GreenLight Vs Urolift
Posted , 28 users are following.
Hi
I live in Toronto, Canada. I have been suffering with BPH for the past five years. I am 54 years old with no children and don't expect to have children. I am faced with two options. Take the greenlight surgery which is completely free and is paid by the government health insurance. The other option is to do the Urolift, but it will cost me $10000 which is not covered by insurance and has to come out of my own pocket. $10000 is a lot of money for me. I am not sure how long the urolift will last and if my prosate will keep on growing even with the urolift in place.I really don't know what to do. Hoping that you'll can give me some suggestions.
1 like, 129 replies
RonTexan daniel1960
Posted
A multitude of patient reports in these forums reflect negatively on Green light laser surgery. For myself I would never consider it, there are much better options such as Button Turp and Holmium Laser enucleation of the prostate; HOlep. My urologist's usual method is Button turp and he recommended it to me until it was discovered that my prostate was too large for Turp also. So my only options were supra-pubic simple prostatectomy (incision below the navel, into the bladder and core out the prostate via the bladder neck, HORRORS) or Holep which accesses the prostate thru the urethra, like Green Light or Turp, except Holep uses a much more precise, more controllable laser than Green light with highly-experienced surgeons and performed only in large University Hospitals or Clinics such as the Mayos. It is much less dangerous and invasive and almost always has very satisfactory results. It may be difficult to find a Holep surgeon but they I'm sure that they exist somewhere in Canada.
If Holep is not a possibility then I would insist on Button Turp. Canada will have many thousands of surgeons performing that procedure. It is widely known to be easier on the patient than Green Light and I would be suspicious of any surgeon still using green light nowadays.
I was very fortunate in finding a Holep surgeon at the Mayo Clinic in Phoenix who could slot me into his schedule in about 30 days. I had the procedure done on October 31st. I never had any actual pain only pink urine and mild discomfort for about a week. It has been thirty eight days now and I am enjoying a new life. I get urges to urinate every three or four hours and can wait for half an hour or so before finding a bathroom. I completely empty my bladder every time. My stream would knock the bark off of a tree. I'm 76 and I don't recall, even as a teenager, having a stream like now. I find that I'm taking a lot more liquids, drinking beer usually instead of wine or liquor, than I used to since urinating was always such a problem. I sometimes get up once every night if I took a lot of liquids the day before. In short, I'm more normal than I have been in at least thirty years and I'm really enjoying my new life.
I have said many times in these forums that if I could go back ten years I would never take any of the meds, such as Flomax. It works fine for awhile but sooner or later it won't be enough and they will prescribe more meds which will effectively castrate you, maybe permanently.
Rather than taking any of the Meds I would first try to have Holep done. If that isn't possible I would have Button Turp, not Green Light Laser. If I were having Urolift done it would be by a surgeon who has done at least a few dozen of the procedures. It's a minimal learning curve but still ............................!
Learning what we have in the last six months of participating in these forums every day I think I would just gut up and have either Holep or Button Turp done and skip Urolift. It 's a stop-gap measure at best and the Prostate will continue to grow. That's another factor about Holep, though, it's a once and done routine, only one percent of Holep patients have another procedure later on.
Whatever you decide (or is decided for you), post your results here and continue to update. Many thousands of BPH patients will read these posts. I first learned about Urolift on the web and here in these forums. I then learned about Holep in these forums. My urologist recommended against both of them. Actual patients, not medical professionals, have given me the information to help me gain a new life and I intend to give back. I am very grateful to the posters who revealed options I never knew existed. I hope you will offer the benefit of your experience as so many others do every day.
Best of luck to you and Merry Christmas!
Ron
Albin RonTexan
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RonTexan Albin
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I still don't know for sure the cost of Holep after Medicare and Medicare supplement but the total is somewhere north of $16,000 at the Mayo. Ouch! I may have to pay a bit out of pocket but not much. The trip to Phoenix and all that for me and for my son to come help me get back (turned out to be unnecessary) was close to $2000 though.
When I tried to have Urolift done just a few months ago Medicare had approved it but the word had not filtered down to the surgeons so it was being done out of pocket but the surgeons assured me that I would be reimbursed by Medicare within a year or so. Your experience shows that HMO's, at least, have caught up.
I know that the Mayos do not accept Medicare Advantage Plans only regular Medicare. A supplement policy will cover anything that Medicare covers. So, if you are considering Holep at the Mayos be sure you have regular Medicare.
There are other locations for Holep other than the Mayos, such as Indianapolis, Nashville, Boston and others, all huge regional University Hospitals. It is done in these Hospitals because of funding the very extensive training and equipment necessary for Holep.
So, my advice, get your insurance in order, then go to the Mayo and have Holep done.
My experience has been that Holep is no more invasive than urolift with one exception; with Holep, Turp, Green Light or any of the procedures that remove prostate tissue you will almost certainly have retrograde (dry) ejaculation. Since the meds gave that to me years ago Holep didn't make it any worse and my sex life is now improving. I don't miss the wet part at all. .
Urolift will not cause retrograde ejaculation so if that's absolutely crucial to you then Urolift may be the right ticket. Just be aware that with urolift there will be another procedure in your future as the prostate continues to grow.
Best of luck to you and be sure to post your results here, good or bad, patients need actual experiences not Dr. BS. Thousands (millions?) of patients worldwide can benefit from your experience.
Ron
derek76 Albin
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There are lots of medical reviews/comparisons of the different procedures online that I will not post as the moderator may not like the commecial aspects of them.
daniel1960 RonTexan
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Thanks for your input. I am very surprised that it costs only $2500 to do the urolift. I wonder if the price is also for Non US Citizens. I have written to them and lets see what they say. My only problem is that I don't want to have the retrogade ejaculation.I did go on Rapaflo for abouta month and experienced Retro and hated it. I have been on hytrin(Terazozin) for the past three years. But think it is not working as it should. I keep on getting unirary infections. That is why I am looking for the surgery. I don't mind doing the Urolift, even if it works out for me for the next five years so long as I don't get the retro. Who knows in the next five years what will be available. Ron what do you know about PEA? I heard that there is a urologist in Portugal who is very successful in curing BPH using this method.
I spoke to my urologist about your view of Holep vs Greenlight(From your previous posts I have been reading your post for the past few weeks), he told me that it is nonsense. It is the same cutting, whether you use a green light laser or red light laser. He told me that he could cut my prostate in such a way with teh green light laser that I may not get retro, but no guarantee. But I don't want to take the chance. So thank you so much your your input, I really do appreciate it.
I wish you a Merry Christmas and Happy New Year 2015 to you and your family.
Dan
derek76 daniel1960
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RonTexan daniel1960
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This is an area where we really need to hear actual results of PAE. If it's a wonder cure we are not hearing about it here. How about it guys? Speak up, there are thousands of sufferers who want to know about PAE!
I certainly don't know much about the procedure so if others can add to my assessment, feel free to do so.
As far as urologist's opinions of procedures other than the ones they prefer, let me say this; Holep is a laser, true but a very precise laser compared with others, allowing the surgeon to approach the capsule more closely without damaging the capsule or the nerves on the capsul surface. He is able to remove a larger proportion of the prostate tissue in some cases leaving only the empty capsule. Other lasers will not do that. That's exactly the same sort of response I got from two urologists concerning urolift and Holep. My long-term uro who is head of urology in a very well-respected hospital had never heard of urolift when I expressed an interest in it about five months ago. He also had never heard of the current version of Holep which is much-improved over the previous version. When I told him that I would have to go out of state to get the Holep done his reply was "doesn't that make you feel in your gut that if no one here is doing it there must be a reason"? I replied, yes but the reason is that Holep has a very high learning curve, each surgeon trains with a mentor for dozens of procedures and only practices in the huge regional University teaching hospitals with every facility at hand to perform a difficult but very beneficial procedure. He replied, well TURP is not easy either. Maybe not, but I think it's a whole lot easier on the surgeon than on many patients.
Surgeons are just human beings like the rest of us, they have to find a sweet spot between liability attorneys and satisfied patients. They are constrained by liability concerns that overshadow everything they do. A surgeon who sticks his neck out on an unaccepted procedure is looking for big trouble. They thus find a routine, Button Turp usually, that works most of the time, is accepted by Medicare and Medicaide, private insurance, is quickly and fairly easily done, is peer-supported universally, who can blame them? So, Button Turp is the gold standard and thousands of these procedures are done compared to much fewer others. I don't believe Green Light is well-accepted anymore and I would not consider it. Best of luck and keep us posted on what you do.
Merry Christmas to all posters!!
Kc110 RonTexan
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daniel1960 Kc110
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Chip_Bunker RonTexan
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How do you knmow you will need more work in the future after having the Urolift?
Are you specualting? Or do you have some empoirical evidence?
Many thanks,
Chip
Jezzaman RonTexan
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I have read some of your other posts but only just seen the one above posted 10 months ago! I note with some anxiety your views on Green Light Laser! I am booked in for this now on 6th October 2015. My brief history is (forgive me if i am repeating myself!) I had AUR on 25th of July this year and was catheterized effectively for 2 months (had one attempt with out and got a bad UTI within 24 hours! and was recathed after waiting 4 agonixing hours in Casualty!) I saw a Urologist at local hospital who said he could offer GLL. I asked about Holep but he said he didnt offer it but could refer me for it at Addenbrookes in Cambridge UK which is a large teaching hospital. In the meantime I have been researching PAE which sounds all round the lowest risk, least invasive procedure so am favouring that. I'd be interested in your thoughts, an all the above; particularly your justification for deeming Holep to be massively superior to GLL.
My latest news is that I had the Foley out on Tuesday last and was taught self cat, but have been managing to void ok without although it varies with what and how much I drink in terms of how many times I have to go; today its been possibly every hour, but I drank 3 coffees, as well as other drinks and I know caffeine is to be avoided; just testing! Sorry to bang on but I guess the more info the better,
regards
jez
Jez
umamimommy RonTexan
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Our 75 year old urologist recommends an OSP, but my Dad is very loathe to undergo such an invasive procedure if there are other options. (He's had anesthesia-related complications in the past).
I have spent many hours calling urologists in his area (New Orleans) to try to locate a surgeon trained in HoLEP so he can at least get a second opinion, but to no avail. I have even contacted Lumenis, the homium laser company, to obtain a physician list, but they has proved fruitless so far as well.
Hi Medicare insurance is state-specific and only covers care in his state (unless emergency room). So my question is: how were you able to locate HoLEP trained urologists/centers?
Any help would be appreciated!
steadyeddy RonTexan
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Hi and thank you to Ron for such a full informative report and to all the other contributers. I'm 69 with low level 3+3 cancer, now on active survailance, and Iv'e been scheduled for a TURPs and I remembered a friend telling me about Green light laser which eventualy lead me here. SO SO very informative thank you to you all once again. Much more reading to do on my part and enqs re what's availalable on the NHS.
derek76 steadyeddy
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kenneth1955 steadyeddy
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steadyeddy derek76
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Cheers Derek, and Ken,,I'm not emptying my bladder suffeciently hence the turps but after reading these inputs I was considering one of the other alternatives like Holep done on the NHS. It's a2 day stay in hospital and a few months before back to normalwith the turps. Specialist never mentioned alternatives ,not sure what his attitude will be now I've questions to ask (again) ?
steadyeddy kenneth1955
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Cheers Derek, and Kenneth,,I'm not emptying my bladder suffeciently hence the turps but after reading these inputs I was considering one of the other alternatives like Holep done on the NHS. It's a2 day stay in hospital and a few months before back to normal with the turps.Specialist never mentioned alternatives ,not sure what his attitude will be now I've questions to ask (again) ?
kenneth1955 steadyeddy
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Ask your doctor. Don't be forced into anything. It is your choice Ken
nktoronto RonTexan
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That is good advice and will help me. My URO tells me he does Laser TURP and its called RESOLV and vaporises tissues by touch, and is better than GL. I could not find any reference to RESOLV on the internet, and I am not sure if I should go back to my URO asking for more info. HOLEP, I believe, is cutting the tissues by laser NOT vaporising them. I am in a dilemma. What to do?
kenneth1955 nktoronto
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BruceWayneIman RonTexan
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Bruce
derek76 BruceWayneIman
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steadyeddy Jezzaman
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Hi Jezz, My urologist wanted me to have the Turps but was strongly obstructive to even consider refering me to Addington for the HoLep. And at one point said I had to decide there and then about the turps !! (He is not happy with me) I have to go back for a flow and retention test in a few weeks,I wouild like to know just what my exact rights are to request/demand a treatment on the NHS in another area. I had a template biopsy 12 months ago (3+3 ) at the Christie Manchester. I've elected for active survailance. He wants me to have another biopsy but is again putting pressure on me not to have a template biopsy nor to go to the Christie as it's out of the trust's area, and template biopsies can't be done in his trust. I know it's all about costs. Do you have any advice, please?
kenneth1955 steadyeddy
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Steady You have the right to have any procedure you want. No doctor can force you to have something you will not consider. The main reaso is he does not do them and it's money out of his pocket. Take care and good like. Maybe try another doctor Ken
ianC steadyeddy
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Kenneth is exactly correct. You may choose any doctor or hospital within the NHS; this is an aboslute right.
Why your urologist is unco-operative I cannot say. The fact he is not prepared to discuss alternatives is itself worrying.
Go back to you GP and request s/he finds another place which will offer the range of procedures. And/or complain to the your local QCC (?Quality Care Commission; I think it is called - the top committee for all local health providers.
There may be a time cost though - some places may have longer waiting times than others.
Failing all that, if you can raise the money, it can be done privately at a cost of about £6-7K
steadyeddy RonTexan
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Thanks Ron, You are so right thousands of us read these comments in an attempt to underestand and find the many options available., My Urologist keeps trying to push me towards a TURPS I I've been trying to get HoLep but it's out of our NHS area.,! !
From all the reading the success of any of these treatments appears to be very much on the effeciency of the surgeon.
Thanks to all who put their experiences on here. edd
steadyeddy kenneth1955
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steadyeddy ianC
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kenneth1955 steadyeddy
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chrisarizona RonTexan
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who was your doctor in phoenix?
BruceWayneIman RonTexan
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Ron Texan, don't know if you're still out there, wanted to thank you for your insightful knowledge on the HoLep Lazer Prostate surgery. I have been using self cath for ten years, my then Dr. couldn't guarentee I wouldn't have to still use Cath after Turp surgery. I was getting urinary infections every other month, had to change something when I say your advice on HoLep surgery. I have a 200g prostate and had HoLep surgery March 13, 2017, Panarama City, Kaiser, Calif. I had 6 hours of surgery one day and two hours the next, large Prostate. There was no pain and minimal blood loss. 35 days now since surgery, still have to wear a pad for urine leakage, getting better every day, have to do Kegel exercises regularly to strenthen muscles. Like you said, when I urinate now," I could knock the bark off a Tree". I can stand at the urinal like a man and take a strong pee instead of hiding in a Bath stall self cathing. I still have a great orgasm during sex, just nothing comes out, gets backwashed to the bladder. Thanks again, everyone that gave advice on HoLep, my Dr. said this is the best option in the World. I feel and Pee like i'm 18 again!! Bruce in La Mesa, ca.
avi51994 BruceWayneIman
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Hello Bruce
?I am very interested to read your message because I am about to do a procedure at Kaiser, Panorama City in Los Angeles. Is there any way I can talk with you.
Looking forward to hear from you, Best Personal Regards
Avi