Independent advice in the UK

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I am getting to the point where I want to consider surgery. BPH is getting worse and Tamsulosin has so many side effects, particularly on libido.I am considering HOLEP, Urolift or FLA but I know more about these procedures and the pros and cons than my Doctor, mainly due to this brilliant forum.

Considering HOLEP at Addenbrookes but is FLA or Urolift available in the UK and is there an unbiased Consultant ( some will say they don't exist ) in the UK to give advice on options or an independent report or paper that has reviewed all of the current surgical options in the UK. Look forward to your replies.

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  • Posted

    Andy sorry that you are having a problem.  If you do not want any side effects the only procedure is Urolift 100% no side effects.  I had my almost 4 years ago.  Orgasm are very intense got better after the procedure.  Ken
    • Posted

      Ken: "Urolift 100% no side effects..."

      Ken, this is not true. There are side effects with Urolift, even though they are much less comparing to most other procedures.

      I know you are happy with Urolift and want everyone to have it done. 😀 I just want to be fair. Hank

    • Posted

      Ken, also I was told by one surgeon that the results could be short lived. Urollift does have side effects, the surgeon I went to explained them in great detail. I don't think you can say 100% no side effects. 

      Side Effects of the Urolift

      These are some of the more common side effects that may occur following the procedure:

      Sensitivity when passing urine

      Urinary frequency

      Strong urge to pass urine at times

      Minimal bleeding

      General pelvic discomfort/pain

      Urinary leakage (relatively uncommon) but linked to urge

      Urinary tract infection (occurs in approximately 5% patients)

      Side effects from the anaesthetic

      Site reference: https://www.bladderandbowel.org.

    • Posted

      These are side effects that happen in most of the procedures and they go away like the other as you heal   But there are no sexual side effects at all.  Unless the doctor puts the bar to close to the bladder neck.  Have a great day  Ken.  
  • Posted

    If your prostate is not too big, try Urolift first. It can be undone if necessary and is the least invasive. There is a Urolift site and you should be able to search for UK doctors who are doing the procedure.
  • Posted

    Have you ruled out PAE for some reason?
    • Posted

      Rich.  I pose the same question.  It has only this Spring been approved by NICE for treatment under the NHS so I guess practioners in the UK may be not that experienced.  I had mine done 6 weeks ago privately in Poland (cost c £2500).  It has I think solved the urine flow problem though it is too early to say if has adversely affected ejaculation.  Alan

  • Posted

    Andy

    I was in exactly your position until my recent HoLEP.

    My flow was getting weaker and weaker, so I had to make a decision, the Tamulosin wasn't working anymore.

    I had been to many urologists in the UK. I had a PAE which didn't work for me.

    Eventually, I researched into the options I had access to me in my area of the UK and based on my research I decided on a HoLEP. I then spent a long time searching for the best surgeon I could access. I then spent a long time talking to him, I took all the reports from all the consultants with me, scans, MRIs, results from the PAE. I looked at the risks of the HoLEP but also looked at the surgeon's performance stats. 

    I then spoke the surgeon again, about all the options I had available to me. And I went for the HoLEP, early days but all is going well.

    I haven't seen a complete independent report or paper that reviews all of the current surgical options, but there is a huge amount of research and findings online. 

    I think most consultants have their procedure of choice, the one they can do, so fully independent of a procedure might be difficult. There are huge number of helplines, I called a few and spoke to prostate nurses about procedures and the risks, they see all the post op recovery, so have a lot of experience. 

    My advice, take your time and use this forum to bounce ideas around, we all want to help each other. I would never promote HoLEP because I had one to someone else as there are so many variables and we have to live with our own choice.

    Good luck.

    Philip.

    • Posted

      Hi Phil,

      I concur about not recommending one's own type of surgery, all of them have good and bad points. I chose Holep because it ticked all the boxes I wanted and for a lot of us we have to grab what is available and try and choose your consultant carefully. My HoLEP has given me all i wanted and more and I know it should stand the test of time whereas many of the other technique's longevity are debatable. Here in Uk most people dont have the capability to shop around for the latest new thing, but I'm extremely happy to have got what I believe is the best alround solution at the moment especially for older men whose need to have a family are long gone.

    • Posted

      Hi Breeze, 

      I agree, we are very limited in the UK, unless you go privately, which procedure you can have done.  It is a very personal choice. Plus, we are all so different, we need the medical profession to give us the detailed information about our condition, and possible outcomes for a procedure, before making a decision. Luckily, I chose wisely like yourself. Philip.

  • Posted

    The urologist I used, Marc Laniado, can do both urolift and holep (or turp). However, not at cambridge. Urolift is not fully reversible as they can only remove the inner tab, not the outer tab, and the tabs being metal do cause a permanent 16mm obscuration to any future MRI you may need if you have a P Ca scare. I believe if your prostate is poking up into your bladder causing a frequency issue urolift is unlikely to cure that. It stands a fair chance of improving flow but for some men is a fail or can need re-work. Holep has a very high success rate and is believed permanent, lifetime fix. It usually causea retro. Laniado now advertises a retro sparing holep but he didn't at the time I had mine done so never discussed. I would guess that the retro sparing holep would entail leaving top of prostate alone and that if you have a frequency issue it would be less likely to cure that, but still give the reliable very high flow rate that is the holep outcome. It is easy to find men on the net for whom urolift failed, but not for whom holep failed. However, I have never seen the overall urolift success rate neither initial nor endurance.

    • Posted

      Nb Ben Challacombe does holep in london too but only privately and his private charge is I believe >>Laniado.

    • Posted

      If your overwhelming focus is orgasm quality and not bothered about risk it doesnt work or longevity, then urolift is best choice and also even quicker, outpatient job. From what I read PAE doesn't always work, causes stroke for 0.5%, and occasionally is painful, but if it does work, neat cure. FLA sounds grand when it works but the swelling seems to leave some people with or needing a catheter for up to 2 weeks. If you're already into catheters 2 weeks is nothing long term. Shame there isn't a reliable enduring retro-free miracle cure that works for all men curing both frequency and flow rate issues. One day.

    • Posted

      Good afternoon Paul.  There was just a 5 year study that came out on UROLIFT and all the men have been fine.  There was 2% of re procedure.  That they had to had more clips.  I had mine done all most 4 years ago. and I have never felt them at all also 2 MRI last year and there were no problem.  You just have to tell them you have it.  All the information on having a MRI done is on the back of my card that I carry with me  If you have a issue with retro ( There are still a lot of us that do not want to give it up )  having your prostate cut out is not for them me.  I have been on this site for many years and there have been some issues with men that had Holep procedure and it is not a fix all there are men on here now that have had to had 2 or 3 procedure over a 10 year span.  I think a lot of the problems were with the doctor because you have to have a skilled doctor for the best results.  I hope you all have a great day  Ken
    • Posted

      Paul,

         Do you have a reference for the 0.5% stroke risk for PAE? This is the first that I have heard of that. Thanks.

      Rich

    • Posted

      Paul / Rich,

      I have also not heard of  "0.5% stroke risk for PAE".  Do you know what the cause would be, is it escaped beads traveling to the brain ? That rate is so low it may be the same rate as the general population of the same age group.

      Thomas

      Thomas

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