Jennifer Robles, MD, on future advancements in HoLEP

A recent study published in the Journal of Endourology showed that while HoLEP utilization increased from 2018 to 2022, there are still areas across the US with limited access.¹ Specifically, the investigators reported that only 34 states had at least 1 active HoLEP surgeon, which they defined as those who performed at least 10 annual HoLEP procedures.

In a recent interview with Urology Times®, lead study author Jennifer A. Robles, MD, MPH, discussed the future for HoLEP in terms of innovation and wider integration into urologic practice.

“I feel like it has momentum and a lot of positive energy in the HoLEP community nationally” Robles explained. “I'm really hopeful that it's not going to take another 8 years before we, say, have a HoLEP provider in every state.”

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.

In terms of the future in HoLEP innovation, Robles touched on a variety of new technologies coming down the pipeline, including better lasers, smaller scopes, and advancements in the morcellator technology. She also outlined technical advancement such as development of apical release to reduce or eliminate stress incontinence following surgery, as well as a shift toward ejaculation-sparing HoLEP.

Overall, Robles concluded, “Any advance in the procedure that can continue to make it better and reduce potential problems for patients is a win for the patients and certainly a win for me.”

REFERENCE

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