Plain-English guidance on enlarged prostate, HoLEP and treatment in Madrid. Patient education from Dr Fernando Gómez Sancha and ICUA. Not medical advice.
Madrid, Spain
Joined August 2026
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I have spent years answering the same questions by email from men considering HoLEP abroad. So I wrote the answers down once, properly. A free patient guide to en bloc HoLEP, in English and Spanish:
holep.icua.es/en.html?utm_so…
Public healthcare and HoLEP: waiting lists and technique
Full video: youtu.be/o428xUnGKkc
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Do not send medical records by ordinary email or social media. Write first without attachments; the guide explains a secure way to share documents.
holep.icua.es/en.html?utm_so…
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Saw palmetto: what the studies really say
Full video: youtu.be/BV7DsxbKkVI
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Why do you end up with a permanent catheter?
Full video: youtu.be/2AlOMwqaHYg
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A negative study I cite on purpose, in a patient guide, about my own technique. Gauhar et al. 2024: 4,392 patients, eight centres. 🧵
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Finding: incontinence similar with and without early apical release; longer operating time and more early complications (haematuria, transfusion) in the release group.
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Why cite it? Because a guide that only shows the studies that agree with the surgeon is marketing. The reader should see how the evidence is read, not just its conclusion.
holep.icua.es/en.html?utm_so…
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Ask how many HoLEPs they do a year, how they measure continence, and their own rates of transfusion, stricture and retreatment. The laser brand matters less than the surgeon's hands.
holep.icua.es/en.html?utm_so…
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After HoLEP: what happens on day one?
Full video: youtu.be/A9x7WEXT27g
A stronger stream often returns sooner. Urgency can take longer if the bladder has been obstructed for years. Clearing the blockage doesn't resolve every bladder complaint overnight.
holep.icua.es/en.html?utm_so…
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If you take blood thinners, never stop them without talking to your doctor. The doctor who prescribed them and the surgical team plan the timing.
holep.icua.es/en.html?utm_so…
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Ask your urologist this before surgery
Full video: youtu.be/pR88GFjKOYM
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Considering travelling to Madrid for en bloc HoLEP? The pathway has eight steps. The first one is not a plane ticket. 🧵
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4. Assessment in Madrid
5. Surgery and discharge
6. Recovery in Madrid, a few days
7. Flying home when the team says it is safe
8. Follow-up at home, in shared care with your own urologist
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Every step is described in the guide, including what can make it longer. Read it before you write to us; it will make the first email better.
holep.icua.es/en.html?utm_so…
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Before any operation, we usually check flow, residual urine, imaging and PSA history — and sometimes we need to look inside the bladder. Surgery helps only if the problem is a real obstruction.
holep.icua.es/en.html?utm_so…
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HoLEP may be considered when pills no longer help, retention keeps returning, or the bladder or kidneys are starting to suffer. Size alone never decides.
holep.icua.es/en.html?utm_so…
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Prostatitis: not cancer, not an enlarged prostate
Full video: youtu.be/gwQD8XeEt9Y
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Dutasteride and sex: what you weren't told
Full video: youtu.be/vw9GILiI3DA
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