HoLEP Frequently Asked Questions

Is HoLEP cancer surgery?

No. HoLEP treats non-cancerous growth of the prostate gland.

The removed tissue is examined to rule out incidental cancer. A clear histology is reassuring, not a diagnosis.

Will I be awake during the operation?

That depends on your anaesthesia choice. General anaesthesia puts you to sleep.

Spinal anaesthesia numbs the lower half of your body. You stay awake but feel nothing during the procedure.

How long does the operation take?

Thirty minutes to two hours, depending on prostate size. Positioning, enucleation, and morcellation each take a share of the total time.

Very large prostates take longer. Your surgeon will estimate your own time at pre-op.

How long will the catheter stay in?

Often one to two days. Some centres run same-day catheter removal for selected men.

Your team monitors the washout colour and your comfort before removal.

How much will it hurt?

Pain after HoLEP is usually mild. Paracetamol and a short opioid course are enough for many men.

Stinging while passing urine is a common early complaint for the first few days, not true pain.

How soon can I go home?

Many men go home the day after surgery. Some go home the same evening.

A fit man with a smooth operation may fit a day-case pathway.

When can I drive?

When you can perform an emergency stop without pain or hesitation. That is usually around seven to ten days.

Plan around traffic. A long jam can leave the bladder full while the prostate fossa is still healing.

When can I go back to work?

Desk work in week two for many men. Manual work waits three to six weeks depending on the job.

The six-week review is a common checkpoint for return to heavy work.

Will HoLEP change my sex life?

Retrograde ejaculation — semen going backward — is common. Erections usually stay the same, and orgasm sensation typically does not change.

If sexual function is a major concern, raise it before the operation so ejaculation-preserving options can be discussed.

Will I leak urine afterwards?

A small minority of men have temporary leaks in the first weeks. Pelvic floor exercises and time handle the issue for many men.

Leaks that persist beyond one year are uncommon and have specific treatments available.

What risks should I know about?

Bleeding that needs transfusion, bladder-neck contracture, temporary incontinence, and rare injury to nearby structures. Serious complications are uncommon.

Your surgeon discusses your own risk numbers at pre-op.

Is HoLEP right for me?

Whether HoLEP fits you depends on prostate size, your health, your priorities, and your surgeon's training. Other techniques may be a better fit in some situations.

A shared decision conversation with your urologist sorts this out.

Can I eat and drink normally after HoLEP?

Yes. Normal food and fluids restart the same day as the operation once your team is happy.

Drink enough water to keep urine pale. Limit caffeine and alcohol in the first week.

How often do I need follow-up?

Visits at six weeks, three months, and one year are common. After that, annual review or a return to primary-care follow-up is the usual pattern.

Bring your IPSS score to every visit.

What if symptoms come back years later?

Symptom return over many years is possible but uncommon. A new IPSS rise is the usual trigger for review.

A 2026 expert consensus from the BEAM meeting confirms the value of structured follow-up and standardised monitoring after endoscopic enucleation[¹]. Options range from lifestyle review to a short repeat procedure if needed.

Can I get a second opinion?

Yes, and it is a sensible step for any elective surgery. Bring your notes, your IPSS, and any imaging.

A consistent plan across two surgeons is reassuring.

What if I change my mind?

You can change your mind any time before the operation. A change of plan is handled through the same channel that scheduled the operation in the first place.

A change of plan can be about timing, about technique, or about whether to operate at all. All are respected.