HoLEP (Laser Prostate Surgery): What to Expect

HoLEP uses a laser to remove the inner part of an enlarged prostate that blocks urine flow. It works well even for large prostates. A catheter is used for a short time afterward.

Warning signs

Before your procedure

Take only the medicines your care team approved. If you take a blood thinner, aspirin, or a supplement and were not told what to do, call the office — do not stop anything on your own.
Arrange a ride home, since you may receive sedation or anesthesia.
Follow your fasting instructions.
Plan for a possible overnight hospital stay.

The day of

Under anesthesia, your care team uses a laser to separate and remove the blocking prostate tissue, then clears it from the bladder. A catheter is placed, sometimes with a gentle bladder rinse. Many people stay overnight.

The first few days

The catheter usually comes out within a day. After it is removed, expect:

Blood in the urine that comes and goes
Burning, urgency, and frequent urination
Some leaking of urine at first — this is common early on and usually improves

Pelvic floor (Kegel) exercises help with early leaking. Drink plenty of water. See the Catheter Care Guide while the catheter is in.

The first few weeks

Early leaking usually improves over the following weeks. As with TURP, urine may turn bloody again around 1 to 2 weeks when an internal scab heals — rest and fluids usually settle it. A dry orgasm (semen going into the bladder) is common and not harmful.

Avoid heavy lifting and hard exercise for about 2 to 4 weeks.

When to call your care team

Call the office number on your discharge paperwork right away, or seek emergency care, if you have any of these:

You cannot urinate at all after the catheter is removed
Heavy bleeding or clots that block urination
Fever of 100.4°F (38°C) or higher, or shaking chills
Severe pain not helped by your medicine

If you have chest pain, trouble breathing, fainting, or another life-threatening emergency, call 911.

Warning signs