January 2026

UROLOGY

HOLEP AFTER PRIOR AQUABLATION

Amy E. Krambeck, MD, details the step-by-step process of a Holmium Laser Enucleation of the Prostate (HoLEP) in a 71-year-old patient with a large prostate (160 cc) and recurrent symptoms following a failed Aquablation. Despite prior intervention and medical therapy, the patient continued to struggle with weak stream, incomplete emptying and poor quality of life.

Dr. Krambeck explains why HoLEP is the preferred solution for very large prostates and cases where previous surgical interventions have failed. The video covers:
  • Preoperative considerations and counseling for revision surgery
  • Unique challenges such as scarring, bleeding risk and tissue inflammation
  • Technical adjustments for hemostasis and patient safety
  • Step-by-step surgical technique, including plane development and morcellation
  • Postoperative benefits, such as long-term symptom relief and improved PSA monitoring
Amy E. Krambeck, MD, Chief of Endourology and Stone Disease in the Department of Urology, the Edmund Andrews Professor of Urology at Northwestern Medicine

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