Green light laser prostate procedure

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Probably been discussed a million times on here but can anyone with knowledge or experience enlighten me on Green Light laser treatment.   Good/Bad??

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  • Posted

    AI have done research in aquablation, GLL and HoLEP. Success of GLL is well documented. Between GLL and HoLEP, HoLEP has better functional outcomes and durability. Both have RE. But ejaculation preservation technique can be applied to GLL but not to HoLEP. For large prostrate, HoLEP is the only answer. Not sure if u agree. 
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  • Posted

    The reason I went for a HoLEP instead of GL was that statiscally it shows greater longevity than GL and hopefully I shan't need to have the procedure repeated again.

    Another reason to consider HoLEP is that unlike GL, prostate tissue is recovered for histology purposes allowing the path lab to look for PCa which in my case they did find a Gleason 6 PCa, thus allowing me to make decisions on treatment, something I wouldn't have been able to do had I undergone a GL, as the PCa would have gone undiscovered.

    Three years on symptom free, peeing like a teenager and not limited to always having to be close to a toilet.

    OK, so I have RE which doesn't bother me but no ED which is great.

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  • Posted

    It is like TURP, but with less bleeding and shorter recovery time. Hank

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    • Posted

      Very good point. laser beam coagulates as it cuts or ablates the prostate tissues is a major advance in BPH surgery.

      apart from the fact that statistically, a patients could be the unlucky one to suffer from a certain complication, advanced age and a large prostate could greatly increase the recovery time.

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    • Posted

      Once after I had an operation as an NHS patient the anesthetist asked me who had performed it. I said Jack. He replied that it wasn't Jack as he knew him but that he had been there. I asked Jack later and he assured me that he had performed it as he had previously told me. He said that there had been another surgeon from Eastern Europe observing who had not had any part of it.

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  • Posted

    A word of caution in respect of over doing physical work following a TURP, GL or HoLEP.

    The surgeon will always tell you not to strain yourself by over exerting the muscles around the prostate for at least two weeks or more, by avoiding heavy lifting, bending, twisting, etc however, I felt so well I did some moderate lifting and bending on day nine following the procedure and paid the consequences when the wound scab detached a couple of hours later leading to very serious haemorrhaging which took a week in hospital to control.

    When I researched the HoLEP procedure before it was carried out, I read up on the complications and what happened to me is a 1 to 2% risk, so be warned, it isn't worth ignoring the advice on over exerting yourself, no matter how well you feel.

    Would I have a HoLEP again (not that I shall need to) despite the complication I experienced, yes I would. The freedom to have a life free of UTIs, needing to pee every half hour or so, getting up a dozen times a night and constantly worrying about going into urinary retention was worth the complications and a few days discomfort.

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    • Posted

      thanks for this very critical advice, which i will remember as i am about to have holep soon. do u think if swimming (force generated mostly by the upper body) within two weeks after holep is recommended?

      i too have read a huge amount of literature and have come to the same conclusion as urs.

      by the way, according to the results of several clinical trials, the durability of holep is more than 10 years. (my uro is expecting the outcomes to last 14 years.) . within this period the reoperation rate is reported to be less than 5 %, and many patients have maintained their excellent functional outcomes.

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    • Posted

      dl, I've read the same re holEp. I think it's the best procedure as long as one is not concerned with RE since it's almost certain, and a small risk of incontinence.

      BTW, have you found out the lower limit of prostate size that can be done with holEp ? Hank

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    • Posted

      I'd give swimming a miss for at least 3 weeks and even after that be careful.

      I might have been just one of the unlucky ones who's healing process takes longer which given my age at the time 67, plus I'm type 2 diabetic is very probable.

      Hopefully, you'll suffer no blood in the urine after a day or two and the catheter will be removed before you go home, either the same or next day.

      If you are not doing pelvic floor muscle exercises start straight away and don't stop until just before the procedure. I've read several accounts of where some men were neither told about the need to do these exercises or they were and they paid no heed to the advice. Bad move and they suffered the consequences of having very little bladder control for weeks and dribbled for months.

      I did the exercises two or three times a day for a month prior to the procedure and benefited greatly, by way of good bladder control and no dribbling within 48 hours of the op.

      One last thing, I had my procedure done with a spinal block anesthetic which made things a lot more pleasant with rapid recovery afterwards. Also you get to chat with the operating room staff and surgeon throughout the procedure which was fun.

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    • Posted

      I think you will find that if the median lobe is the main cause of the urethral restriction, a prostate with minor enlargement would justify the HoLEP procedure, as was the case in respect of my restriction.

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    • Posted

      Range of Prostate size which is operable by HoLEP :

      25 -800 cc.

      25cc is a real life experience whereas 800cc is from literature (could be from a paper by peter gilling, an authorative on holep.). there are plenty of posts by patients who had 130 to >200cc prostates sucessfully operated on by HoLEP, they are very happy with the outcomes.

      For prostate size larger than 80cc, open prostectomy is often required or suggested, but holep is uniquely best qualified for that range of prostates.

      After HOLEP, incontinence, which is transient, could be as high as 17%, but there is a technique called bladder neck preservation reduce the chance to less than 2%. Dr. Miller of Vanderbuilt and Dr. Das of JEFFERSON, both use this technique.

      All resective procedures that removes tissues from the prostate seem to give RE, though the chance of having it could be reduced if ejaculation preservation technique is applied.

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    • Posted

      Sincere thanks to ur advices.

      indeed, my uro's office did not tell me about pelvic floor exercise but had read it from posts. will start it right away.

      i appreciate ur time in replying to my question.

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