Jennifer Robles, MD, discusses the growing interest in HoLEP

Data from a recent study showed that from 2018 to 2022, HoLEP utilization increased by 52%. This analysis builds off prior work published in 2020 which showed that rates of HoLEP only accounted for about 4% of all benign prostatic hyperplasia (BPH) procedures in 2014.²

In an interview with Urology Times®, lead author Jennifer A. Robles, MD, MPH, shared her thoughts on the surge in utilization across the US. According to Robles, the recent growth is multifactorial.

For starters, she explained, “Number one, I think that there's increased broad recognition that HoLEP achieves excellent outcomes [and] that it has better efficacy and better morbidity profile than the majority of other BPH procedures that are out there. There's been more and more data that has come out about that over the years that has really convinced people about that.”

Robles is an assistant professor of urology at Vanderbilt University Medical Center and the chief of urology at the Tennessee Valley (VA) Healthcare System in Nashville, Tennessee.

Robles also attributed the growth in HoLEP utilization to other factors such as better advancements in HoLEP technology.

“Specifically, the lasers that we use for hole up are now much better,” she said. “They're much faster. They have better hemostasis. I think that's really helped people to take up the procedure.”

She also explained that as the number of physicians who do HoLEP increases, so do the number of residents and fellows who get trained to do the procedure. This means that HoLEP can then “spread like wildfire.” Trainees also now have the opportunity to learn the procedure from training courses offered by the AUA, or from procedural videos on YouTube.

All of these contribute to the growing interest in HoLEP procedures.

REFERENCES

1. Robles J, Shin YE, Rojanasarot S, Miller NL. Niche No More? Mapping US Trends and Regional Disparities in Holmium Laser Enucleation of the Prostate from 2018 to 2022. J Endourol. 2025.doi:10.1089/end.2025.0188

2. Robles J, Pais V, Miller N. Mind the Gaps: Adoption and Underutilization of Holmium Laser Enucleation of the Prostate in the United States from 2008 to 2014. J Endourol. 2020;34(7):770-776.doi:10.1089/end.2019.0603