My HoLEP experience.

Posted , 13 users are following.

Just thought I'd inform anyone interested that a week ago this 70-year-old UK citizen had a self-funded HoLEP procedure at Addenbrookes Hospital, Cambridge.

Consultant urologist Mr Aho informed me the procedure went very well.  And I think to confirm that, after only five days, at least to my naked eye, blood in my urine disappeared.

I've had absolutely no pain at all. The only transient discomfort was when peeing, as a little stinging was evident.  But this disappeared after about 4 or 5 days.  

My flow rate has dramatically increased.  Incredibly I can now push out 300 mL in 10 seconds.   Frequency has more than halved. 

But crucially importantly, the prior dreadful quality-of-life negatively affecting 'void urgency' has disappeared.

So just one week post operation I'm now confident my three separate painful emergency full retention/haematuria trauma hospital stay admission episodes of recent months are very much a thing of the past.

My only regret is I didn't have this HoLEP procedure quite some years ago.   

My very grateful thanks to all forum members who  take time to contribute, educate and assist fellow BPH sufferers in their various difficulties and battles.

I think it's fair to say that thanks to modern science , ingenious inventions, highly skilled clinicians and hospital staff , I now have a much enhanced freedom quality of life!

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  • Posted

    Excellent news Ben. My experience was similar. Do not be alarmed if say at start week 3 there is more bleeding and you pass the odd clot with a momentary painless jolt of surprise. Rest well if this happens and for me, the bleeding and clots stopped after a few days and never came back. I experienced a few very slow small beneficial changes right up to the 6 month mark. Your first few ejaculations might feel weak or almost non existent and even slightly sting; most of that goes over time, the net positive feeling at that moment ends up about the same, a less intense peak which lasts slightly longer hence total "area under the curve" at that time ends up about the same. I experienced occasional reversion to a slight frequency issue, solution being to not pee when first feel the urge, feeling then goes away, when you do pee make sure you are peeing at least 300 ml to keep the bladder calibrated. My flow rate measured as 36ml a second. I can accurately count seconds in my head, so allowing for average a bit less than peak I make sure I have a strong flow for at least 10 seconds. This very mild tendency to overactive bladder is probably just me and nothing to do with holep. Before holep, and before prostatitis which immediately preceded holep, I would pee 2 to 3 times a night, stream often sluggish; now 0 to 2 times, most often once after 5 to 6 hours which is OK. I'd rather sleep through and not pee for 8 hours, but at age 50 once is totally normal. Do not fret if clots and bleeding come, it will worry you but will not last. Just scab tissue falling off

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    • Posted

      Cheers Paul, that's good info.  Because as you can imagine, with my family recent haematuria etc history, I have a thing about blood and/or clots appearing in the urine.

      In regards to my nocturia post HoLEP, I'm currently averaging just under two getups per eight hours.  But I think that's chiefly because I currently drink quite a lot of non-alcoholic non-caffeine liquid to help to continue keeping things clear.

      Really pleased to hear that you're continuing to do well.

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  • Posted

    I had my HoLep with Mr Aho amost two years ago, self funded as you are, and it took away all the symptoms - like night and day! I was left with a small stricture, found six months later but that is managable with a weekly catheter pushed up the urethra to keep it open.

    Would I do it all again - oh yes!

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  • Posted

    Ben, before doing the Holep, was your bladder flacid and worn out?
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    • Posted

      Hello Dennis , Thankfully no it's not worn out and it's certainly not flaccid, leastways so far as I'm aware .  But I can tell you on at least three occasions and in about as many months whilst in full retention it's been under extreme , and I mean extreme, stress.

      Before the HoLEP I'd been seven weeks with a Tiemann catheter and leg bag.

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  • Posted

    As you say freedom. After I had my GL PVP in Newcastle in 2004 I took myself off to New Zealand and travelled around for a month on busses without toilets.
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    • Posted

      I can imagine, how great that was, not having to worry about restrooms etc.  Back in 2002, my wife and I traveled to Yosemite National Park, and I remember always on the look out for restrooms. The visit, would have been much more enjoyable, if I wasn't always worried about where the next rest room was located!

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  • Posted

    Hi Ben,Congratulation on your surgery. I'm 87almost 88 with complete retention,doing cic for 8 months now.Did you have the same condition i have. Did they check your bladder before you had surgery.  

    Thanks for this info Ben,

    frank,

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    • Posted

      Hello Frank,

      Without going into a very long message, it's difficult to precisely answer your query.

      Basically over the last 5 to 6 months, I've had three occasions when I've been in full retention.

      On the first occasion I was catheterised at hospital and allowed home without catheter.  However peeing was even more difficult after that experience.

      Several weeks later a similar thing occurred, this time with significant blood in the urine, was hospitalised for three days on a drip, the blood eventually cleared and was given catheters and instructions how to go on.

      Again a few weeks later, third occasion occasion, I couldn't get any catheter and tried through the prostate, result panic stations chiefly due to plenty of blood and little or no urine.  Hospitalised for five days, again put on a drip, eventually blood in the urine pretty much cleared, Tiemann catheterised and allowed home.

      Prior to last Saturday's HoLEP procedure, over the last several weeks I've had a number of prostate hospital checks, one of which was a cystoscopy which illustrated my 155 cc prostate was indeed significantly pushing into the bladder.

      Further, a recent mpMRI T3 scan I had illustrated a huge transitional zone.  The peripheral zone of the prostate was squashing the large hypertrophic transitional zone.  Apparently that situation is typical of BPH sufferers.

      For further info.  In the past few months I did compile at least a couple of lengthy posts about my previous HoLEP history/situation.

      Best regards.

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  • Posted

    That is wonderful for you and well done indeed. What one needs to know, however, is can similar results be expected by other men, and it should be obvious the answer is 'no'. So what I ask, if you actually know, is what qualified you as a good candidate ?

    There are factors like was your bladder in good working order other than the outlet obstruction? Did you have a central lobe (tri-lobar prostate)?. How large was the prostate in grammes? Did the prostate intrude into the bladder at all? Anything else you know, or perhaps your urologist might vounteer useful data ?

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    • Posted

      Hello gbhall ,

      My qualifications to be a good candidate you ask ...? 

      Well pretty much all my life I've tried to keep myself in reasonable and not overweight trim. This chiefly achieved by eating and drinking sensibly.

      But irrespective of that, I would imagine anybody in fairly good shape would be a reasonably good candidate for the HoLEP procedure.  Although obviously, if one does have a HoLEP procedure it's preferable to have the HoLEP urologist to be a good well practised dextrous operative 'candidate too'…!

      As commonly known, there is also an issue when giving a general  anaesthesia to people over a certain age.

      As regards condition of my bladder.  Whilst in hospital, several weeks prior to the HoLEP I had a Tiemann catheter inserted.  At that time I was prescribed finasteride, and about two or three weeks after that, if I wanted, I was able to void past the catheter. 

      A couple of weeks ago when I mentioned this to consultant urologist Mr Tev Aho, he commented words to the effect that that's a good sign your bladder is functioning satisfactorily.

      Also perhaps somewhat relevant to your query.  Neither of the two urologist consultants I have seen, for whatever reason, have ever mentioned testing and/or assessing the bladder etc condition by such as the Uroflowmetry test.

      Incidentally, although no sign of carcinogenic evidence were evident from recent tests I've had from an mpMRI T3, cystoscopy and CT scan. Following the HoLEP procedure I await for hospital lab analysis of the removed prostate debris.  The results should be through in 4 to 6 weeks

      For the answer to a couple of your other queries please see my reply to Frank which I have just posted.

      Best regards

       

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    • Posted

      What was your PSA prior to the Holep ?

      Mine was around 7.8 with a 135 grm prostate before I had the Thulium/Holmium laser procedure and down to 0.74 after it and the histology report was clear.

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    • Posted

      Prior to hospitalisation, it was around 6.5 .  Not had it checked since HoLEP procedure.  Of course it will be interesting to see what it is when I do.
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    • Posted

      Prior to my HoLep with Mr Aho my PSA count was 25 (having had three biopsies) I also had bladder stones which seemed to be the chief cause of my discomfort. I haven't had it checked in 2 years!

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    • Posted

      Mine April 29 2016 was 16.92, a few days later 9.66. This was coincident with clear symptoms acute prostatitis but I still had to have 3t mp mri and tp mri guided biopsy. On the day of the holep June 6th 2016 they were supposed to test the blood taken for psa again but they messed up and didn't. Anyway after holep they said wait 2 months, did so and it was 0.66 August 2016, tested again October 2016 routine medical 0.66 again. Pre holep prostate volume was 22cc, estimate is 6 cc abated and 6 cc of chips caught in filter basket for cancer testing, leaving 10cc behind. So now it is 10 cc.

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    • Posted

      What I've read about PSA levels, it appears that often they have to be taken with a pinch of salt.  But obviously it's nice to see the number below what is estimated to be the official upper limit for one's age.

      Regarding calculation size of the prostate.  When I asked urology consultant Tev Aho the question after the HoLEP tissue removal "does the prostate outside diameter reduce", I believe/think I understood the answer, the prostate outside size stays the same. 

      Therefore if that's correct, given that my prostate was prior HoLEP pushing into my bladder, it seemingly to one extent or another still is ….?

      If I have this consultant Urologist's reply correct, this is interesting.  Because in my case 155 cc was the pre-HoLEP prostate volume size.

      With HoLEP coring out the tissue that was restricting the urine to flow through the urethra. If this cored out chips/debris reduction was let's say 55 cc.  Would then my official medical prostate size be calculated to be 100 cc?  Or would it still officially be 155 cc, given that apparently the official prostate size remains as was.

      So to summarise, I wonder does the prostate size post HoLEP continue to be based on just the seemingly unchanged outside diameter?

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    • Posted

      My URL told me from cystoscopy my prostate was pushing up on my bladder, showing me the pic, and that by working on that area in holep he could undo this. I presumed the removal of inner tissue did allow the outside to flop in a bit.
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