After performing over 10,000 prostate enucleations and training urologists in more than 50 countries, I have published what I believe is the most comprehensive resource available on en-bloc HoLEP: the Manual de Enucleación Prostática HoLEP en Bloque.
354 pages distilling two decades of real surgical experience. Not abstract theory. Real cases, step-by-step technique, complication management, and everything a urologist needs to master this procedure.
Why an en-bloc HoLEP manual?
Benign prostatic hyperplasia (BPH) affects over 50% of men older than 60. Holmium laser enucleation of the prostate — HoLEP — has established itself as the gold standard for large prostates. Both EAU and AUA guidelines recommend it as a first-line option regardless of prostate size.
En-bloc HoLEP takes this a step further. Instead of enucleating the prostate in multiple fragments (the classic trilobular approach), en-bloc technique removes the entire adenoma in a single piece. The advantages are clear:
- Shorter operative time — fewer steps, less tissue manipulation
- Superior hemostasis — better visualization throughout the procedure
- More intuitive learning curve — the anatomical plane guides the surgeon
What you will find in this manual
This is not a theoretical textbook. It is a surgical manual built in the operating room:
- Detailed surgical anatomy — the dissection planes that make the difference between a clean enucleation and a complicated one
- Step-by-step technique — from initial incision to morcellation, with intraoperative images
- Complication management — what to do when things do not go as planned
- Learning curve — how to structure your training, how many cases you need, which mistakes to avoid
- Special cases — prostates over 200 grams, patients on anticoagulants, complex anatomies
- Outcomes and evidence — long-term follow-up data from thousands of patients
Who is this book for
Any urologist looking to incorporate HoLEP into their practice or improve their results with the en-bloc technique. Whether you are starting your learning curve or already experienced with the trilobular approach, this manual provides the perspective of someone who has operated in over 50 countries and trained hundreds of urologists live.
It is also a useful reference for urology residents who want to understand the technique before facing the laser for the first time.
Book details
- Title: Manual de Enucleación Prostática HoLEP en Bloque
- Author: Fernando Gómez Sancha
- Publisher: Simed Software
- Pages: 354
- ISBN: 978-84-09-42726-0
- Edition: 1st edition
Where to get it
- Official website — manualholep.icua.es — full information, table of contents, and direct order— worldwide shipping available
The experience behind the manual
I have spent over 20 years refining the en-bloc HoLEP technique. I have operated in more than 50 countries — from university hospitals in Europe and the Americas to surgical centers in Asia and Africa. Every live surgery, every complex case, every question from a colleague in training has contributed to shaping this manual.
At ICUA, our center in Madrid, we perform HoLEP as our reference procedure. The results speak for themselves: reoperation rates below 1%, average catheterization of 24 hours, and patients recovering their quality of life within days.
This manual is my way of sharing everything I have learned. If you perform HoLEP or are considering adding it to your practice, I hope you find it as useful as it would have been for me at the beginning of my career.
Dr. Fernando Gómez Sancha
Co-owner of ICUA — Clínica CEMTRO, Madrid
@fgomsan | LinkedIn
