Plain-English guidance on enlarged prostate, HoLEP and treatment in Madrid. Patient education from Dr Fernando Gómez Sancha and ICUA. Not medical advice.
Madrid, Spain
Joined August 2026
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I have spent years answering the same questions by email from men considering HoLEP abroad. So I wrote the answers down once, properly. A free patient guide to en bloc HoLEP, in English and Spanish:
holep.icua.es/en.html?utm_so…
A stronger stream often returns sooner. Urgency can take longer if the bladder has been obstructed for years. Clearing the blockage doesn't resolve every bladder complaint overnight.
holep.icua.es/en.html?utm_so…
If you take blood thinners, never stop them without talking to your doctor. The doctor who prescribed them and the surgical team plan the timing.
holep.icua.es/en.html?utm_so…
Ask your urologist this before surgery
Full video: youtu.be/pR88GFjKOYM
Considering travelling to Madrid for en bloc HoLEP? The pathway has eight steps. The first one is not a plane ticket. 🧵
4. Assessment in Madrid
5. Surgery and discharge
6. Recovery in Madrid, a few days
7. Flying home when the team says it is safe
8. Follow-up at home, in shared care with your own urologist
Every step is described in the guide, including what can make it longer. Read it before you write to us; it will make the first email better.
holep.icua.es/en.html?utm_so…
Before any operation, we usually check flow, residual urine, imaging and PSA history — and sometimes we need to look inside the bladder. Surgery helps only if the problem is a real obstruction.
holep.icua.es/en.html?utm_so…
HoLEP may be considered when pills no longer help, retention keeps returning, or the bladder or kidneys are starting to suffer. Size alone never decides.
holep.icua.es/en.html?utm_so…
Prostatitis: not cancer, not an enlarged prostate
Full video: youtu.be/gwQD8XeEt9Y
Dutasteride and sex: what you weren't told
Full video: youtu.be/vw9GILiI3DA
HoLEP removes the prostate tissue blocking your urine channel, through the urethra — no cut in the abdomen. It can be used for small glands and for many very large ones.
holep.icua.es/en.html?utm_so…
We always analyse the tissue. Always.
Full video: youtu.be/6Z4TGjKbk4U
Don't confuse BPH surgery with cancer surgery
Full video: youtu.be/uKa1OhZmTD0
Very large prostates are where many techniques run out of road. Our 2025 series of 754 en bloc HoLEP included 110 glands of 120 g or more. 🧵
Stress incontinence at six months: 0.9% in the ≥120 g group, 0.15% in smaller glands. No significant difference (p=0.27). Retreatment within follow-up: under 2%.
Centre-specific outcomes, labelled as such: this team, this hospital. They do not predict your result. They do say that size, on its own, is not a reason to be told there is no option.
holep.icua.es/en.html?utm_so…
GreenLight laser: the 3 drawbacks
Full video: youtu.be/pR88GFjKOYM
Don't book a non-refundable flight before the team reviews your case.
Send records first. A provisional schedule comes after that — not before.
holep.icua.es/en.html?utm_so…
After HoLEP they stop all the medication
Full video: youtu.be/AahYZPmo0f8