HoLEP two weeks on.

Great news for you.  Congratulations!

Hi Rogcal, Thanks for the warning and to be honest, I was peeing slightly more blood in the day after my first exercise one day 11. I will take it steady for a few more weeks but  it's hard because I feel so well.

I drove myself home the following day.  As I had my HoLEP carried out under a spinal anesthesia, I wasn't affected by the usual of cocktail of drugs given when having a GA.

Just be careful when entering and exiting your vehicle so as not to place to much strain on the lower abdominal muscles and put an absorbent pad on the seat, just in case.

Ptflow,

Good luck with your operation. I wore small stick on pads for the first week to catch the few dribbles. Doing your pelvic floor exercises helps to control dribbling so they need to be done before and after the op. The main problem for me was missing the bowl in the first few days because the speed of release was so quick, instantaneous, whereas it took seconds before the op for the flow to start. I put a waterproof mattress protector on the bed just in case but not needed. The hospital told me not to drive for the first two weeks. My partner drove me from the hospital and I started driving locally 7 days after.  One  should clarify this with your consultant.

 

Very helpful, many thanks

Glad to hear you are doing better. 

Was urinary retention a problem for you prior to your operation.?Do you have a large median lobe? What was the size of your prostate prior to operation?

What were the risks the doc told you about the holep?

Thanks

Changejobs, yes, I was having to get up from 4 to 7 times a night even though I had been on tamulosin and dutasteride for a year. My size was 70 grammes but admit I never asked to see the mri image so cant say whether lobes or not. I was just happy that a second consultant said he would do the op. My first consultant wanted to put me on anti urine pills at night and then do more tests i.e treating the symptons and not the cause. So, I got referred to another hospital which is a centre of excellence for urinary problems.

I was briefed about the risks again just before the op and it was a bit frightening as it is for all operations. But the main points were probably RE and incontinance.. If you look at the urology dept at the Freemans hospital, newcasle uk there is all the infirmation you need about HoLEP. I didnt ask my consultant re the % chance of RE as not at my age bothered about it. I rather he did what hes experienced and good at rather than being pre occupied about my seminal fluid canal.

Hi David,

Good luck to you and hope you have an equally good experience as myself. I look forward to hearing about your progress.

Does Holep have any advantages over a Button Turp?

I’m considering both. 

Hi phil, I'm not qualified to give an answer as to what is best. I think they both should give long term results. To my laymans knowledge green laser was introduced as a better less traumatic option to turps. GL HAS BEEN ON THE GO FOR OVER 10 years and then Holep was brought out as an improvement over GL. With GL you cant do an biopsy whereas with holep one can i shoud get my results in about a weeks time. Good luck

Disclaimer:  I have no medical training or any first hand knowledge of these procedures.  That said, my opinion is that the skill of the surgeon is more important than the technique.  Almost all the well-established TURP-like procedures will produce significant symptom relief.  So that means choosing one you (and your doctor) are comfortable with.  The advantages of Holep are it removes almost all of the prostatic material and may have a shorter recovery time than the TURP (monopolar or button) procedure.  OTOH, I believe retro is almost assured with Holep while it may be likely with TURP but the surgeon can more easily work around the ducts to avoid it.

Surely the laser procedures are much more precise than the hot wire TURP procedures.

I have had GL and Thulium/Holmium a similar procedure to Holep and each had a quick recovery. The only disadvantage of GL is that it does not save any tissue but if patients have been shown to be cancer free that is not a factor. 

Thank you and lee and derek. 

I also believe the surgeons experience and skill are more important than the procedures discussed. 

The shorter recovery time and ability to do a biopsy are definite advantages of Holep. 

I don't know if that's the case or not.  One would have to review the results of clinical trials and look at the instances of capsule perforation.  Sometimes what seems intuitive is not actually the case.

I was only the eighth patient of the one who did my GL. The senior surgeon had a look and they discussed it before he began and he came back halfway through to see how it was going.

Has anyone heard of a tuvp/Turp “sandwich” procedure?

There’s a urologist that’s been doing these since the ‘80’s. His name Shalom Katz, unfortunately he’s in Israel but did some training in the states. I will try to find out more information.