HoLEP big success 2 weeks on .....

Paul I'm scheduled for HOLEP in July 14.

How about a update on the procedure

OK update : 2 weeks on (just after above post), I peed blood and clots for a day or two, alarming but it passes and from then on, no more pee-pain.  I found at first orgasms were pretty insensate (from 7 weeks on when first experienced), annoying at age 49, over the next 2 months they improved but a year on I guess, hard to be perfectly objective, but there is still a bit of sensation gone at that moment and I guess I won't ever get that back.  R.E. too (fine, was advised).  No ED, no other dysfunction.  Peeing : I can hold on a long time, go for hours in the day, overnight I tend to annoyingly wake up at 7:00 (gone to bed midnight) and realise I need a pee but not sure if that is why I woke up, and not really sure I need to "go" so very badly, just have the feeling no chance getting back to sleep if I don't.  It's a lot better than peeing 2 to 3 times a night like I was for a few years before.  I try to not go to the loo too often, I think it gives some people slightly overactive bladder if you do - often if hold on, the feeling of needing to pee goes, doesn't come back for a while.  Need to keep the thing calibrated. I like the thought that there's less prostate tissue left to get cancer in.  I do sometimes wonder what urolift would have been like, but there seem more people that doesn't work for, it obscures subsequent MRIs, only the inner tabs are removable, it obscures MRIs partly, and holep at least is a fairly reliable enduring solution.  I was relieved not to be in the 2% that get a stricture, that sounds annoying.  Do not panic if you cannot pee at first after the op, it is scarey if that happens but the swelling goes down and an hour later, maybe you can.  NB two month on appointment revealed no cancer in the HOLEP samples taken, PSA was 0.66 (had peaked at 17 during what is now thought to have been acute prostatitis that first took me to a uro 5 weeks before Holep).

Thanks, I get up every 2 or 3 hours a night . Tried Urolift And didn't work out for me, Holep at Mayo Phoenix on July 14th next option other to live with.

Thanks for feed back,

I had BPH, and couldn't pee

I had done HoLEP 6 weeks ago in Mexico. I am in Ontario, and HoLEP

?is not available here, and there was 2 month+ wait time for TURP.

Now I can pee.

?Retero is not a problem for me. When I read comments about the different

?procedures, I think, that HoLEP is the best method. Catheter 48 hours,

?back to normal in a week. HoLEP removes most tissue, and it can be tested. Unfortunatelly in my case, a cancer was found.

probably a good thing that they found something now, could have got worse later,how much does it cost in Mexico?

I'm heard they find 10 % cancer, but treatable so finding now is good for you.

I have paid around $8000USD plus hotel, travel, and food.

?I didn't go through travel agency. I have found the doctor, 

and arranged everything by myself. Everything went well,

?I got to Mexico, next day tests, and day 2, surgery.

Like a ckockwork. In the hospital 24 hours.

I would recommend doing the same.

?The doctor was dificult to find. I have researched all forums, and at the end

I found him by searching for Holep and Mexico. There are several doctors that do HoLEP in Mexico.

I am hoping to go to doctor K for FLA for the cancer.

?I have to find out, if FLA can be done on HoLEP patient.

?I also have 3TMRI scheduled on July 14, to see if the cancer can be found

Interestingly, before the HoLEP, I had a PSA test, 1.5, which is low,

?digital rectal exam was negative for cancer, and I had an MRI,

which also showed me as cancer free.

?Then thanks to the HoLEP, the cancer was found (Gleason 7 (4+3))

?Makes me wonder how many people with BPH also have cancer and don't know about it. Methods like green light, resum, and others, that don't collect sample, may miss existing cancer. Aparently blind biopsies can miss half of cancers, specially if they are small.

​Watchful waiting? or FLA or MRgFU or HIFU or laser activated drug or something else.

For the sake of argument, let's suppose patient X does indeed have undiagnosed PCa. I ask rhetorically.  Is it possible that any of these prostate procedures can exacerbate PCa?  Seems to me, in my uneducated thinking, that a more thorough DX for PCa should be performed BEFORE these procedures.  Anyone?

​PSA is good most of the time, but not always.

​Biopsy can miss PC,

3T MRI is apparently quite good, but can also miss cancer.

​There are some other tests like PCA3 test or MiPS test, but they are not commonly used. I am also interested if there is a sure way to diagnose cancer. I have seen a new method on TV, but it has to have an access to the tissue. Currently it is not used for prostate. It is a probe, that sends frequency to the tissue, and from that they can tell 99% if it is a cancer or not.

Holep is 100% retrograde. I knew about it, and have decided that it is worth it. It doesn't bother me. Some guys on the forum talk like it is the end of the world. The sensation is different, but not worse.

?No problem with impotence and incontinence.

Before, the prostate was 39ml, and 19g was removed.

?Before I couldn't pee, and there were times I had to go to emergency.

?There they let me wait, until there was so much pressure, that it pushed it's way through. Waiting is the most popular treatment for everything in Canada.

I was in major discomfort. Before Holep I had to get up 2 to 4

times/night,

after Holep 1 to 2 times/night. Because I had peeing problem for long time, I suspect that the uretra hot narrower.

Immediatelly after holep,

?when the catheter came out, I coudn't pee and had to take Flomax and saw palmeto. but I could stop that in couple of days and now can pee well and don't take any medication. But I never got the 'pee like a horse'.

Together. Both seem to have work for me.

?Now and for a while I don't have to take anything.

?Flomax made me dizzy though. I was like in a fog.

?The saw palmeto didn't have any sideffects. I took 

?both only for couple of month, as my symptoms were worstenning.

Why did you dicide on holep instead of fla ?

I think, what I had was prostatitis and BPH. I had the problem 3years, but for most of the time I coud pee. My symptom was continuous discomfort in the prostate area. I went to the doctor, and he gave me antibiotic. It didn't help.

?Then he said that nothing would be done, as long as I can pee.

?5 month ago I started to have problem peeing, so I went back, and he gave me Flomax, and appointment to see uro. I went to the internet, and forums,

?and have found over 20 diferent methods for threatihg BPH.

I have liked Gat Goren, but I didn't have spaghetti vains in the scrotum, I liked FLA, but it requires longer catheterization, and may reqire ability to self cath. I have tried it, and couldn't do it. I have looked at PAE and REZUM, but have found too many bad outcomes. Same for TURP, and green light.

?When I have researched Holep, the most common comment I found: 'why didn't I do it sooner'. I didn't find anybody who had bad experience with it.

?It removes most tissue from all methodes, and has the easiest recovery.

And pae you think the blood supply will come back ? And did you ever get any Abxs cocktails for your prostatitis , would you do surgery again ? And why would you suggest it for bph vs the others being its 100 percent retrograde is not to my liking but as you say to each his own ?

Gat and Goren are radiologists, who have found a real reason for enlarged prostate. Damaged valves in the veins in scrotum, that cause larger ammounts of hormones to reach prostate, causing it to grow.

?They block the veins with coils.

?My doctor was against overtreating, so no testing or treatment.

?I didn't have any other treatments, so I am biassed and I think, that HoLEP is the best method for BHP. Having to go through it confirmed my decision.

?I haver tried self cath, and I couldn't do it. The retrograde might be individual. It seems to be a big problem for people who don't have it,

?and not such a big problem for people who have it.

?Retrograde prevents one from having children naturally. 

I didn't think much about PAE, because it is irreversible, and there are foreighn objects in the body. I have seen on one of the forums comment,

?that PAE may have caused part of the bladder neck to die. Don't quote me on it, ?It is not verified, but if they release the beeds in a wrong vain, it could choke off the blood supply to somwhere unintendet. (just my own impression)

Yes but technically wouldn't fla be more accurate of a surgery ? Like some one said cuts medium lobe accurately vs resum depends on surgeon

The only draw back is longer Catheter times , it would seem to me the MRI would bring less risk in general but then again any surgery with prostatitis could and possibly make it full blown

Roll of the dice I guess ?

HoLEP

ThuLEP

Holap

Simple prostatectomy enucleation

Aquablation

Turp

ejaculation preserving TURP

Bipolar TURP

Button TURP

FLA Focal laser ablation

(PVP). Photoselective vaporization of the prostate green light laser

ISV embolization of varicoceles 

Resum

Cryoablation

Dr Song 3D method

iTind

Radical prostatectomy

PAE

(TUNA) Transurethral needle ablation

(TUIP) Transurethral Incision of the Prostate

(TUMT). Transurethral microwave thermotherapy

UroLift