Benign prostatic hyperplasia (BPH) is widely known as a condition that commonly occurs in men after middle age. As the prostate enlarges, it compresses the urethra and causes various urinary symptoms. In the early stages, symptoms can often be managed with medication. However, when the prostate becomes significantly enlarged or when medication fails to provide sufficient relief, surgical treatment may be required. Among the available options, HoLEP (Holmium Laser Enucleation of the Prostate) is considered an effective treatment that removes the enlarged prostate tissue using a holmium laser. One of its main advantages is that it causes minimal bleeding while allowing rapid recovery and providing strong treatment outcomes.
According to a study published in the World Journal of Urology in 2024, the effectiveness of HoLEP surgery can vary significantly depending on the experience of the surgeon. In an analysis conducted by a single surgeon involving 500 patients, the average surgical time for the first 100 cases was 67 minutes, whereas the average time for the last 100 cases was reduced to 43 minutes. This reduction in surgical time is associated with several positive outcomes, including decreased bleeding, faster recovery, and a lower risk of complications.
A shorter enucleation time also reduces the overall physical burden on the patient and tends to contribute to a faster postoperative recovery. In addition, as surgeons gain experience, the total amount of laser energy required during the procedure decreases, allowing the same clinical results to be achieved more efficiently with less energy. These findings highlight that the surgeon’s technical expertise and experience are just as important as the performance of the surgical equipment itself.
Although various laser surgical techniques and energy-based methods have been introduced, the study suggests that the surgeon’s level of experience has a greater influence on surgical outcomes than the specific technique used.
BPH cannot be evaluated solely based on the size of the prostate. In addition to prostate volume, physicians must consider the location and pattern of enlargement, the severity of lower urinary tract symptoms, changes in bladder or kidney function, the presence of complications, the duration of the disease, and the patient’s previous treatment history. When surgery is deemed necessary, the optimal surgical method should be selected individually for each patient based on these factors. This approach requires not only access to multiple surgical treatment options but also extensive clinical experience.
Dr. Ryu Kyung-ho of Goldman Urology Clinic’s Gangnam branch explained that surgery for BPH involves more than simply removing prostate tissue with a laser. Because each patient’s prostate size, shape, and symptom severity are different, a personalized approach based on sufficient clinical experience is essential. He added that procedures such as HoLEP have a long learning curve, and the surgeon’s experience directly affects recovery speed and patient satisfaction. Therefore, patients considering surgery should evaluate not only the surgical technique but also the surgeon’s experience and the number of accumulated cases when choosing where to receive treatment.