In 2013, holmium laser enucleation of the prostate (HoLEP) may be the new 'gold standard'.

In this review article, we assess why holmium laser enucleation of the prostate (HoLEP) has become an important treatment modality for benign prostatic hypertrophy (BPH). Meta-analysis comparing HoLEP with both open prostatectomy (OP) and transurethral resection of prostate (TURP) shows TURP to be as effective with less morbidity. More recently, HoLEP has long-term durability data confirming a very low reoperation rate. This article investigates how previous hurdles to the widespread uptake of HoLEP have been overcome. Recent literature shows that the learning curve is actually similar to many other current urological procedures, and that the efficiency of HoLEP is equal to that of other surgical procedures. HoLEP is also beneficial in the growing population of men on anticoagulation who require treatment for BPH. Finally, HoLEP is the only laser treatment for BPH with level 1 evidence and endorsement in both the American Urological Association (AUA) and European Association of Urology (EAU) guidelines.