Disclaimer: the following information is general advice only and should not replace advice your personal physician has given you as each patient and clinical situation is unique.

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1).  What are typical symptoms of an enlarged prostate?

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Symptoms of an enlarged prostate typically include weak urinary stream, straining to empty, sensation of incomplete bladder emptying, urinary urgency or frequency, night time urination or hesitancy. Having such symptoms does not necessarily mean you have an enlarged prostate as other conditions can also cause similar symptoms.

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2) What is HoLEP?

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HoLEP stands for Holmium Laser Enucleation of the Prostate.  It is a size independent treatment option for enlarged prostate and urinary tract symptoms.  In other words, there is no prostate too large or too small for HoLEP.

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3) What are the benefits of HoLEP? 

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HoLEP is an "enucleation" based surgical technique, which means that all possible obstructing glandular tissue is removed, which results in long-lasting results. It provides similar benefits as robotic simple or open simple prostatectomy, but is much less invasive. Most other surgical techniques out there including Urolift, ReZUM, Transurethral resection of the prostate (TURP), Greenlight laser photovaporization (PVP or "laser prostatectomy"), Aquablation, or Transurethral Microwave therapy (TUMT) all result in partial removal of the blocking tissue, which usually leads to need for re-treatment in 5-10 years.  Furthermore, since all blocking prostate tissue is removed, HoLEP leads to excellent improvements in urinary flow rates and reductions in the amount of urine left in your bladder after voiding.

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4) Are there any downsides to HoLEP?

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The two main side effects after HoLEP include permanent retrograde ejaculation and temporary urinary incontinence.  HoLEP causes no negative effects on your erections and men can still have an orgasm, but no semen will come out. This occurs because once the prostate is maximally opened, the path of least resistance for the semen after orgasm is to go backwards into the bladder.  This is not dangerous and the semen is simply urinated out later. 

The temporary leakage sounds awful, but temporary is the key word. Furthermore, the leakage can often be prevented or reduced by performing Kegel exercises before and after the surgery. The leakage doesn't occur in everyone and usually resolves shortly (weeks - months) after the surgery. 

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5) Am I a candidate for HoLEP?

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You certainly may be! Call to schedule a consultation with Dr. Lee to find out more (Clinic Scheduling line: 614-293-8155)

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6) Why should I have HoLEP with Dr. Lee?

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HoLEP is difficult to learn so it is important to go to a highly experienced surgeon to make sure you have the best possible outcome.  Dr. Lee matched to and completed a highly competitive fellowship with Dr. Amy Krambeck. He learned how to perform HoLEP from one of the most experienced HoLEP surgeons in the world and he is proud to be able to offer HoLEP to the people of Ohio.  Research shows that it takes at least 50 HoLEPs to become proficient at the surgery and Dr. Lee completed over 300 HoLEPs during his fellowship with Dr. Krambeck.  As a testament to his HoLEP skills, Dr. Lee has participated in multiple courses to teach other surgeons how to perform HoLEP (AUA 2022, WCE 2022, and will also teach at AUA 2023).  Lastly, at Ohio State University, Dr. Lee uses the Lumenis Moses 2.0 laser, which is the best laser available on the market.  He is currently the only surgeon in central Ohio to perform HoLEP.

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7) What happens to the urethra?

 

The urethra is an organ that is only a few millimeters thick. The portion of the urethra that goes through the prostate is removed along with the prostate tissue.  However, since the outer part of the prostate is left in place after HoLEP, your "urethra" will grow back from the healthy tissue in your bladder and in the penis to cover the inner part of the hollow prostate.

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