Both GreenLight and HoLEP are proven, effective, and safe treatments—choosing the right one depends on your goals, health, and lifestyle
The Question Many Men Ask
When managing urinary symptoms caused by an enlarged prostate (BPH), the question often arises:
“Which treatment is best for me?”
It’s a fair question—but not a simple one. The reality is, there is no one-size-fits-all answer. The “best” option depends on factors such as:
The size of your prostate
The severity of your symptoms
Your overall health and medications (e.g., blood thinners)
Your age and lifestyle
Your personal priorities—such as recovery time, long-term durability, or preserving sexual function
This newsletter explores two of the most advanced and widely used laser options today:
GreenLight Laser Therapy
HoLEP (Holmium Laser Enucleation of the Prostate)
Both can dramatically improve urinary symptoms, but they work in different ways and offer distinct advantages.
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What Is BPH and Why Does It Matter?
Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland.
As the prostate grows, it can press on the urethra (the tube that drains urine from the bladder), leading to:
A weak or interrupted urine stream
Difficulty starting or stopping urination
Feeling like your bladder never fully empties
Needing to urinate multiple times at night
Sudden urgency to urinate
How common is BPH?
Affects about 50% of men in their 50s and 60s
Increases to 70–80% of men by their 80s
Not everyone with BPH needs treatment. But when symptoms interfere with quality of life—or when the bladder begins to struggle—surgical treatment is often the most effective option.
GreenLight Laser Therapy: Quick Relief, Faster Recovery
GreenLight laser therapy uses a targeted green light beam (532 nm wavelength) to vaporize excess prostate tissue that blocks urine flow.
Advantages of GreenLight:
✅ Minimally invasive
✅ Less bleeding (safe for men on blood thinners)
✅ Most men go home the same day or next morning
✅ Faster return to normal activities and work
✅ Low risk of erectile dysfunction
Other things to know:
Ejaculatory changes (dry ejaculation) are very common
No tissue is collected for pathology (fine if PSA/MRI is clear)
About 1 in 10 men may need repeat treatment in the future
GreenLight is often a good choice for men with mild-to-moderate prostate enlargement, who want rapid recovery with minimal downtime.
HoLEP: Long-Term, Comprehensive Relief
HoLEP (Holmium Laser Enucleation of the Prostate) uses a different wavelength laser (2,100 nm) to peel away the entire enlarged portion of the prostate—similar to scooping out the inside of an orange and leaving the peel.
HoLEP
Advantages of HoLEP:
✅ Removes more tissue than GreenLight → stronger, longer-lasting relief
✅ Works even for very large prostates
✅ Tissue is sent for lab testing (helps exclude hidden cancer)
✅ Excellent long-term durability
Things to consider:
Slightly higher bleeding risk than GreenLight
Recovery is a bit longer; catheter may stay in place longer
Short-term incontinence can occur (usually improves over weeks)
Ejaculatory changes are almost universal
HoLEP is often the best choice for men with very large prostates or those who want a “one-and-done” durable solution.
Bottom Line: Both Are Excellent Options
Ultimately, the decision between GreenLight and HoLEP depends on your priorities and personal circumstances.
Your Priority | You Might Prefer |
|---|---|
Shorter recovery, minimal bleeding, quicker return to work | GreenLight |
Maximum tissue removal, long-term durability, large prostate | HoLEP |
Preserving erections | Both have low erectile dysfunction risk |
Avoiding changes to ejaculation | Consider alternative minimally invasive options |
Real-World Examples:
Younger man (50s–60s): sexually active, moderate prostate size, wants quick recovery → may choose GreenLight
Older man (70s–80s): severe symptoms, large prostate, prefers one-time treatment → may benefit more from HoLEP
Bottom Line: Both Are Excellent Options
GreenLight and HoLEP are both proven, effective, and safe for treating BPH.
The “right” choice comes down to your health, prostate size, lifestyle, and goals. The best way to decide is through an informed conversation with your urologist—someone who understands the nuances of both procedures and can guide you based on your individual situation.
A Note from Dr. Chabert
Every man’s experience with BPH is unique, and so is the decision about treatment. While both GreenLight and HoLEP are excellent options, the “best” choice really depends on your health, your prostate, and your personal goals.
The first step is to have a discussion with your GP, who can assess your symptoms and arrange the right tests. If needed, your GP can then refer you to a local urologist for specialist care.
A urologist will take into account your prostate size, health history, and personal priorities, and then guide you through whether GreenLight, HoLEP, or another treatment is the most suitable path forward.
You don’t need to navigate this alone—help is available, and effective solutions exist.