Large or very large prostate
HoLEP has no size limit. It is an endoscopic alternative to open prostatectomy: Dr. Acuña has operated on prostates up to 250 grams without incisions.
Dr. Juan Antonio Acuña
Christus Muguerza · Obispado, Monterrey, Mexico
HoLEP in Mexico: holmium laser prostate surgery in Monterrey.
HoLEP surgery in Mexico for enlarged prostate, with a bilingual, board-certified urologist. 200+ prostate surgeries, prostates up to 250 g, and catheter removal in 24 hours in our practice.
Prof. license 4210936 · Specialty license 6675269 · CMU cert. 2479-25U
Response within 24 hours · Monday–Sunday, 8am–8pm
★★★★★Texas · Google
“Excelente doctor. Muy satisfecho con la atención del doctor Acuña desde Houston TX. Su amabilidad y profesionalismo me brindó mucha confianza para realizarme una cirugía de próstata HoLEP que me realizó en Mayo 2024, todo fue un éxito. 100% recomendado.”
★★★★★Google
“I received excellent care from Doctor Acuña. He performed my HoLEP surgery a week ago and everything is going very well, I feel quite good. I highly recommend the Doctor — he is an excellent physician.”
Who it is for
Who HoLEP surgery for enlarged prostate is for
Holmium laser prostate surgery in Mexico — HoLEP surgery for BPH — is indicated when an enlarged prostate significantly blocks urine flow. These are the cases Dr. Acuña sees most often:
Symptoms despite medication
Weak stream, urgency, or getting up several times at night even with treatment.
Urinary retention or a catheter
HoLEP removes the obstructing tissue so you can stop depending on a catheter.
Patients on blood thinners
The holmium laser coagulates as it cuts, so bleeding is low. Anticoagulants are managed case by case with your cardiologist.
Recurrent infections or kidney damage
Complications of obstruction where surgery stops being optional.
“The technique is chosen based on your case, not the other way around.”
Ask if you are a HoLEP candidate
Holmium laser
What the HoLEP procedure in Mexico involves
HoLEP stands for Holmium Laser Enucleation of the Prostate. It is a holmium laser prostate surgery done through the urethra, with no external incisions. The laser separates the adenoma — the overgrown tissue squeezing the urinary channel — from the prostate capsule; the tissue is then broken up and removed completely.
Removing the tissue completely is what sets HoLEP prostate surgery apart from laser techniques that vaporize tissue: everything removed goes to pathology, so the same procedure also helps rule out prostate cancer. The European Association of Urology (EAU 2024 Guidelines) recommends HoLEP as a first-line surgical treatment for BPH regardless of prostate size.
In Dr. Acuña’s practice, the catheter is removed in 24 hours, hospital discharge is at about 2 days, and the post-operative incontinence rate is under 1%. These are results from his clinical practice; individual results vary.
For HoLEP in Monterrey, Mexico, the surgeon’s experience matters as much as the laser. Dr. Acuña is board-certified by the Mexican Council of Urology, with a fellowship in Endourology and Minimally Invasive Surgery (Hospital Civil Juan I. Menchaca, Guadalajara) and a fellowship in Andrology at Hospital Fundación Puigvert in Barcelona. He operates at Christus Muguerza, Hospital Ángeles, Doctors Hospital and Hospital Zambrano.
For your first visit, bring your kidney and bladder ultrasound and your PSA level. The consultation includes a physical exam, a review of your results and a clear plan of action — with no pressure to decide on the spot.
Your first step can be a virtual consultation from the U.S. Read about HoLEP cost in Mexico or the guide for patients from Texas.
HoLEP vs other options
Is HoLEP better than TURP, GreenLight, UroLift, Rezum or Aquablation?
Which prostate surgery is best depends on prostate size, symptoms and overall health. This is a general comparison — Dr. Acuña performs HoLEP and TURP.
| Procedure | How it works | Prostate size | Tissue for pathology |
|---|---|---|---|
| HoLEP | Holmium laser removes the entire adenoma (enucleation) | Any size | Yes |
| TURP | Electric loop removes tissue in pieces | Small to moderate | Yes |
| GreenLight laser | Laser vaporizes tissue | Small to moderate | No |
| UroLift | Implants hold the prostate open; no tissue removed | Smaller prostates | No |
| Rezum | Water vapor shrinks tissue over several weeks | Smaller to moderate | No |
| Aquablation | Robotic waterjet removes tissue | Moderate to large | Limited |
| Simple prostatectomy | Surgical removal through an abdominal incision | Very large | Yes |
General information based on current guidelines. For the best laser surgery for enlarged prostate across all sizes, the EAU lists HoLEP as size-independent; the right option for you is decided at consultation.
01Is HoLEP better than TURP?
In HoLEP vs TURP comparisons, HoLEP shows equivalent or better outcomes with lower morbidity (Descazeaud et al., 2011) and has no size limit. TURP remains a solid option in selected cases. Dr. Acuña performs both.
02HoLEP vs GreenLight laser: what is the difference?
GreenLight vaporizes prostate tissue, so nothing is left for pathology and it is more limited in very large prostates. HoLEP removes the adenoma completely and sends it to pathology.
03HoLEP vs UroLift and HoLEP vs Rezum: which is better?
UroLift and Rezum are less invasive options mainly for smaller prostates and do not remove tissue. HoLEP removes the obstruction completely and works for any size. The choice depends on your prostate and symptoms.
04HoLEP vs Aquablation and HoLEP vs prostatectomy for a very large prostate?
For very large prostates, HoLEP is an endoscopic alternative to an open or robotic simple prostatectomy, with no abdominal incision. Dr. Acuña has operated on prostates up to 250 g with HoLEP.
05How long do I stay in Mexico for HoLEP?
In Dr. Acuña’s practice, discharge is at about 2 days. Plan your trip around the consultation, surgery and discharge; follow-up continues by WhatsApp.
Next step
HoLEP in Mexico: holmium laser prostate surgery in Monterrey.
HoLEP in Mexico with Dr. Acuña: holmium laser prostate surgery in Monterrey for any prostate size, catheter out in 24h. Bilingual. WhatsApp +52 81 3402 5427.