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What is the new prostate procedure?

The HoLEP procedure is a unique, laser-based, endoscopic surgery for voiding dysfunction. This non-cancerous condition of an enlarged prostate prevents urine from emptying effectively, which the procedure addresses by passing a laser into the urethra and carving out tissue.

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New Prostate Procedure

Dr. Abhay A. Singh of St. Luke’s Center for Urology successfully performed the first-ever Holmium Laser Enucleation of the Prostate (HoLEP) procedure at St. Luke’s on a patient in late April. This represents the first time this minimally invasive treatment modality -- which many experts consider the gold standard treatment of large prostate glands -- was offered to patients within the St. Luke’s University Health Network. Singh said that the network offers a variety of medical and surgical options to men with voiding issues, and described the HoLEP procedure as “not only another powerful surgical tool in our arsenal, but also an elegant procedure that has been proven to help many men, including those with very large prostates -- some of whom may otherwise have to consider a more invasive surgery. We are excited to offer this surgery to more patients moving forward.” The HoLEP procedure is a unique, laser-based, endoscopic surgery for voiding dysfunction. This non-cancerous condition of an enlarged prostate prevents urine from emptying effectively, which the procedure addresses by passing a laser into the urethra and carving out tissue. The excess tissue is then ground up and sucked out, clearing a pathway for a significant improvement in the patient’s ability to void completely. He likens the 1.5 to 3-hour procedure to carving out the inside of an orange while leaving the outer rind intact. In addition to reductions in bleeding/blood loss, the likelihood of regrowth of the prostate, and time using a catheter, the HoLEP procedure offers the ability to treat any size prostate and experience a faster healing time. Singh’s patient at St. Luke’s was unable to void at all, and had to catheterize himself before the HoLEP procedure was performed. He reported that the patient is recovering well and is now voiding with no difficulty at all. The capacity to offer this minimally invasive surgery to patients of St. Luke’s helps to address a highly common condition for men, particularly those over the age of 60, and those with a family history of non-cancerous enlargement of the prostate. While there isn’t much men can do to avoid the condition, Singh notes that those who are diligent about diet and exercise often experience less severe symptoms. Having performed a range of voiding dysfunction surgeries for years, including HoLEP, Dr. Singh says a man’s typical response after undergoing the laser prostate-reduction treatment is “I wish I had done this sooner.” Many men, he said, “are understandably hesitant or concerned about undergoing surgery and dealing with the risk of side effects. They typically put it off until they really have no choice and that’s when they pull the trigger. Afterward, they feel so much better and realize that they didn’t have to suffer as long as they did.” Singh, who joined the St. Luke’s University Health Network in 2021, earned his medical degree from UMDNJ – Robert Wood Johnson Medical School and honed his skills in robotic and endourology through a fellowship at Thomas Jefferson University Hospital in Philadelphia. He completed a general surgery internship at Walter Reed Army Medical Center, followed by a urology residency at Duke University Hospital. Following his residency, he served as an active-duty U.S. Army urologist at Fort Benning, Georgia, and at Fort Belvoir, Virginia, where he was named chief of urology. He specializes in robotic surgeries to treat both cancer (kidney, prostate and bladder) and for reconstructive purposes, as well as endoscopic surgeries that address voiding dysfunction and stones in men and women.

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