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uncommon.","revision_rate_pct":{"min":1,"max":4,"unit":"percent","qualifier":"Reoperation for stricture, bladder neck contracture or residual adenoma regrowth within about 5 years."},"scars":"No external incisions or scars; the procedure is performed transurethrally.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operative session for standard HoLEP."},"stages":[{"code":"enucleation_morcellation","label":"Laser enucleation of adenoma, then morcellation and catheter placement in one operation","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed during the same operative session."}}],"qualifier":"One-stage transurethral procedure."},"success":{"metric":"Postoperative average maximum urinary flow rate (Qmax)","value":20,"unit":"mL/s","horizon":"12 months","population":"Adult men with symptomatic BPH and bladder outlet obstruction","evidence_status":"limited"},"techniques":[{"name":"Standard three-lobe HoLEP with morcellation","suits_whom":"Men with symptomatic BPH of any prostate size, including large glands.","recovery":"Catheter 1-2 days; return to light activity in about 1-2 weeks."},{"name":"En bloc HoLEP (EBEP)","suits_whom":"Men with BPH where the surgeon prefers removing the adenoma as a single piece.","recovery":"Broadly similar to standard HoLEP; some series report faster early continence recovery."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":1,"max":2.5,"unit":"hours","qualifier":"Operative time for a typical prostate; varies with gland size and surgeon experience."},"initial_assessment_documents":["Prostate ultrasound report with volume","Recent PSA test result","Uroflowmetry and post-void residual results","Urinalysis and urine culture report","List of blood thinners and other medications"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay 4-7 days including 1-2 nights in hospital, catheter removal and pre-flight check."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team treating you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check the facilities and standards at the clinic or hospital where you will be treated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that you understand the possible complications and side effects of the treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Check how your aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Get a second opinion from a doctor on the treatment and whether it is necessary","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"A doctor can give you a valuable second opinion as well as advice about treatment options and whether it's necessary.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"A hard sell when offered treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"Pressure to make a quick decision about treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"No discussion of possible complications before booking treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-13","next_check_at":"2027-02-11"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Lab report on removed prostate tissue, checked for cancer","document":"pathology report","source":{"url":"https://www.uhsussex.nhs.uk/resources/holmium-laser-enucleation-of-the-prostate-holep/","host":"uhsussex.nhs.uk","quote":"The removed tissue will be sent to the laboratory for analysis to check for any signs of prostate cancer.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T2","text":"Gives the planned catheter removal timing for home follow-up","document":"catheter removal plan","source":{"url":"https://www.uhsussex.nhs.uk/resources/holmium-laser-enucleation-of-the-prostate-holep/","host":"uhsussex.nhs.uk","quote":"This is typically on day 3 after surgery, based on the best chance of successful removal.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T3","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including 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