: 978-3-030-23993-0

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