Holmium laser prostatectomy: current techniques.
BACKGROUND
During the past 7 years, holmium laser prostatectomy has evolved into an enucleation procedure, incorporating the use of established surgical planes. Holmium laser enucleation of the prostate (HoLEP) uses the excellent incisional and hemostatic properties of the holmium laser wavelength. Clinical outcomes with this may be superior to transurethral resection of prostate. HoLEP is also a minimally invasive therapy for larger glands that have traditionally been treated by open prostatectomy.


METHODS
There are four steps to performing HoLEP: (a) creation of bladder neck incisions, (b) enucleation of the median lobe, (c) enucleation of the lateral lobes off the prostatic capsule, and (d) transurethral morcellation. In most cases, postoperative irrigation is not needed and the catheterization time is less than 24 hours.


CONCLUSIONS
HoLEP is an emerging technique in the surgical management of benign prostatic hyperplasia. There is a learning curve with this procedure, because the technique is very different from transurethral resection of prostate.
Tan
Andrew H H
AH
Department of Urology, Tauranga Hospital, Tauranga, New Zealand.
Gilling
Peter J
PJ
D006695:Holmium; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D011468:Prostatectomy / Q000295:instrumentation / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013525:Surgical Instruments; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery
D006695:Holmium