HoLEP procedure

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This procedure looks like the best one available. The problem is that I cant find any doctor in Oregon that does it. Does anybody know of one? 

 

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  • Posted

    My preferred treatment would be FLA. That said if I had to do something today and couldn't afford the the cost of FLA I'd go with HOLEP. Seems to off longevity over most other procedure. Of course that's probably because it removes a substantial amount of prostate tissue.

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  • Posted

    I have had 2 PAE'S in the last year  and with limited success I've decided to get a Holep Procedure done at Jefferson University in Phila by a Dr. that has been doing them for 20 years. I'm tired of living in between bathroom visits, always wondering whether this will be the time I won't be able to urinate. The prostate continues to grow, so procedures like urolift will only prolong the inevitable. The most pressing issue with untreated BPH is that it will eventually injure your bladder. I've had enough. Will let you know how it goes. Early May  Mike

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    • Posted

      No one has been doing HoLep for twenty years. There was a prior Holmium laser surgery that I turned down in 2004 as it was rather rough and ready and opted for GL. Another earlier laser procedure was Gyrus.
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  • Posted

    If you insist on HoLEP, contact Lumens, the manufacurer and distributor of HoLEP equipment. They have a list of practitioners in your area. They have a website.
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    • Posted

      The Lumenis website is here:   however I do not see a "physician finder" on their website.

      Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.

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    • Posted

      Hi Derek, I just met with Dr Das at Jefferson yesterday. He has been doing Holep since 1998. He was one of the 1st. I feel very comfortable that in phila, he is the guy. thanks for the suggestion though. I will follow up as to how things turn out. I did seriously think of Resum and met with a urologist that does it with about 50 procedures done. After my cystoscopy, and the visible problems with my bladder, no medium lobe, but lateral penetration by both lobes into my bladder, i just want to get the enucleation and be done with this problem! Wish there was viable alternative but I've already spent around 15,000 for the PAE's and cant afford FLA. I am a candidate for urolift but my take is that it only will buy some time because the prostate will continue to grow, it only stucturally opens the urethra but does not solve the basic problem. Retro grade ejaculation is not great but if I can pee, its the price I have to pay with Holep.

       

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    • Posted

      The company is Lumenis.  I tried to post a link to their website but it seems like links are not allowed.  At least that's what I infer since my post of 2 hours ago "is waiting to be moderated."  In any case, I did not see a physician finder on their website, I guess you have to contact them via the website.  I tried that a couple times on the Urolift website and never got a reply.

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    • Posted

      Urologists really need to become transparent and on their websites list the BPH treatments that they perform. Its ridiculous.  I've found that even within urological groups, you can't find out what each surgeon is trained in unless you set up an appointment, which is a pain with being in an HMO and all the referrals. The companies don't want to list the Dr's because they don't want to be ever dragged into potential law suits. Its a real challenge to find out options when one is searching for what to do. I know that I feel like you almost have to become an expert, which is rediculous, to really wade through all the misinformation about our condition.

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    • Posted

      Hi Ronk, I think if i could go back 2 years ago prior to the PAE's, I would choose to try REZUM. Having suffered with these 2 failed procedures, and keep in mind that they actually did shrink my prostate from 150 gms to 80 gms, so technically the procedures worked. Clinically, it was a different story. I still had most of the symptoms and had to suffer the disappointment of travelling 2 times to North Carolina, out of pocket expenses, recovery, etc., and still have the condition! It was severely disappointing. Almost unbearable mentally. In effect, the pae's allowed me to technically be in limbo for 2 more years before i have come to the point that i definitely need to have surgical intervention. The 4-5 weeks of urethral irritation, with the possibility of intermittent or continual cic during the recovery phase with rezum, is something i'm just not up for at my stage. i want relief. and i know that holep will definitely cure the problem. yea, i know the price. its worth it to me. i have a business and i need to get back to being engaged with my responsibilities, instead of being continuously focused on my bathroom needs. I haven't been able to travel by car for over 2 years to CT. to see my grandkids. They are only 21/2 hours away, but i can't mentally drive there for fear of problems on the road. god forbid if there is a major traffic jam! Even going 45 minutes into the city to see Dr. Das the urologist that will perform my surgery was stressful. i'm worn down.  need to get off the perserve my ejaculation train at any cost mentality. I feel that sex is important even at 63 but its not worth my health both mentally and physically. I would tell anyone in my position that the most important thing long term to protect is you bladder and kidneys, not your penis. If something needs to not work quite right let it be your penis, not your bladder or kidneys. You cant live without them! Good luck to all. Hope my travel has given you something to think about. I also think I'm done with forums! Remember that most of us on them have had problems. I'm sure there are millions of guys with success stories but they arent posting! I want to get to that point. God Speed. Oh and one more thing about pae and other new techinques. Because I had 2 Pae's, it will be harder for the dr. to enucleate my prostate when he perrforms the holep because of adhesions that have occured when my protate arterial supply was blocked. he has performed holep on other guys that have had pae and it makes the holep surgery more difficult. what you chose now will have ramifications down the line.

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    • Posted

      FWIW I've found contacting a doctor's office and asking to speak to the nurse or PA can mine a lot of useful information. As to speaking directly to the doctor, good luck on that one smile

      Jim

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  • Posted

    Hi Lew,

    There is no "best one" available either today or yesterday. LUTS is not a uniform condition with uniform causes. A less invasive procedure like Urolift or FLA may be good for mild or moderate BPH/LUTS but not for a more severe case. TURP, HoLep and other more invasive procedures may offer more relief but they have a different side effect profile. Do you have a very large prostate? Holep seems to shine in that area if you are willing to risk retro ejaculation which is common with the procedure. Learn as much as you can about both your condition and the options before making a decision.

    Jim

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    • Posted

      i totally agree. after 5 years with this condition and 2 years post Two PAE's, I've not only lived LUTS, but have become an expert in studying all the options. Quite Frankly, they all have shortcomings. With the size of my lateral lobes, and the condition of my bladder, HoLep is the best of the worst. But I agree, that each individual must decide and prioritize what it is that want to accomplish. I wish all of us had better, safer, less invasive, and less expensive options. But right now, it seems that its up to each person to wade through the urological mine field that is BPH treatments. I have found having been to 5 urologists, and a interventional radiologist, that there is no general consensus. More research needs to be done for this male problem!

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