Advances in HoLEP technology and technique – Current state of play

Abstract

Background: Until recently, Holmium laser enucleation of the prostate (HoLEP) utilisation has been limited despite its perceived benefits over alternative surgical and minimally invasive benign prostatic hyperplasia (BPH) treatments. Objective: The purpose of this review is to highlight our experience with recent advances in laser and morcellator technologies that have made it easier for urologists to consistently offer HoLEP as a safe, efficient, and effective in an ambulatory (day surgery) setting. Methods: Our narrative review focused on contemporary studies published within the last five years. Conclusions: Technological advances coupled with increasing availability of training opportunities has and will continue to improve patients’ accessibility to the gold standard in BPH surgical treatment. Furthermore, we will describe refinements in laser enucleation techniques that have improved procedural efficiencies, rates of temporary post-operative urinary incontinence, and preservation of sexual function. The effects of technical modifications on functional and durability outcomes are to be seen in further prospective studies. Level of Evidence: Level 7 (Expert Opinion)