HoLEP Surgery for
Enlarged Prostate
in Patna
Holmium Laser Enucleation of Prostate (HoLEP) — the world's most advanced laser prostate surgery. No cut on skin. Works for any prostate size. Permanent solution. Minimal bleeding. Performed by Dr. Kumar Rajesh Ranjan, M.Ch. Urology. Call 091222 37338.
Holmium Laser Enucleation —
The World's Most Advanced Prostate Surgery
HoLEP (Holmium Laser Enucleation of Prostate) is the gold standard surgical treatment for enlarged prostate (BPH — Benign Prostatic Hyperplasia). A laser fibre is passed through the natural urethra — absolutely no cut is made on the skin — and the obstructing prostate adenoma is completely removed using a high-powered Holmium laser.
Unlike TURP (which shaves the prostate and leaves tissue behind), HoLEP removes the entire obstructing tissue — similar in completeness to open prostatectomy, but performed through the urethra. This means far less bleeding, faster recovery, and a dramatically lower chance of the prostate growing back and needing repeat surgery.
Symptoms of Enlarged Prostate (BPH)
Benign Prostatic Hyperplasia (BPH) is extremely common in men above 50. Recognise these symptoms and consult our urologist — HoLEP provides permanent relief from all of them.
Weak or Slow Urine Stream
Reduced force of urine flow — the most common early symptom. The enlarged prostate squeezes the urethra, reducing the flow rate. Worsens gradually over months to years.
IPSS: ObstructiveFrequent Urination (Day & Night)
Urinating more than 8 times a day, or waking up 2+ times at night to urinate (nocturia) — severely disrupting sleep quality and daily life.
IPSS: IrritativeUrgency — Cannot Hold Urine
Sudden, compelling urge to urinate that cannot be delayed — can cause embarrassing leakage (urge incontinence). Significantly impacts quality of life.
IPSS: IrritativeHesitancy & Straining to Start
Difficulty starting urination — standing at the toilet for 30–60 seconds before flow begins. Progressive worsening indicates increasing obstruction.
IPSS: ObstructiveIncomplete Bladder Emptying
Feeling that the bladder has not fully emptied after urination — residual urine leads to recurrent UTIs, bladder stones, and eventually kidney damage if untreated.
⚠️ Needs EvaluationAcute Urinary Retention
Sudden complete inability to urinate — a urological emergency requiring immediate catheterisation. Often the event that leads men to finally seek surgical treatment for BPH.
🔴 Emergency8 Reasons Why HoLEP is Better Than Any Other Prostate Surgery
HoLEP outperforms TURP, open prostatectomy, and laser vaporisation on virtually every important parameter. Here is why the world's best urology centres have adopted HoLEP as the gold standard.
No Skin Cut
Entire procedure through the urethra — no incision on the body. No wound, no scar, no hernia risk, no wound infection.
Any Prostate Size
HoLEP works equally well for small (20g) and very large prostates (200g+). TURP is limited to prostates below 80–100g and cannot treat very large prostates.
Minimal Bleeding
The Holmium laser simultaneously cuts and seals blood vessels — minimal intraoperative bleeding. Safe even for patients on blood thinners (aspirin, warfarin).
Lowest Recurrence
HoLEP removes the entire adenoma — the obstructing tissue has nowhere left to grow. TURP leaves tissue behind, which can regrow and cause symptoms to return.
Short Hospital Stay
Catheter removed Day 1. Most patients discharged Day 1–2. Significantly shorter than open prostatectomy (5–7 days) and similar or shorter than TURP.
Tissue for Pathology
Removed prostate tissue is sent for biopsy — incidentally detecting early prostate cancer in some patients. Laser vaporisation burns tissue, leaving nothing for analysis.
Stop Prostate Medicines
After HoLEP, patients can stop alpha-blockers and 5-alpha reductase inhibitors permanently — major long-term cost saving and freedom from daily medication.
Precise Laser Control
The Holmium laser allows millimetre-precise enucleation along the surgical capsule — the same anatomical plane as open surgery, ensuring complete tissue removal.
HoLEP vs TURP vs Open Surgery — Complete Comparison
See exactly how HoLEP compares to the older prostate surgery techniques — and why it is now the global gold standard.
| Parameter | ⚡ HoLEP (Gold Standard) | 🔵 TURP (Conventional) | ⬛ Open Prostatectomy |
|---|---|---|---|
| Skin Cut / Incision | ❌ No cut — urethra only | ❌ No cut — urethra only | Large abdominal incision |
| Tissue Removal | 100% — complete enucleation | 80–90% — leaves some tissue | 95–100% — open removal |
| Max Prostate Size | Any size (20g – 300g+) | Limited to under 80–100g | Any size (larger ones) |
| Bleeding Risk | Minimal — laser seals vessels | Moderate | High — blood transfusion risk |
| Blood Thinners Safe? | ✅ Yes | ❌ Must stop before surgery | ❌ Must stop before surgery |
| Hospital Stay | 1–2 Days | 2–3 Days | 5–7 Days |
| Catheter Duration | 1 Day (removed Day 1) | 2–3 Days | 5–7 Days |
| Return to Work | 1–2 Weeks | 2–3 Weeks | 4–6 Weeks |
| Recurrence Rate | Very Low (<1% at 10 years) | 10–15% regrowth at 10 years | Low |
| Tissue for Biopsy | ✅ Yes — complete specimen | ✅ Yes | ✅ Yes |
| Stop Prostate Medicines | ✅ Yes — permanently | ✅ Yes | ✅ Yes |
What Happens During Your HoLEP Surgery?
A step-by-step guide to your HoLEP surgery at Satyadev Hospital — from pre-operative preparation to going home.
Pre-Op Assessment
PSA blood test, uroflowmetry (urine flow measurement), post-void residual (PVR) scan, TRUS prostate measurement, urine culture, blood tests, ECG, anaesthetic review. No need to stop blood thinners for HoLEP.
⏱ Day before surgeryAnaesthesia (Spinal or General)
HoLEP is usually performed under spinal anaesthesia (waist-down numbness) — comfortable, minimal systemic side effects. General anaesthesia available if preferred. You feel nothing during surgery.
⏱ 15 minutesLaser Enucleation of Prostate
A resectoscope with Holmium laser fibre is passed through the urethra. The laser precisely separates the adenoma (obstructing tissue) from the surgical capsule — like peeling a fruit. The entire adenoma is pushed into the bladder in 2–3 lobes.
⏱ 30–90 min (varies by size)Morcellation — Tissue Removal
A morcellator instrument is introduced into the bladder to cut the enucleated adenoma tissue into small pieces and aspirate them out — similar to a kitchen blender but inside the bladder. Tissue is sent for pathology biopsy.
⏱ 10–20 minutesCatheter & Recovery
A urinary catheter is placed at the end of surgery and continuous bladder irrigation run overnight. Catheter is removed the next morning when urine is clear. Most patients void satisfactorily immediately — discharge Day 1–2.
⏱ Home in 1–2 DaysWho Should Have HoLEP Surgery?
HoLEP is suitable for the vast majority of men with BPH needing surgery. Your urologist will review your symptoms, flow tests, and prostate measurements to confirm suitability.
✅ Good Candidates for HoLEP
- ✓Moderate to severe BPH symptoms (IPSS > 8) not controlled by medications
- ✓Men who want a permanent, medication-free solution for prostate problems
- ✓Any prostate size — small (20g), medium (60g), or very large (100g, 150g, even 200g+)
- ✓Patients on blood thinners (aspirin, clopidogrel, warfarin, rivaroxaban) — no need to stop
- ✓Recurrent urinary retention (repeated inability to urinate) requiring catheter
- ✓Recurrent urinary tract infections due to incomplete bladder emptying
- ✓Hydronephrosis (kidney swelling) due to bladder outlet obstruction
- ✓Bladder stones from BPH — treated in the same sitting as HoLEP
- ✓Previous failed TURP with regrowth of prostate tissue
- ✓High-risk patients (heart disease, diabetes) who benefit from minimal blood loss
⚠️ When HoLEP May Not Be Suitable
- ✗Active urinary tract infection — must be treated before surgery
- ✗Urethral stricture severe enough to prevent scope passage — needs treatment first
- ✗Prostate cancer requiring radical prostatectomy — different procedure needed
- ✗Uncorrected bleeding disorder — very rare absolute contraindication
- ✗Mild BPH symptoms (IPSS < 8) — medications or watchful waiting first
- -Neurogenic bladder dysfunction — prostate removal will not help if bladder is not working
- -Note: Patient's desire for preserved antegrade ejaculation — retrograde ejaculation is expected after HoLEP, as with all BPH surgeries
Your HoLEP Recovery — What to Expect
HoLEP has the fastest recovery of all prostate surgeries. Most patients are back to full activity within 2 weeks.
Surgery Day
HoLEP done. Catheter in place. Overnight bladder irrigation. Comfortable in ward with oral fluids.
Day 1
Catheter removed morning if urine is clear. Trial of voiding. Most patients pass urine satisfactorily. Walking and eating normally.
Day 1–2
Discharged home with oral antibiotics and pain tablets. Some mild frequency and urgency is normal for 2–4 weeks.
Week 1–2
Light activity at home. No heavy lifting. Hydrate well. Mild urinary urgency and frequency settles gradually.
Week 2–4
Return to full normal activity. Uroflowmetry confirms excellent flow. Stop prostate medications permanently.
Meet Your HoLEP Surgeon in Patna
Dr. Kumar Rajesh Ranjan is an M.Ch. (Master of Chirurgiae) qualified urologist — the highest postgraduate surgical qualification in urology in India — with over 15 years of specialised urological surgery experience. He trained at leading institutions and brings the most advanced urological techniques to patients in Patna and Bihar.
HoLEP requires specialised training beyond standard urology. Dr. Ranjan's expertise in endoscopic and laser urology makes Satyadev Hospital one of the very few centres in Bihar offering this world-class procedure — previously only available in major metropolitan cities like Delhi, Mumbai, and Chennai.
Why Choose Satyadev for HoLEP in Patna
Patients from across Bihar and neighbouring states travel to Satyadev Hospital for HoLEP — because it is one of the very few centres offering this procedure in the region.
One of Very Few in Bihar
HoLEP is available at only a handful of hospitals in Bihar. Satyadev Hospital brings this world-class procedure to Patna — previously only available in Delhi, Mumbai, and Chennai.
M.Ch. Qualified HoLEP Surgeon
Dr. Kumar Rajesh Ranjan has the highest qualification in urology and specialised HoLEP training — ensuring safe, effective, and complete prostate enucleation every time.
Advanced Holmium Laser Equipment
High-power Holmium laser system with morcellator — the same technology used in the world's best urology centres. Equipment quality directly impacts HoLEP outcomes.
Safe for High-Risk Patients
Minimal bleeding means HoLEP is safe for elderly patients, diabetics, heart patients, and those on blood thinners — who cannot safely have TURP or open surgery.
Insurance Accepted
CGHS, ESIC, and major TPA insurance accepted. Check Ayushman Bharat coverage for HoLEP. Call 091222 37338 for insurance eligibility for your specific case.
4.7★ Google Rating
434+ verified reviews — consistently rated the most trusted urology centre in Patna. Patients travel from across Bihar, Jharkhand, and UP for Dr. Ranjan's expertise.
HoLEP Surgery — Insurance Coverage
at Satyadev Hospital
CGHS, ESIC, and all major TPA insurance accepted. Check Ayushman Bharat eligibility for HoLEP prostate surgery. Our insurance desk will confirm coverage before admission.
Men Who Had HoLEP Surgery at Satyadev
Real experiences from patients who had HoLEP prostate surgery at Satyadev Hospital, Patna.
"Mujhe 5 saal se prostate ki problem thi — raat ko 5-6 baar uthna padta tha, flow bahut slow tha. Kaafi medicines khayi par aaram nahi mila. Dr. Ranjan ne HoLEP kiya — 2 din mein ghar aa gaya. Ab ek baar bhi raat ko nahi uthta. Puri zindagi mein pehli baar aisa feel hua ki sahi se pesha aa raha hai."
"Mera prostate bahut bada tha — 140 gram. Doctor ne bataya TURP nahi hoga, open surgery lagegi. Lekin Satyadev Hospital mein Dr. Ranjan ne HoLEP se sab remove kar diya — bina koi cut ke. Blood transfusion bhi nahi lagi. 2 din mein discharge. Bahut achha experience raha. Highly recommend."
"My father is 78 years old and on blood thinners for his heart. Other hospitals refused surgery due to his age and medications. Dr. Ranjan at Satyadev Hospital performed HoLEP without stopping his blood thinners — minimal bleeding, discharged in 2 days, catheter-free. The improvement in his quality of life is remarkable. Extraordinary surgeon."
Frequently Asked Questions About HoLEP in Patna
Answered by Dr. Kumar Rajesh Ranjan's team at Satyadev Hospital, Patna.