Male 69 HoLEP precedure done this weekend UK

I'm a 69 year old male who started with enlarged prostate problems, BPH, some 15 years ago and started with the pills some 12 years ago. I started on both tamulosin and dutasteride for 6 months to get the condition under control quickly which they did and then went off the dutasteride for months until the flow rate became so slow that I would go back on both pills for some 6 months until the flow rate improved again and then went off the dutasteride again. I repeated this kind of format until the last year when my prostate had grown to some 70 grams and I need both pills to control my condition. I could have stayed on both pills permamently for better effect but am wary of taking pills in general.

I decided to go the operation route, about 9 months ago, after I had a couple of times where I had not been able to pee and had to take myself off to the hospital for catheterisation and also I was having to get up 3 to 7 times a night for pees. I asked my doctor for a referral to the Freemans at Newcastle who have a good reputation in Urology and have the latest equipment. I was delighted when I was accepted by the Freemans and had my operation this weekend.

The Freemans have been doing the HoLEP procedure for a few years and this is what I was recommended and wanted. I had read about the greenlazer technique which has been going for some 15 years when it was first announced and knew that this was a general improvement on the TURPS procedure. So when I read about the newer HoLEP procedure I was elated that things were being advanced. I am aware that the HoLEP procedure is mainly different from Green Laser because with the green laser it is not possible to do a biopsy to check for cancer whereas with HoLEP a biopsy can be done. There are other differences as well but can't elaborate on these.

I arrived at the hospital at 0700 this saturday and was operated on at about 11am and it took about an hour. I had had a general anaesthesia and found the whole experience very pleasing. The consultant showed me the new laser equiptment which had been used for some 3 months and had replaced the older laser which had been used for some 5 years. I must admit though that when my consultant saw me two hours before the op to discuss my procedure and explain what could go wrong it was a little scary but it is something that has to be said. I was made relaxed by all involved and everything was explained to me at all stages. I was eating toast and drinking tea at 1pm and hardly felt any aftermath of the anaesthesia and felt no pain. I had a catheter installed and drank a cup of liquid per hour and on each catheter bag change the blood in the urine decreased as expected. I spent the night in hospital and had the catheter removed at 7am. A nurse offered me a mix of tramodal, paracetamol and another pill for pain at 11pm which I took even though I had no pain just in case pain set in during the night. I am sure that the pills were not needed because at no point during my stay in the hospital did I have pain and now at 1030 on Monday I am pain free without pain killers. I didn't sleep at night because I was hyper with elation that I had at last got the procedure of my choice and was confident that the op had gone well and would be effective.

So, when the catheter is removed in the morning the hospital need to know if you are able to pee without the catheter and more importantly that one is not retaining any urine after doing your pee. On peeing you press the buzzer for the nurse who brings the scanner to measure what urine residue is left in your your bladder. It took me 21/2 hour to do my first freestyle pee and on scanning my bladder there was over 100 mls of urine. The second pee took another 11/2 hours and the residue was some 70 mls and on my third screen my residue was less than 70 which was consider OK for me being released home. This test is very important because it shows whether the residue is increasing or decreasing and its an increasing residue that builds up during the day to cause one to have to pee through the night. Most people have some residue after peeing. Also it was heartening to see that on each pee the blood staining was less and less. I did fear the the catheter being removed but it was painless and the first few freestyle pees there was a little painful start to the pee but nothing to worry about. I was a little apprehensive about the talk of urine in the pee but it is nothing to worry about at all.

I left the hospital at about 1 30 pm with my partner driving [not allowed to drive for 2 weeks] and arrived home 2 hours later. Still drinking a cup of liquid every hour and was astonished at my new flow rate and start up time. I can never remember peeing with such a force, my flow rate is a least 5 or 6 times better than of late and after years of peeing only about 150 mls I was now peeing some 450 mls. Last night I had my last pee at 11pm and slept until 6am without needing to get up through the night, a first for over ten years. To say I'm elated it is an understatement. I do know that I'm expected to have some blood in my urine for up to 2 weeks but right now it is clear.

In conclusion I am very pleased with this op and cant see any reason why it wont be good going forward for many a year. My doctor made it clear that I would probably have retrograde ejeculation but for me its not a problem because the pills were giving me this condition but my organisms where still good and I'm not wanting children at my age. I did avail myself of all the advice about other procedures on patientinfo ie, staples, ablation, stopping blood supplies etc etc but for me it was a no brainer to get something that is tried and tested and good for a lot of years. Of course its too early to say whether my apparatus will work when really needed but have no doubt it will. But at this stage, I have no dribbles or leakage, I have good flow rate and volume and slept through the night for the first time in over tens years. I also am at this stage in no pain at all and it feels like I've not had an op at all. I'm not saying one procedure is better than another as it depends on many variable, I'm just saying how HoLEP has gone for me at this stage. I will follow up in a few weeks time.

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