VIDEO ANSWER

Why doesn't everyone do HoLEP?

Name: TURP vs GreenLight Laser vs HoLEP: Which Surgery to Pick?
Uploaded: 2026-06-13T13:41:20Z
Duration: 337 s
Description: Retreatment rates depend on what counts as another intervention and on the follow-up period. A percentage without a stated follow-up cannot be directly compared with rates at five or ten years.

Dr. Fernando Gómez Sancha · Urologist · Medical Director of ICUA

Video published: 2026-06-13 · 0:27 · Excerpt 4:14–4:42

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How to interpret retreatment figures

Retreatment rates depend on what counts as another intervention and on the follow-up period. A percentage without a stated follow-up cannot be directly compared with rates at five or ten years.

At five years, Epic Cosmos (2026) reported surgical retreatment of 4.4% for HoLEP/ThuLEP combined and 7.1% for TURP. This is an unadjusted observational comparison between groups; it does not establish superiority for every patient.

Carletti et al. Five-year Retreatment and Medication Restart Rates Following Benign Prostate Hyperplasia Treatments: A Nationwide Real-world Analysis Using Epic Cosmos. European Urology Focus. 2026;12(3):383–392.

Editorial clarification based on the cited sources. It does not establish a new medical review of the video.

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4:15 So, why does not everyone do HoLEP? The answer is simple, the learning curve. The holmium laser enucleation is technically a bit more demanding than other operations like transurethral resection and green laser.

4:31 It requires specific training, supervised practice, and [music] many cases to master it. Not all centers have the equipment or trained surgeons. This is a reality.