HoLEP vs TURP: What the Hospital Needs to Invest in Each

Two techniques, two equipment profiles

TURP removes prostate tissue in chips with an electrode loop on a resectoscope, powered by a monopolar or bipolar electrosurgical generator. HoLEP, holmium laser enucleation of the prostate, uses a holmium laser fiber to separate the adenoma from the surgical capsule as a whole lobe, which is then pushed into the bladder and morcellated.

So the TURP tower is a resectoscope, an HF generator, a camera and irrigation. The HoLEP tower adds a high-power holmium laser, laser fibers, a laser-compatible resectoscope and a morcellator. This is the main reason HoLEP is a larger capital decision.

Capital equipment for each procedure

For TURP the core is a resectoscope such as the SHARK with sheaths of 22/24 and 24/26 Fr and an electrosurgical unit. The Richard Wolf HF-GENERATOR 2260 offers cutting power up to 400 W and presets for monopolar and bipolar TUR-P, TUR-B and bipolar enucleation.

For HoLEP the laser is the centrepiece. The MegaPulse 70+ is a 70 W holmium:YAG laser (2100 nm) with Lithotripsy, Soft Tissue and Expert modes, pulse width from 50 to 1100 µs in Expert mode and RFID detection of the sterile fiber. The morcellation step is handled by PIRANHA, which is designed to work with SHARK resectoscopes.

• TURP: resectoscope, HF generator, camera, irrigation
• HoLEP: holmium laser, fibers, resectoscope for laser use, morcellator with suction pump
• Both: imaging tower, monitor, reprocessing capacity

Consumables, reprocessing and running cost

TURP uses electrodes and loops, which wear out and are replaced regularly. HoLEP uses laser fibers and morcellator blades. PIRANHA offers the Vmax blade in disposable and reusable versions, so the department can choose between single-use convenience and reprocessing. Compare the per-case consumable list from each supplier, not only the equipment price.

Laser installation has requirements of its own: electrical supply, floor loading, laser safety signage and eyewear for the team. The MegaPulse 70+ weighs 200 kg, so confirm the route into the theatre. Our laser safety guide explains the room measures.

Learning curve and OR time

TURP is widely taught and most urologists are already trained. HoLEP has a longer learning curve and needs mentoring, supervised cases and a team that knows the laser, the morcellator and the irrigation settings. Departments often plan a ramp-up period with lower case numbers while the first surgeons gain experience.

Theatre planning differs too: HoLEP needs morcellation time and a laser-ready room, while TURP needs the resection time and, for monopolar cases, attention to irrigation fluid and fluid balance. For a bipolar approach, see our bipolar resectoscope guide.

Building one service that offers both

Many departments keep TURP as the standard workhorse and add HoLEP as a second technique. A resectoscope platform that supports both reduces duplication: the same SHARK family is used for resection and for laser enucleation, and the same imaging tower serves both. Planning around shared components keeps the total investment more manageable.

For a recommendation matched to your case mix, volumes and room layout, Beckfinity specialists can prepare a side-by-side equipment plan. Request a quote through the contact page, and see the broader urology equipment supplier in the UAE overview.