Procedure · Prostate

HoLEP surgery in Yorkshire

Last updated: 9 June 2026 · Reviewed by Mr Sanjay Rajpal, Consultant Urological Surgeon · GMC 6106646

HoLEP is a laser operation for men whose enlarged prostate is blocking urine flow. Mr Sanjay Rajpal offers private assessment for HoLEP and other enlarged prostate treatments through clinics in Leeds and Bingley.

Best suited to: men with significant obstruction, urinary retention, larger prostates, recurrent symptoms despite medication, or a need for durable prostate surgery.

What HoLEP is

HoLEP stands for Holmium Laser Enucleation of the Prostate. A telescope is passed through the waterpipe, and a laser separates the obstructing inner prostate tissue from the outer capsule. The tissue is then removed from the bladder. There are no cuts on the skin.

When HoLEP may be considered

Medication has not controlled urinary symptoms.
The prostate is large or the blockage is marked.
There has been urinary retention or repeated catheterisation.
There are complications such as bladder stones, recurrent infection or kidney strain related to obstruction.
The priority is a durable operation rather than a smaller symptom-relief procedure.

How it compares with other treatments

HoLEP is one option among several. GreenLight laser, Aquablation, TURP, Rezum, UroLift and medication can all be suitable in the right circumstances. The decision depends on prostate size, anatomy, bladder function, bleeding risk, sexual priorities and how strongly symptoms affect daily life.

Assessment before surgery

Assessment usually includes symptom scoring, urine testing, flow rate, bladder scan, PSA review, prostate imaging where needed and a discussion of risks and alternatives. Some men need cystoscopy or prostate MRI before a final recommendation is made.

Recovery and expectations

Most men notice a stronger flow quickly, but urgency, frequency and mild bleeding can take weeks to settle while the inside heals. Retrograde ejaculation is common after tissue-removing prostate surgery. Continence usually improves as swelling settles, but temporary leakage can occur and will be discussed before consent.

Questions to ask before deciding

Useful questions include: how large is my prostate, how much urine is left behind after I pass urine, is the bladder still strong, and is HoLEP the most suitable option for my anatomy? It is also worth asking about catheter timing, return to driving, return to work, blood-thinning medicines, sexual side-effects and the chance of needing another procedure in future.

Why experience matters

HoLEP is a specialist operation with a learning curve. The quality of assessment matters as much as the operation itself: not every man with urinary symptoms needs surgery, and not every prostate operation gives the same balance of durability, bleeding risk and sexual side-effects. A careful consultation should make the reasoning behind the recommendation explicit.

Private clinics

Initial consultation is available at Spire Leeds Hospital and The Yorkshire Clinic in Bingley. The secretary can help with appointment choice, insurance authorisation and self-pay information.