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The holmium laser was one of the first energy sources used to perform anatomical endoscopic enucleation of the prostate (AEEP). The term AEEP refers to total enucleation of the BPH component of the prostate in a similar fashion to open simple prostatectomy. Total adenomectomy results in maximal disobstruction of the prostate.

DIAGNOSTIC


The patient in this case is 73 years old. He has been on tamsulosin for 4 years to treat bothersome lower urinary tract symptoms. He has a history of raised PSA and had benign TRUSP biopsies of the prostate in 2014. Four months prior to HoLEP he went into acute urinary retention and has had an indwelling urethral catheter since that time. He has failed 2 trials without catheter and also has a 7mm bladder calculus. Prostate volume is estimated at 93cc on TRUS. He is very keen to be free from the catheter and has elected HoLEP due to the large volume of his prostate and the fact that HoLEP provides a 98% chance of becoming catheter free.

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Dr. Tevita Aho Consultant Urological Surgeon at The Princess Grace Hospital, London, UK Urology
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