My HoLEP experience.
Posted , 17 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!
2 likes, 37 replies
alan1951 ben_87928
Posted
What a great post, Ben! You've brought a lot of hope to a lot of guys. Thank you for posting.
Jezzaman ben_87928
Posted
Its very encouraging to hear of your experience at Addenbrookes with Holep.
I have BPH but it was improved with PAE last year, however not cured as I have had 3 episodes of full retention since! (only when out drinking however!)
There are just a couple of questions I have for you.
When you say it was self funded, was this because you could not get it on NHS or simply because the wating list was too long?
Also according to my research and also what the Urologists tell you is that 80% of patients end up with Retrograde Ejaculation. I would be interested if you could share with us whether that is the case with yourself? I assume though its too early to tell at the moment?
Thanks very much.
paul96555 Jezzaman
Posted
ben_87928 Jezzaman
Posted
Hi Jezzaman,
Regarding funding. Really a number of reasons I went self pay. Previously knowing of the several weeks waiting list for NHS at Addenbrookes, I suppose top of the list was having an away weekend do coming up in several weeks time. And given prior HoLEP symptoms it would've been a difficult if not embarrassing situation.
I also as my post mentioned I had a Tiemann catheter fitted and although it was good for achieving pretty much a full night's sleep, although it wasn't in any particular discomfort, I was getting to the stage where I wanted to see the back of it.
With regard to the HoLEP itself. I only had six days notice about the Saturday morning HoLEP opportunity! So it was very much all a rush travelling the 300 mile round trip down on the Wednesday for the three Addenbrookes hospital tests. Then I had to transfer the funds and get booked in for a Friday evening/night stay in Cambridge. So all in all, for this old country bumpkin, it quite a hectic few days!
Regarding retrograde. As Paul mentioned tis yet early days and at 70, I'm allowing time for 'things' to settle down. BTW, something I haven't mentioned. I'm pleased to see the back of finasteride. I still have some skin sensitivity and itching, but the itching has reduced somewhat since finishing taking finasteride about 10 days ago. Which again was just one of the other number of reasons for getting my prostate HoLEP post-haste sorted at a highly respected and regarded hospital.
paul29249 ben_87928
Posted
If you never had retention but had BPH for 20 years and been on flomax do you think it's a good idea to get HOLEP?
ian57943 ben_87928
Posted
Hi Ben, I had almost exactly the same experience as yourself, AUR and a trip to A&E. Putting in a catheter was a problem so they needed a scope and I had that done on 2 ocsassions when my TWOC failed (that was twice as well). Previously, back in Jan I had a very high PSA of 20 so in Feb I had a template biopsy that meant the prostate enlarged so much (it was over 100cc at the start) I need a catheter. The histology came back clear after they took 32 samples (and that is way more than the normal 12!).
I have looked into PAE as I thought it was less invasive but after speaking to a consultant at UCL he said it was only older gentlement, I was too young it seems at 64!.
So I went back to the urologist at Luton & Dunstable but the waiting list for HoLEP was months and months, meanwhile I was in daily torture with the indwelling catheter. So I paid up and had it done on Sunday 23rd April, out the next day and the progress to date has been great. No pain, just small leaks for which I use pads during the day but overnight seems leak free, though I do get up once and I have slept through to 5AM sometimes. This was the situation starting 3 years back so I am back to that more or less. The surgeons took out 87 cc of the gland which is a lot.
My experience has matched Paul's regarding ejeculations, pleased that things happen at all but being out of the danger zone of AUR is something I am very thankful for.
ben_87928 ian57943
Posted
Hi Ian, Thank you for the interesting UK-based post.
What with one thing and another, we appear to have a fair bit in common. Not to mention ' missing prostate tissue'… Although, perhaps unlike yourself, I never thought to ask the amount of removed tissue.
As regards biopsy. About three years ago following a hospital DRE and then a self-funded 1.5 T MRI scan which apparently showed up some sort of small 5% prostate volume anomaly. I was again offered a biopsy. However for a number of reasons, on both occasions I again decided against it.
Incidentally following the aforementioned hospital DRE. As soon as the particularly heavy-handed DRE check was over, the I believe Romanian DRE medic said to the nurse book this gentleman in for a biopsy. At which point I intervened and said thank you, but at this stage I don't wish to have one. At which point the Romanian medic somewhat aggressively questioned my decision!
My point in mentioning this is. It's my view easy to understand how people can perhaps get bounced into a questionable procedure which given the nowadays technology isn't always necessary!
As you adhered to Ian, the great thing is following successful HoLEP procedures, it's almost certainly the case, particularly if one behaves cognitively sensibly, AUR/s are unlikely to raise their bloody ugly head again !
dai12345 ben_87928
Posted
Glad to hear your HoLep went well. Tevita Aho did mine at the Nuffield in Cambridge 3 years ago and it was a total success. The only (expected) negative was the RE which hasn't worried me as I'm 72. What a lovely guy Mr Aho is and very experienced with HoLep. For info I did have a little blood in the urine for 5 weeks. The lack of pain and very fast recovery surprised me.
paul96555 dai12345
Posted
I didn't comment on pain .... the first week was tiresome, some pain every time I peed. Sort of deep inside, not at the meatus and not just as start to pee like the second and third pee after cystoscopy. Drinking lots to keep pee dilute, including during the night, helped a lot. After end week 2 no pain. I think it is because the urethra inside the prostate is entirely cut out with the prostate tissue, and the new urethra there is the cut surface I.e. the scar. Which you are peeing right over. NB the moment the catheter was withdrawn just 15 hours after the operation, was momentarily very sharply painful.
paul29249 ben_87928
Posted
Glad to here, you are doing well, please keep me updated, I'm scheduled for HOLEP in July. No sure if I should wait or get it. On flomax 10 year's now and just got on cealis. Please keep us updated
DG64751 ben_87928
Edited
I had a holep 5 days ago self funded and its already changed my life. Dr Aho was recommended but I decided to have it done nearer to me in Norfolk. I originally had a urolift in april which failed after 2 weeks. I'm curious to know what investigations people had (if any) to determine the viability of a Urolift. i wish I'd gone straight for the HoLEP.
cali-mike1970 DG64751
Posted
Can you tell us your age , prostate size and symptoms? how has the recovery been pain-wise?
DG64751 cali-mike1970
Posted
im 48 and dont know how large my prostate was. AFTER my urolift failed this April, i got in touch with the consultant and he eventually agreed to a cystoscopy ( my first ever). This determined that my median lobe was acting like a ball valve and blocking the bladder exit evert time i tried to pee. despite using 5 clips, these did not seem to have held as the median lobe was causing havoc again. the cystoscopy clearly showed that this was no longer pinned back. in terms of symptoms, i started suffering from frequency, urgency and very poor flow. iwas not voiding properly and getting up 5-6 times a night. solifenacin was prescribed to work alongside the tamsulosin and we agreed during the cystoscopy that holep would be the next procedure. he had previously suggested rezum on the phone after the urolift failed.
in terms of the urolift procedure, it was not painful to pee once the 3 way catheter was removed after 24 hrs. the pain came only at the end of the pee when stopping the flow. it was quite painful during the first day with pink urine but after a day, all pain went. flow is now perfect and i void in one go with lots of pressure. after 6-7 days of intermittent clear/pink urine i started to notice the occasional small clot shooting out during urination. it has now been 10 days and there is no pain but occasional pinkness. I did not feel that i could wait 18 months on the nhs having waited a year for the failed urolift but remain very angry that they didnt perform more investigations before suggesting urolift.
cali-mike1970 DG64751
Edited
at 48, did you consider aquablation to try to avoid the risk of RE? in the UK, it think there are doctors doing ejaculation sparing techniques like TURP and greenlight if you look around. maybe they are private practice. holep sounds great but will do after i turn 60, not at 52; curious your thought process
james16058 cali-mike1970
Posted
I totally agree with you but I think it is a matter of choice. I was offered HOLEP even at 60 and thought I will probably wait for Aquablation due to the risk of RE. Most urologist try to avoid procedures with the risks of RE for under 50s.