HoLEP 4 weeks on.

Posted , 15 users are following.

Hi again, 

I'm 4 weeks on tomorrow from my HoLEP surgery at Newcastle, UK and am pleased to say that I'm continuing to be very pleased with the improvements that this has given me. These last few days there has been no blood in my urine and had no scabs of any sort. I'm getting 2 or 3 nights where I sleep through and on other days just need to get up once. I do make sure I have a final pee after my 30 mins read. I was expecting to have RE but to my very pleasant surprise things have starting to work again this week. I didn't even as ask my consultant about RE as I just assumed it would happen.

in my case, I understand why so much emphasis is put on the exercising of the pelvic floor muscles. Sometimes when I'm in the house and put off going for a pee for too long, I then get a desperate urgency to pee and one needs to be able to hang on until getting to the toilet., hence the need for pelvic muscles to be working well. This never happens when I'm outside and is becoming less of a problem with time.

In conclusion, I would say I'm as near normal as I've ever been and should have had the op sooner and am grateful for the skill of my surgeon and the care I got at the hospital. My 36 hours there was more of a jolly than an ordeal.

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  • Posted

    Very pleased to read all is OK and no major hiccups.
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    • Posted

      Hi rogcal, 

      Thanks, it really is a great op and will report again, probably for the last time at the 6 weeks stage.

      I'm feeling so much better now I'm sleeping through the night and it's good to get off the two types of pills at last but in fairness the pills do work well until the prostate gets too big and in my case that was nearly after  ten years. 

      Good luck to you.

      tony

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  • Posted

    Glad to hear you're doing well. HOLEP was top on my list of procedures to have done before FLA came onto the scene. Holep has very low retreatment rates. Since FLA is so expensive HOLEP is a very good long lasting alternative

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    • Posted

      Thanks, If I was much younger and private I may have tried one of the many other newer treatments. Too be honest, I read about all the other treatments on here and couldn't find any other treatment that is, at this moment in time, simple and affective long time. No doubt there will be a better solution coming, especially for younger patients, but HoLEP for older patients seems an effective way forward.

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  • Posted

    Great news! 

    What is the basic difference between Holep and Button Turp?

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    • Posted

      My understanding is that Holep essentially carves out the prostate tissue, leaving only the prostate capsule.  Because the laser cuts the tissue rather than vaporizing it (like the Greenlight does), the chunks are flushed into the bladder and must be morcellated (i.e., chopped up) so they can pass through the resectiscope.  The process requires a lot of training, hence the relative lack of practitioners (at least in the US.)  

      The button TURP is like a conventional TURP in that the channel is opened up but it uses a bipolar spherical shaped electrode that when energized creates a plasma field which vaporizes the tissue.  Advantages are less blood loss, no possibility of TUR syndrome, and somewhat less traumatic to the patient.  It requires little training since the process is so similar to the traditional TURP.

      My urologist claims the button doesn't do as good a job at removing tissue as the loop resection.  He says he starts with a loop and then uses the plasma button to smooth the surface at the end of the procedure.  I am going to get a more thorough explanation during my next visit in 2 months.

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    • Posted

      If only the prostate capsule were left there would surely be no ejaculate ?

      The prostate secretes fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and it’s expelled with sperm as semen.

      The vasa deferentia  bring sperm from the testes to the seminal vesicles. The seminal vesicles contribute fluid to semen during ejaculation

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    • Posted

      My comments were based on things I have read (or thought I have read.)  I could be wrong.  It wouldn't be the first time!  I have also read that retro is just about a sure thing with Holep although the OP says it didn't happen with him.  A little knowledge is a dangerous thing which is why one should never assume information on an internet forum is correct.

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    • Posted

      It is very difficult to put a figure on retro fro this and other forums as successful patients drift away. I certainly did not get retro with GL. If the median lobe is not to bad and the bladder neck is avoided you should be OK. The Newcastle team who did mine used a bladder neck sparing version whenever possible.. 
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  • Posted

    Hi Phil, 

    To be honest, I don't know as It's not a treatment I studied much, although it has been discussed on here a few times. Turps has been going a long time and then green lazer came out 15 years which was considered a less traumatic op than turps and then green lazer was superceded by HoLEP which again has improved on Green laser.

    As mentioned before, one can get a good idea about HoLEP by finding the Newcastle [uk] Urology department website where they have in depth detail of a few prostate BHP treatments.

    good luck.

     

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    • Posted

      Hi,  

      yes, started back at the gym a week ago, am taking it easy but doing bench press and stomach exercises no problems. I went the last time 2 days ago and forget I'd had an operation and not suffered any set back. 

      Obviously you need to see what your doctor says about getting back to sports.

      Good luck and be good to hear how you get on.

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    • Posted

      You were able to go the gym at 3 weeks after the Holep?  If yes, that’s great. 

      The doctor I saw said Holep removes almost all of the prostate thus patients do not need retreatment or another procedure. He works in a major Medical Center and if I wanted another procedure such as Button Turp or Rezum (did say it’s relatively new without long term data), he would refer me.  

      I would need to stay in the hospital for one night. 

      I’m planning on seeing another urologist who does Button Turp and compare notes.  I am interested in seeing data comparing long term retreatment rates and other variables between Holep and BT. 

      Keep up the good progress and don’t forget to do planks, 👍

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    • Posted

      Hi Phil, 

      I should have said , 'went to gym at end of 3rd week'. 

      Planks are something that I should do more. I do do burpees , single legs which is a kind of plank but should do the side and back too. 

      Good luck with your research, there's plenty of actual accounts of most treatments on here so plenty of resource.

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    • Posted

      I read through the info on Newcastle urology website. Quite impressive amount of information for each procedure. 

      What made you decide on Holep over GL?

      Thank you

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    • Posted

      >>The doctor I saw said Holep removes almost all of the prostate

      ? - maybe it varies with size.  My uro said of my 28gramme prostate, about half was removed by Holep. 

      It is commonly said Holep can remove more than greenlight, and makes re-operation less likely to be necessary after growth occurs.  I think it can remove more than TURP too, and is the most suitable for monster sized prostates.  I didn't have the impression that it removed almost all, though. 

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    • Posted

      More tissue removed, (the capsule remains) from Holep means no additional procedure necessary. 

      That is my understanding based on reading and the uro I consulted with on Friday. 

      The Holep is more involved with a longer recovery time vs GL. 

      If I get 5 years with GL, perhaps a new or improved procedure will be available. Or go with Holep and be done with bph.  

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    • Posted

      In all my years of reading I have never heard anyone say that HoLep is a one off with no future growth. Though if your one takes it all away it may do but with what consequences ?

      No long recovery for Breeze he was soon back to normal without being completely cored.:-) 

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    • Posted

      Results of a 5 year study published in March 2018 on the Greenlight XPS 180watt system showed that only 1% (4 of 370) of the patients needed surgical re-intervention during the 5 year study period.  At the end of the study the average drop in IPSS score was 75%.
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    • Posted

      Whose study was it. Apart from regrowth after eight years I had been happy with the results although my flow was not as good as I had expected perhaps because of their  bladder neck sparing technique. However that was not a real problem.
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    • Posted

      Published by Canadian Urological Association Journal.  If you use this phrase in Google "photoselective vaporization of the prostate functional outcomes" it should be the sixth reference and it will point to an article in Sciencedirect.com from the Journal of Urology.  Not sure who the original publisher was but I think it was the Canadian journal.

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    • Posted

      >>In all my years of reading I have never heard anyone say that HoLep is a one off with no future growth

      - that is exactly what I read before I had my holep, and also what the uro said... No guarantees said but holep has the lowesy chance that you come back for a repeat in 20 years, unlike with turp or gl; because more is taken out with holep. I don't think however it leaves you with only the capsule, in my case estimate was half left.

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    • Posted

      I think that they are taking away more than they need to as you still need prostate tissue to function. Perhaps Breeze will ask his excellent team at his follow up.

      With the Thulium/Holmium procedure I had after my regrowth I was left with 55grms from a 135 grm prostate. It did not occur to ask after my original GL how much had been lasered. I was told in great detail what had been done with diagrams but not that.  

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