Benign Prostatic Hyperplasia (BPH)

What is HoLEP?

Holmium laser enucleation of the prostate anatomically removes the entire adenoma (the part of the prostate that enlarges in BPH) — equivalent to open prostatectomy but through the urethra with no incision. Superior to TURP for large prostates (>80g).

Why China?

• Size-independent: HoLEP treats any prostate size — unlike TURP which has upper limits
• Cost: $5,500-$9,500 vs. $15,000-$35,000 in the US
• Short hospitalization: 2-3 days (vs 5-7 days open prostatectomy)
• Low bleeding: Holmium laser excellent hemostasis — suitable for anticoagulated patients

Who is a candidate?

• Symptomatic BPH with IPSS ≥8
• Prostate volume 30-300+ grams
• Failed or intolerant to medical therapy
• BPH complications: urinary retention, recurrent UTI, bladder stones

Outcomes

Qmax improvement: 150-200%. IPSS reduction: 70-80%. Retreatment rate at 5 years: <3% (vs 10-15% TURP). Transient incontinence: 5-10% (mostly resolve by 3 months).