HoLEP outcomes: long-term durability data

Durability of symptom relief

• Randomised 7-year follow-up. In a randomised trial with follow-up approaching eight years, none of the HoLEP patients remaining in the analysis had required reoperation for BPH.³
• 10-year cohort. In a 10-year follow-up cohort, approximately three quarters of men remained free of clinically significant symptoms at that interval.⁶
• Single-centre 10-year series. In a single-centre series of more than 1,000 HoLEP procedures, Kaplan-Meier freedom from any repeat prostate surgery was 95% at ten years.⁸

HoLEP vs TURP at scale

A recent national registry of more than 33,000 primary surgical interventions for BPH reported that 97% of HoLEP patients had not required a further prostate operation at three years, compared with 93.5% after TURP.¹⁷ The same registry showed lower reoperation rates at high-volume centres - another reason surgeon and hospital experience matter.

Meta-analysis of randomised trials

A 2025 meta-analysis of 13 randomised trials comparing HoLEP with TURP found that HoLEP:

• Removed a larger proportion of obstructing tissue.
• Produced a lower bleeding rate.
• Required a shorter catheter time and hospital stay.
• Showed its advantage grow as prostate size increased.⁹

Sexual function

Published long-term cohort data and a 2024 narrative review report no significant deterioration in validated erectile function scores at 12 months and beyond.¹⁵ Most men (approximately 70 to 80%) will have reduced or absent ejaculate afterwards, because opening the bladder neck allows semen to pass into the bladder rather than out through the urethra.¹⁵

Continence

Transient stress incontinence occurs in a minority of men in the first few weeks and tends to improve with early pelvic-floor exercises. Persistent incontinence is uncommon and is less likely at high-volume centres.^{7, 13, 14}