HoLEP-- Need some input on this procedure

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I have an appointment with a Urologist on May 27 concerning this procedure. He is highly regarded in the field of HoLEP sergury. What must I know going into this meeting? Has anyone on this thread had this sergury? What has been the outcome long term? 

Any comments would be appreciated.

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  • Posted

    HoLEP is a type of laser.  I had laser TURP on Dec. 4, 2016.  I recommend getting the surgery if you are dealing with long-term prostate problems.  I didn't want to take tamulosin the rest of my life.  Even with the tamulosin, my urine stream was weak.  The main thing is to rest after the surgery and don't lift or strain for at least six weeks.  Look at it this way.  You'll be under anesthesia, won't know what's happened until you wake up, have a catheter for a few days, then live many years with the stream of a 21 year old!  Get fixed.
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  • Posted

    Green Light is also laser which I had 4 years ago. They also told me that recovery would be 6 weeks. It took 8 months with a lot of blood loss, 3 years later trauma from an auto accident caused retention to reccur plus tissue had grown back in the prostate. They now wanted me to undergo TURP but I said no and wore a Foley catheter for 8 months until my symptoms returned to about 75 percent of normal.
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  • Posted

    Hi James - I too am a great believer in this procedure. I had several years of gradually reduced flow due to an enlarged prostate, and was offered a TURP procedure at the start of those problems, which I turned down. From reading reports on this website, I'm so glad I did. But eventually after taking Saw Palmeto remedies to shrink prostate, then Tamsulosin via my doctor, and Finasteride from the consultant, I ended up with complete urine retention (very painful), then a catheter inserted at hospital emergency for 3 weeks. After negotiating with insurers, a planned HoLEP was recommended by a new urologist, went to his preferred consultant. All went very smoothly, two nights stay, 3 days catheter, then that was removed and all functioned 'like a 21 year old'. Ask your consultant about the benefits, less bleeding, urine just a bit pink for two or three weeks and a little tenderness down there, but then it's all good. Ask him to explain RE - it's not a big deal for me, but in most respects things work fine after the first few weeks.

    Hope you have a very positive result, and join the club! There are several newer procedures, but my received advice was to go with HoLEP which is proven and has excellent results.

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    • Posted

      Thanks John, at this point I need all the positive input I can get. I had a meeting with a Dr. this morning and am "scheduled" for DaVinci robotic surgery on June 29th. I had set this appointment to discuss questions I had about the surgery and asked about HoLEP. She said that she was not skilled to do it but could direct me to a Dr. who is highly skilled and in the same hospital system. I feel somewhat better getting this positive feedback.

       

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  • Posted

    there are less invasive procedures to see if you are a candidate for. A few on the forum have had REzum recently - too recently to guage results. Also PAE does pretty much the same thing in an even less invasive way. Urolift has worked for a lot of guys. Holep will leave you with Retro ejaculation and has a long recovery. IF you can wait to see how REzum and PAE work out for people on this forum, I'd suggest it. The outcome with lasers isn't always good - although lots of guys on this forum have had good results. 
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    • Posted

      Thanks for the input. Unfortunately PAE is not covered by Medicare so that's out. Urolift is out because my prostate is too large, TURP is out for same reason. From the description of REzum it sounds like a short term fix and similar to the TUMT I had a while back that was short lived. I think the outcome is dependant on the operators skill and the Dr. I am seeing is reported to be one of the best.
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  • Posted

    I too had HoLEP. Only one night in. Not much bleeding, but micro-haematuria for a few weeks and lekocytes fo 15 months. Neither any trouble, just longer than the urologist had led me to expect.

    I was fine to walk several miles the next day.

    Urine flow was good, and no need for tamsulosin any more.

    I few nights without needing to get up, but generally I get up at least once (it used to be 2 - 4 times) and no retention (it had got as high as 1L) now.

    So I agree this seems the best way to deal with the problem.

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    • Posted

      Leukocytes are white blood cells in the urine, indicating healing/infection (I test mine as part of my daily self-tracking, with reagent test strips). But I had the doc do a culture and there was no infection, so all was OK.
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  • Posted

    James, I can't say much more than has already been said on the HoLEP procedure other than to say I found it the answer to my particular prayer.

    I'd been down the usual route of Tamsulosin, Saw Palmetto and Dutesteride, was offered a TURP then Green Light Laser but held out for what I believe is the best "rebore" procedure available.

    Procedure was done and dusted in under 90 minutes using a spinal block anaesthesia and was home 20 hours later without a catheter.

    Limited bleeding and now peeing like an 18 year old.

    Good luck.

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  • Posted

    I had HoLEP last January and am very pleased with the result.  Having followed this blog since then, I'm convinced HoLEP is the best answer for BPH.  It's very different from TURP, which burns the tissue out to make a bigger passage.  The need for a repeat procedure is higher with TURP.  HoLEP cuts the tissue, which is then 'morecelated' (ground up) and flushed out.  My prostate was 85 grams; now it's 46.  Plus, they biopsy the tissue for cancer which can't be done with TURP.  Was in the hospital for less than 24 hrs.
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  • Posted

    James what ever you decide you have to deal with the side effect and the treatment.  It seam to me all the doctors have told you about is Turp and Holep.  Both take a lontg time to heal and you may lose alot of blood.  This will alo give you retro ejaculation.  Have you ever had it.  They tell you there is no diffrece bt there is.  And how does the doctor know does he have it.  I had retro with a pill that I was on.  Got off that quick.  Had a urolift done a year ago and still going strong.  And my orgasm are more intence they when I was younger.  Why should you give up anything if you can have something else that will work the same.   To me it looked like the doctors that you saw were pushing a Turp or a Helop.  Maybe thats all they know   Looked into a urolift or a PAE.  before you have anything done.  Take care and good bless  Ken 
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    • Posted

      Kenneth, I appreciate your concern for my well being but no more than I am comcerned. My prostate is too large for Urolift and PAE is not FDA approved so no Medicare coverage. Yes I am now experiencing RE and don't care for it but I see it as a small prive to pay for a comfoftable future. Your posts are well meaning but I think you have to allow others to seek the best for them.
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    • Posted

      Strange coming from someone who hasn't had good results with it but...you might want to look into Rezum. It IS FDA approved and for most there is no long recovery and no RE. You can always have a a more invasive procedure if something less so doesn't work. FWIW, my doc says he has a patient who hasn't been able to pee in 4 years going normally 6 weeks after getting Rezum done.

      As we get older, the fallout from anasthesia and surgery gets greater and this blog is replete with TURP horror stories.

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    • Posted

      I have looked at this and it is very similar to the Trans Urethral Microwave Thermal Therapy (TUMT) that I had done January '15 and had little to no lasting effect. I just passed on the Rezum as not in service long enough to earn a good track record. 
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    • Posted

      I know I am just trying to help.  It is a shame that none of the others will not work on you.  But I feel why should you give up something for something else.  I had a urolift and its been great.  I will never have retro again.  It was not the same and the doctors should till a patient the true.  There will be a change. But we all have to pick what is best for us.  We should njot have to deal with that lose because life is hard enough to have something else taking from us.  Take care and best wishes.  Hopw it works out for you.....Ken 
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    • Posted

      Rezum is defeinitely new and while the initial results have been encouraging, you're right that there is no real track record established. My experience notwithstanding, from what most other people have said, an uncomfortable week is all you risk by trying it and if it works it spares you the longer recovery and lifetime of RE. If it doesn't, you can always have the HoLep which otherwise seems to give good results in the hands of someone experienced.

      Good luck with whatever you decide. 

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    • Posted

      Hey James that is true But they will never get my permission do that to me 2 months ago I had emergency surgery for bladder rentention and bleeding also had bladder spasm.  I had a urologist that was not mine and before he did  the surgery I made him sign a paper that he was not to remove or core out the prostate and he was not t touch my bladder neck.  He did sign it and  so did a nurse.  I had 3 blood clogs around my prostate he burned them and all is well.  It was caused by my blood thinner.  When I go into a hospital no one does anyth to me unless I give them permission.  And that's the way it is.   Have a great day Ken
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    • Posted

      Very thru James. I am also scheduled for TURP bipolar for June 1, 2016 just few days after your HoLep. I am only 51 year old. I hope your surgery will go well and you will have uneventful recovery. Wish you all the best. Keep us posted with your experience.
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