Anyone had HoLEP procedure with Dr James Roberts, San Diego, CA, USA ?

Posted , 7 users are following.

Anyone had HoLEP procedure with Dr James Roberts, San Diego, CA, USA ?

How was your experience ? I followed up on a tip from this forum and called his office. It's true that he does the procedure. When asked how long he has been doing HoLEP, the nurse answer was: "Geezzz! Since he started working in this office and it has been a long time ago." I was told the procedure will be done at either Sharp or Mercy hospitals in San Diego, but he is booked well into May.

The good news is they do take my Medicare Advantage HMO, but I need to get a referral from my PCP first. No more pills ? No more catheters ? Wow! I am so excited at the prospect. Having HoLEP done in my hometown, with insurance covering it. πŸ˜€

HoLEP is by far my preferred choice. Second is bipolar TURP. Sure, it comes with some risks. Retro ejaculation risk at 75% ? I already have RE from my doxazosin. It would then be a positive since it means I would have 25% chance of no longer have RE. Incontinence risks ? I think I can handle the few months of temporary incontinence, or even the 1% of permanent. In return, I might be able to forget the pills, the catheters for a long, long time.

0 likes, 18 replies

Report

18 Replies

Next
  • Posted

    I can't vouch for Dr. Roberts but I can highly recommend HoLEP having had it done in June 2016. It seems you asked the key question and that concerns his experience with this procedure. If he has done

    "hundreds"or more that's a requirement for a good outcome. If I were you I would book a slot ASAP.

    Report Reply
    • Posted

      Thanks James. Could you give us more info about your case, before and after ? We don't seem to have many HoLEP people around. It seems they all walk away after the procedure, because of the success, I hope. πŸ˜€

      Report Reply
    • Posted

      Well, like you I had reached the point of self cath and pills with a PSA of 9. My GP suggested I see his favorite Urologist who, after examination told me that my prostate was too large for a TURP whereupon he (being a true surgeon) said I was a candidate for a simple open prostatectomy . WOW I'm thinking that is a BIG DEAL and decided against it. From there I saw a young female Urologist who specialized in robotic surgery which seemed okay but still had me concerned as to what function I may or may not loose. Of course there are no guarantees with any surgical procedure and she was not very helpful when I was asking questions re possible ED, RE incontinence etc. but she did bill for the visit.

      I was also doing research on all the available and upcoming methods and settled on HoLEP because it was " the new Gold Standard" for BPH and urinary retention plus there was a skilled surgeon local to me (I live on Long Island, NY) and was happy to know that my Insurance would cover the cost.

      Hospital experience was well orchestrated. The surgery took three hours and all tissue removed with the laser is morsellated and sucked out and checked for any signs of cancer. Overnight in hospital with great care by nursing staff. Home the following day with foley catheter installed. Cath removed three days later.

      I should say that prior to surgery I was told of the likely hood of incontinence for a period of time and should practice "Kegel" exercises to strengthen the sphincter that has become weakened. I was wearing "Depends" for a few months then just a pad for a while and then back to near normal. I still have minor leak occasionally but not a real issue. RE is pretty much guaranteed.

      Any other questions you have please feel free to ask.

      Report Reply
    • Posted

      Thanks for sharing James. Your case is a text book HoLEP, just as I've read. I feel like I have nothing to lose. I even experience occasional stress leakage currently, probably from self cathing and/or the pills, but it's no big deal. My only concern is that my prostate is not that large, about 60g. I've read that HoLEP is good for any prostate size, but I won't know if Dr Roberts would agree to that until I see him.

      Report Reply
  • Posted

    Hank, that sounds great! I'm like you, I hated taking pills for my enlarged prostate. At first, I would have head aches, dizzyness etc. Now with self-cathing, I'm free of those pills and have a great comfortable feeling of an empty bladder. In my case, I don't know if a Holep would help. My bladder is flacid from years of being enlarged. Good luck to you!

    Report Reply
    • Posted

      Thanks Dennis. I have a similar bad bladder, it's why I am only considering HoLEP, which has about 99% success of improvement in urinary retention, with the average improvement of about 200ml, because it removes obstructions very well, almost like a prostatectomy. Less obstruction means less work for the bladder, more chance to rehab, less retention.

      I am also self cathing and it has served me well for the last 3 years. But I think it's time for me to move on.

      Report Reply
    • Posted

      Hank, good luck! This is interesting. 200ml, is very good. I would be happy to pass that much urine on my own. I wonder if there are any doctors in Hawaii?

      Report Reply
  • Posted

    I have an appointment with Dr. Roberts last week of April, he is booked way out. Had my second ultra sound last week and learned my prostate is 177ml-cc, retaining 210ml, have damaged my left kidney due to urine backup. MY GP is getting excited that I need to do something RIGHT NOW. He is suggesting I do the microwave procedure to buy some time. He will not give me CIC as he believe it will lead to UTI's. I have no clue how much additional damage to my kidney I will do in another 2 month waiting for the first appointment and the surgery but it gives me pause. When I see Dr. Roberts I will discuss CIC while I wait.

    Report Reply
    • Posted

      The nurse said he is booked well into May. How bad is your kidney damage ? 210ml is not that bad. CIC if done cleanly has very low risk of UTIs, actually it lowers UTI if you have retention. I have been doing it for 3 years and zero UTI, knock on wood. And I am not doing CIC that cleanly either.

      I am not sure I'd go for microwave.

      When you see Dr Roberts, ask him if he would recommend HoLEP for a 60mg prostate for me. I know HoLEP is best for larger prostates like yours but I've read it can be done on any size.

      Report Reply
    • Posted

      Im like Hank. I've been doing cic for close to three years, as far as I know, I haven't had an infection. I think you should insist on doing cic's with that doctor of yours. After all, it's your body and not his that will have kidney problems, potentially!

      Report Reply
  • Posted

    Sadly Dr. Roberts does not do HoLEP. My only options through him because I have 177gr prostate is simple prostatectomy, which is a open surgery process. I asked about robotic surgery and he would hand me off to another doctor in the group that does the procedure. I have to say I really liked Dr. Robert, easy to talk to very informative. He claims about 4% incontinence with the open procedure. I'm not ready for those odds yet. Still in the hunt for HoLEP.

    Report Reply
    • Posted

      Sorry to hear that he doesn't do hoLep. The nurse that you and I talked to must have been mixed up. Hmmm. Back to the drawing board. DaveCanPee on this forum had robotic open prostatectomy and had good results. But I still prefer HoLep.

      Report Reply

Join this discussion or start a new one?

New discussion Reply

Report as inappropriate

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up