International Patients: Prostate Surgery in Madrid with Dr. Gómez Sancha

Dr. Fernando Gómez Sancha · Medical Director, ICUA · Clínica CEMTRO, Madrid, Spain
Last updated: March 2026

If you are reading this from outside Spain and considering where to have your prostate surgery, you have probably done a fair amount of research already. Perhaps you have a very large prostate and your urologist has recommended open surgery. Perhaps you have been offered a TURP but have read that retreatment is common. Or perhaps you simply want access to one of the most experienced HoLEP surgeons in the world, and your search has led you here.

At ICUA, we have been receiving patients from around the world for over 15 years. We have developed a streamlined process so that coming to Madrid for surgery is straightforward, safe, and free of surprises.

Why patients from around the world choose ICUA

The short answer: experience, technique, and results.

• Over 10,000 HoLEP procedures performed by Dr. Gómez Sancha — one of the largest individual series in the world.
• A proprietary technique published in peer-reviewed journals: en bloc enucleation with early apical release, with verifiable results in 754 consecutive patients.
• International training reference centre: over 400 urologists from 60+ countries have trained in our technique at ICUA.
• Dedicated team: multilingual coordination, preoperative video consultation, fixed all-inclusive quote before you travel.
• Clínica CEMTRO: a leading private hospital in Madrid with state-of-the-art technology.

But beyond the numbers, what our international patients value most is direct communication with the surgeon throughout the entire process. At ICUA, you speak directly with Dr. Gómez Sancha during your preoperative video consultation. Not with an intermediary, not with a call centre.

The process step by step

Step 1 — First contact and medical records
You write to us by email or WhatsApp. You send your medical records: prostate ultrasound (with volume), blood test with PSA, flowmetry if available, and any additional investigations. Our team reviews the documentation and confirms whether you are a candidate for HoLEP.

Step 2 — Video consultation with Dr. Gómez Sancha
A 20–30 minute video consultation in which we review your tests together, I explain which technique is most appropriate for your case, answer all your questions, and set realistic expectations about the outcomes.

Step 3 — Fixed quote and planning
We send you a detailed, fixed quote that includes everything: surgery, anaesthesia, hospital stay, disposable materials, histopathology, and follow-up. No hidden extras. Our coordinator, Vanesa Cuadros, helps with travel planning: surgery dates, accommodation near the clinic, and logistics.

Step 4 — Arrival in Madrid and surgery
We recommend arriving the day before surgery. The operation is performed at Clínica CEMTRO. Most patients stay one night in hospital and return to their hotel the following day with their urinary catheter in place.

Step 5 — Recovery in Madrid (5–7 days)
The catheter is removed at a follow-up visit a few days later. We perform a control flowmetry and ensure everything is in order before you return home. Madrid is a comfortable city for recovery: good weather, excellent food, and your hotel will be minutes from the clinic.

Step 6 — Remote follow-up
Once you are home, we follow up by video consultation. We provide a comprehensive clinical report in your language and a detailed medical invoice to facilitate reimbursement from your insurer or healthcare system.

Practical information

Getting to Madrid

Madrid-Barajas Airport has direct flights to and from all major European cities, the Middle East, Latin America, and many destinations in Asia and North America. Clínica CEMTRO is in north-west Madrid, well connected by public transport and surrounded by several hotels within a short distance. We can recommend nearby accommodation with special rates for patients.

Languages

Dr. Gómez Sancha is fluent in Spanish and English. Coordination with Vanesa Cuadros and the ICUA team is available in Spanish, English, and for many patients, Portuguese. For other languages, we arrange translation assistance as needed.

Cost and billing

The quote is fixed and in euros. It includes everything needed for surgery and initial postoperative follow-up. We issue a detailed medical invoice and a comprehensive clinical report to facilitate reimbursement in your country. The cost of HoLEP in Spain is significantly lower than in the United States, the United Kingdom, Switzerland, or the Gulf states, with outcomes comparable to or better than leading international centres.

Do I need a visa?

Citizens of the European Union, the United Kingdom, the United States, Canada, Australia, Japan, and most Latin American countries do not need a visa for stays of up to 90 days in Spain. For patients who do require one, we provide medical documentation to support the visa application.

Common questions from international patients

How long do I need to stay in Madrid?

Plan for 5–7 days in total: arrive the day before surgery, one night in hospital, and 3–5 days at a hotel while we monitor your recovery and remove the catheter. Most patients fly home comfortably within a week of surgery.

Can my partner or family come with me?

Absolutely. Many patients travel with their partner. Madrid offers plenty for a companion to do while you recover — it is one of Europe's great cities for food, culture, and walking. Some couples treat the trip as a short holiday once the medical part is complete.

What if something goes wrong after I return home?

Complications after HoLEP are rare, but we are always available. You will have direct contact with our team by email and WhatsApp. If a situation arises that requires in-person attention, we coordinate with a local urologist in your area or arrange your return to Madrid if necessary. In over 15 years of treating international patients, this has been an exceptional occurrence.

My prostate is very large — can I still have HoLEP instead of open surgery?

This is one of the most common reasons international patients come to us. Many have been told they need open surgery because their prostate is over 100, 150, or even 200 grams. In our experience, prostate size is not a limitation for HoLEP — in fact, larger prostates often benefit the most from enucleation. Our published series includes prostates well over 200 grams, all operated endoscopically with excellent outcomes.

A personal note: Receiving a patient who has travelled from another country to be operated by me is an enormous responsibility. That person has placed their trust not only in my medical judgement but has also left their home, their family, and their support network to put themselves in my hands. I take that trust very seriously, and the care our international patients receive reflects that commitment.

Are you outside Spain and want to know if HoLEP is right for you?

Send us your medical records and we will respond within 48 hours with an initial assessment.
📞 +34 91 435 28 44 · ✉ icua@icua.es
WhatsApp: +34 91 435 28 44

Scientific references

1. Iscaife A, Rodríguez Socarrás M, Talizin TB, et al. Contemporary results of En Bloc HoLEP for large prostates. World J Urol. 2025;43:401. PubMed
2. Saitta G, Becerra JEA, Del Álamo JF, et al. 'En Bloc' HoLEP with early apical release. World J Urol. 2019;37:2451-2458. PubMed
3. Gauhar V, Gómez Sancha F, Enikeev D, et al. Results from a global multicenter registry of 6193 patients (REAP). World J Urol. 2023;41:3033-3040. PubMed

Related articles

→ What Is HoLEP? A Complete Guide to Holmium Laser Enucleation of the Prostate → HoLEP Prostate Surgery: What to Expect Before, During and After → Finding the Best HoLEP Surgeon: What to Look for and Why Experience Matters → How Much Does HoLEP Surgery Cost? Factors That Affect the Price

How Much Does HoLEP Surgery Cost? Factors That Affect the Price

Dr. Fernando Gómez Sancha · Medical Director, ICUA · Clínica CEMTRO, Madrid, Spain
Last updated: March 2026

It is a fair and necessary question. You have every right to know how much your surgery will cost before making a decision. And you have every right to understand what you are paying for and why prices vary so much from one centre to another.

I will be as transparent as possible about the factors that influence the cost of HoLEP surgery, what a serious quote should include, and why the lowest price is not always the most economical option in the long run.

Why does the price of HoLEP vary so much?

If you have been requesting quotes, you have probably encountered very significant differences between centres. This is because the cost of a HoLEP depends on multiple factors, and not every centre includes the same items in their quote.

Prostate size

A 40-gram prostate is not the same operation as a 180-gram one. With large prostates, surgical time is longer, more operating theatre time is needed, more anaesthesia time, and occasionally an extra night in hospital. Prostate size is the single factor that most influences the duration of the procedure and, therefore, the associated costs.

Type of anaesthesia

HoLEP can be performed under general anaesthesia or spinal anaesthesia. Spinal anaesthesia, when feasible, is safer in older patients, allows faster recovery, and slightly reduces costs. In our practice, most patients are operated under spinal anaesthesia.

Length of hospital stay

At ICUA, most patients stay one night in hospital and go home the day after surgery with their urinary catheter, which is removed at a follow-up visit a few days later. Some centres keep patients in hospital until catheter removal — this increases hospital costs without proven clinical benefit.

Surgeon experience

Let me be direct about this. The fees of a surgeon who has performed 10,000 procedures are not the same as those of one who has performed 50. And they should not be. Surgeon experience is the single factor that most influences HoLEP outcomes — complication rates, speed of recovery, likelihood of requiring retreatment, and continence preservation.

When comparing quotes, do not compare numbers alone. Compare what those numbers represent.

Equipment and technology

The holmium laser is a sophisticated piece of equipment that requires constant maintenance and disposable laser fibres of significant cost. A morcellator is also needed to fragment the tissue, along with an operating theatre equipped with a high-definition endoscopic tower. Centres with their own up-to-date equipment can offer greater efficiency than those that hire equipment on a per-procedure basis.

What should a HoLEP quote include?

A complete, honest quote must include all components with no hidden extras. At ICUA, we provide a fixed, itemised quote that includes:

• Surgical team fees: surgeon, assistant, anaesthetist.
• Operating theatre time: full surgical duration.
• Disposable materials: laser fibre, morcellator, catheter, irrigation supplies.
• Hospital stay: private room, medication, nursing care.
• Histopathological analysis: examination of the removed tissue — essential to rule out incidental prostate cancer.
• Postoperative follow-up: follow-up appointments, catheter removal, control flowmetry.

A word of caution when comparing quotes: Some centres offer an attractive initial price that does not include the anaesthesia, histopathological analysis, or follow-up visits. Always request a full breakdown before making comparisons. A quote that does not include pathology analysis of the removed tissue is, in my view, unacceptable — choosing not to analyse the tissue means choosing not to diagnose a possible incidental cancer.

Insurance and HoLEP

Private insurance in Spain

Most private insurers in Spain cover surgery for benign prostatic hyperplasia, including HoLEP, when there is a medical indication. However, conditions vary between companies and between policies. Some points to consider:

• Some insurers require prior authorisation and may insist that medical treatment has been tried before approving surgery.
• Reimbursement may be partial if the surgeon or facility is not within the insurer's approved network.
• Co-payment policies may cover a variable percentage of the total cost.

At ICUA, we treat patients from all major Spanish insurers and manage the necessary authorisations. We recommend checking with your insurer before your first visit to understand the specific conditions of your policy.

International patients

We receive patients from all over the world — Europe, the Middle East, Latin America, Asia. For international patients, we provide a detailed medical invoice and a comprehensive clinical report that facilitates reimbursement from your insurer or healthcare system in your home country. The cost of HoLEP in Spain is significantly lower than in countries such as the United States, the United Kingdom, or Switzerland, with outcomes comparable to or better than the leading international centres.

The hidden cost: the surgery that needs repeating

This is the most important consideration in this article, and one that rarely appears when prices are being compared.

Transurethral resection (TURP) — the classic technique — has a retreatment rate of 10–15% at 8–10 years. This means that roughly one in seven or eight patients will need to be operated on again. That second operation is more complex, carries more risk, and naturally comes with an additional cost.

HoLEP, by removing the entire adenoma, has a retreatment rate below 2%. In our series of 754 patients with long-term follow-up, the likelihood of requiring reoperation due to regrowth is exceptional.

If a HoLEP costs somewhat more than a TURP but virtually eliminates the possibility of a second operation, which is truly the more expensive option? And that is without factoring in the cost to quality of life — going through surgery again, another period off work, another recovery.

The right question is not "how much does it cost to have surgery?" but "how much will it cost to solve this problem once and for all?" And the answer to that second question almost always favours HoLEP.

Why Spain? A note for patients travelling for surgery

Spain has become one of the leading destinations in Europe for prostate surgery, and for good reason. The combination of highly experienced surgeons, modern private hospital infrastructure, competitive pricing, and a pleasant climate for recovery makes it an attractive option for patients from countries where either the wait is too long, the cost is prohibitive, or the expertise in HoLEP is limited.

At ICUA, we have developed a streamlined pathway for international patients: remote consultation with review of imaging and blood tests, a fixed all-inclusive quote before you travel, surgery within days of arrival, and a detailed discharge report in your language for continuity of care back home, although we remain available for continued online follow-up.

How to request a personalised quote

Every case is different. Prostate size, the patient's medical conditions, and their insurance situation mean it is not possible to provide a single price for everyone.

What we can do is give you a fixed, detailed quote with no hidden extras after the first consultation, once we have the ultrasound and know your case. If you are coming from outside Madrid or from abroad, we can carry out an initial assessment by video consultation using the tests you already have, and provide an indicative quote before you travel.

Want to know how much your surgery would cost?

Request a consultation or video consultation. We will provide a fixed, personalised quote with no obligation.
📞 +34 91 435 28 44 · ✉ icua@icua.es

Scientific references

1. Iscaife A, Rodríguez Socarrás M, Talizin TB, et al. Contemporary results of En Bloc HoLEP for large prostates. World J Urol. 2025;43:401. PubMed
2. Gauhar V, Gómez Sancha F, Enikeev D, et al. Results from a global multicenter registry of 6193 patients (REAP). World J Urol. 2023;41:3033-3040. PubMed
3. Rücker F, Lehrich P, Gilfrich C, et al. HoLEP in three different techniques: a comparison of 600 patients. World J Urol. 2021;39:4063-4069. DOI
4. Tricard T, Xia M, Trambert C, et al. Open prostatectomy is dead — long live endoscopic enucleation of the prostate! World J Urol. 2023;41:1457-1463. DOI

Related articles

→ HoLEP vs TURP, GreenLight, Aquablation & Open Surgery: An Evidence-Based Comparison → HoLEP Prostate Surgery: What to Expect Before, During and After → Finding the Best HoLEP Surgeon: What to Look for and Why Experience Matters → International Patients: Having HoLEP Prostate Surgery in Madrid