HoLEP (Holmium Laser Prostate Surgery) in India

HoLEP (Holmium Laser Enucleation of the Prostate) is a modern, minimally invasive operation for an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). An enlarged prostate can cause a weak urine stream, frequent urination at night, a feeling of incomplete emptying and, in some men, complete inability to pass urine. HoLEP uses a holmium laser through the urinary passage to remove the entire obstructing part of the prostate, with no cuts on the body and very little bleeding. It works for prostates of almost any size and gives long-lasting results, and experienced urologists in Delhi and Gurgaon perform it routinely for international patients.

Cost of HoLEP laser prostate surgery in India starts from USD 3000 at leading JCI / NABH accredited hospitals. 2-3 days in hospital; total stay in India 7-10 days.

Final cost depends on the hospital, room category, doctor, implants/medicines used and the patient's medical condition. Share your reports with Satyug Healthcare for a free written estimate.

About the Procedure

• HoLEP is an endoscopic operation: a telescope is passed through the urethra, so there are no external incisions or scars.
• The holmium laser is used to separate (enucleate) the enlarged inner lobes of the prostate from the outer capsule, much like peeling an orange, removing the whole obstructing tissue.
• The freed tissue is pushed into the bladder and then removed with a morcellator, which cuts it into small pieces that are suctioned out and sent for histopathology.
• Unlike TURP, which is usually limited to small and medium glands, HoLEP is size-independent and is an excellent alternative to open prostatectomy for very large prostates (over 80-100 g).
• The laser seals blood vessels as it cuts, so bleeding is minimal and HoLEP is often suitable for men taking blood thinners.
• Because the whole adenoma is removed, the need for repeat surgery in the long term is very low compared with many other BPH procedures.

Purpose of the Procedure

• To relieve urinary symptoms caused by an enlarged prostate, such as a weak stream, straining, frequency and night-time urination.
• To allow men with urinary retention to pass urine naturally and be free of a catheter.
• To protect the bladder and kidneys from damage caused by long-term obstruction.
• To reduce recurrent urinary infections, bladder stones and bleeding related to BPH.
• To provide a durable, minimally invasive alternative to open prostate surgery for large glands.
• To reduce or stop the need for long-term prostate medicines and their side effects.

Diagnosis and Tests Before the Procedure

• Consultation with a urologist and a symptom score questionnaire (IPSS) to assess the severity of urinary symptoms.
• Digital rectal examination to assess the size and consistency of the prostate.
• PSA blood test to screen for prostate cancer; an MRI and/or biopsy may be advised if PSA is raised.
• Ultrasound (transabdominal or transrectal) to measure prostate volume and residual urine after voiding.
• Uroflowmetry to measure the strength of the urine stream.
• Urine routine and culture; any infection is treated before surgery.
• Blood tests including kidney function, blood count, blood sugar, clotting profile and viral markers.
• ECG, chest X-ray, echocardiography if needed and physician/cardiology review for anaesthesia fitness, particularly in older men.

Step-by-Step Procedure

1. Admission: the patient is admitted on the day of surgery after fasting, and blood thinners are managed as advised by the physician.
2. Anaesthesia: HoLEP is done under spinal or general anaesthesia.
3. Cystoscopy: a telescope is passed through the urethra to inspect the prostate and bladder.
4. Enucleation: the holmium laser is used to separate the enlarged prostate lobes from the capsule while sealing blood vessels.
5. Morcellation: the enucleated tissue is pushed into the bladder, cut into small pieces by the morcellator and removed; the tissue is sent for histopathology.
6. Catheter placement: a urinary catheter is inserted, sometimes with continuous bladder irrigation for a few hours; surgery usually takes 1-2 hours depending on gland size.
7. Ward recovery: the patient starts eating and walking on the same or next day.
8. Catheter removal: the catheter is usually removed 24-48 hours after surgery, and the patient's ability to pass urine is checked.
9. Discharge: most patients go home 2-3 days after surgery with medicines and pelvic floor exercise advice.

Risks and Possible Complications

• Burning, urgency and frequency when passing urine for a few weeks after surgery, which gradually settle.
• Mild blood in the urine, sometimes appearing again 2-3 weeks after surgery as scabs come away.
• Temporary leakage of urine (stress incontinence), which usually improves within weeks to a few months with pelvic floor exercises.
• Retrograde ejaculation (semen going back into the bladder) in most men, which does not affect sexual pleasure but reduces fertility.
• Urinary tract infection, treated with antibiotics.
• Urethral stricture or bladder neck narrowing later on, which is uncommon.
• Rare need for blood transfusion, bladder injury or further surgery, and the usual risks of anaesthesia.

Your specialist will explain the risks specific to your condition. Choosing an experienced, high-volume hospital keeps complication rates low.

Recovery and Aftercare

• Most men notice a much stronger urine stream immediately after catheter removal.
• Hospital stay is usually 2-3 days, and most patients feel well enough to walk around the city within a week.
• Drink plenty of fluids, avoid constipation and avoid heavy lifting, straining, cycling and sexual activity for about 4-6 weeks.
• Pelvic floor (Kegel) exercises help speed up recovery of full urinary control.
• Patients are usually fit to fly 5-7 days after HoLEP, once the urologist confirms good urine flow and no significant bleeding.
• The histopathology report is reviewed before departure; PSA is usually rechecked after about 3 months at home.
• Video follow-up with the urologist is arranged after return home.

Why Choose India for HoLEP laser prostate surgery?

• JCI and NABH accredited hospitals with the latest medical technology
• Highly experienced specialists, many trained in the USA, UK and Europe
• Cost 60-80% lower than the USA, UK, Gulf countries and Singapore, with the same international-standard care
• No waiting lists - treatment can usually be scheduled within days of arrival
• Free end-to-end support from Satyug Healthcare: opinions, visa letter, airport pickup, interpreter and accommodation

Step-by-Step Process to Travel to India for Treatment

1. Share your reports - send your latest reports, scans/CD, angiography or echo films and passport copy to Satyug Healthcare on WhatsApp (+91-8860606766 / +91-9910655125) or email.
2. Free medical opinion & cost estimate - within 24-72 hours we share opinions and written cost estimates from 2-3 JCI/NABH-accredited hospitals and specialists.
3. Choose hospital & doctor - compare doctor experience, hospital, room category and total cost; we help you decide with no extra charge.
4. Visa Invitation Letter (VIL) - the hospital issues a VIL for the patient and up to two attendants; we arrange it within 24-48 hours.
5. Apply for Indian e-Medical Visa - apply online for the e-Medical Visa (patient) and e-Medical Attendant Visa (family) using the VIL; most approvals come in 3-5 working days.
6. Book flights & accommodation - we suggest flights and arrange a guest house, service apartment or hotel near the hospital to suit your budget.
7. Free airport pickup - our representative receives you at the airport and takes you to your hotel or directly to the hospital.
8. Hospital admission & treatment - a dedicated coordinator and language interpreter stay with you for registration, tests, doctor consultations, the procedure and billing.
9. Discharge & follow-up - you receive the discharge summary, prescriptions and fitness-to-fly certificate; follow-up checks are done before you fly.
10. Return home & tele-follow-up - we arrange airport drop and stay connected for online follow-up consultations with your doctor in India.

Contact Satyug Healthcare - International Patient Helpdesk: +91-8860606766 | +91-9910655125 (WhatsApp available) for a free medical opinion and cost estimate.