HoLEP Surgery Melbourne
Holmium Laser Enucleation of the Prostate (HoLEP) is a gold-standard minimally invasive procedure for treating benign prostatic hyperplasia (BPH), or enlarged prostate. Dr Dias pioneered Day Case HoLEP at Western Health, enabling same-day discharge with excellent outcomes for urinary flow and symptom relief.
Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)
Last clinically reviewed: 26 August 2026
Benefits
- Gold-standard treatment for BPH with highest success rates
- Suitable for prostates of any size, including very large glands
- Minimal blood loss compared to traditional TURP
- Same-day discharge possible (Day Case HoLEP)
- Lower retreatment rates compared to other BPH procedures
- Tissue can be sent for pathology to exclude hidden cancers
- Rapid improvement in urinary symptoms
- Long-lasting results with excellent durability
The Procedure
HoLEP is performed under general or spinal anaesthesia. Using a specialised endoscope passed through the urethra, Dr Dias uses holmium laser energy to precisely separate the enlarged prostate tissue from the surrounding capsule—similar to scooping out the flesh of an orange from its peel. The removed tissue is then pushed into the bladder, morcellated (cut into small pieces), and removed. This technique allows complete removal of the obstructing tissue regardless of prostate size, which is why HoLEP is effective for even very large prostates where other techniques may not be suitable.
Who Is a Candidate?
HoLEP is ideal for men with moderate to severe lower urinary tract symptoms (LUTS) caused by BPH who have not responded adequately to medications. It is particularly suitable for men with larger prostates (over 80 grams) where other procedures may be less effective. Men taking blood-thinning medications can often safely undergo HoLEP due to its excellent haemostatic properties. Dr Dias will assess your symptoms, prostate size, and overall health to determine if HoLEP is the best option for you.
Recovery
As a Day Case procedure, many patients are discharged on the same day of surgery. A catheter is typically required for 1-2 days post-operatively. Most patients notice immediate improvement in urinary flow once the catheter is removed. Mild burning during urination and blood in the urine are common initially and resolve within 1-2 weeks. Normal activities can usually be resumed within 2-3 days, with full recovery expected within 2-4 weeks. Sexual function is typically preserved, though retrograde ejaculation (dry orgasm) occurs in the majority of patients.
Risks & Considerations
HoLEP is a very safe procedure with low complication rates. Potential risks include urinary tract infection, temporary urinary incontinence (usually stress incontinence that resolves within weeks), bleeding requiring transfusion (rare), urethral stricture, and retrograde ejaculation. The risk of requiring a repeat procedure is very low (less than 2% at 10 years), which is significantly lower than other BPH treatments.