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My holep story.
Chronic prostatitis for 25 years.
bph for past 10 years or so. Both getting worse with time.
Prostate was 76cc based on 3T MRI done in 6/2019.
Prostatitis symptoms were constant burning in pelvic and genital
region and with frequent urination (24/7). I woke up with burning
pain at least 3 times a night.
Have been on antibiotics on and off for 25 years.
Typically on antibiotics for 3 weeks minimum at a time.
In recent years I have one to 2 flareups a year.
Have been on antibiotics as long as 8 weeks at a time.
Antibiotics take the edge off of the extreme pain when I get a flareup, but they don't eliminate the pain and frequency.
After a course of AB's I revert back to my baseline level of moderate pain and frequent urination.
Antibiotics cause significant stomach upset and abnormal bowel movements.
It takes up to 6 months after each round of AB's for my stomach to
get back to normal again.
Ejaculation causes a significant flareup in pain and frequency that
lasts 1-2 days. I take nsaids for this. No AB's.
No doctor every recommended surgery and many testimonials of people
with chronic prostatitis who had turp done said it only made things worse.
I finally found a Holep doctor in Long Island, NY who has been doing Holep
for 9 years who was the first to say that he had success treating prostatitis patients and actually recommended surgery.
He said he no longer does Turp or Green light and felt confident that both of those procedures would make things worse for a prostatitis patient because they leave behind a lot of prostate tissue and cause a lot of scarring.
I had Holep on Jan 14, 2020 in an outpatient clinic. I wanted
spinal anesthesia but due to a miscommunication I ended up having
general anesthesia. General anesthesia has been linked to increased
risk for dementia in the elderly. I am 65. I went home the same day
with a catheter which was excruciatingly painful due to prostatitis.
Dr said a normal bph patient without prostatitis would not have had
so much pain. I also had a lot of bleeding. Catheter was removed the
next morning in doctor's office. Continued to pee blood for about 2
weeks. Never experienced any clots coming out.
The burning and frequency improved over 3 months. At about 3 months
the rate of improvement slowed down considerably. Now at 5
months I am definitely much better off than before surgery but I still
have mild lingering burning and frequency. Dr said I could continue
to see gradual improvement over many more months.
My stream is also back to what it was in my youth. I had no incontinence.
I have had to go on antibiotics for a flareup every year for the past
20 years or so in the spring (probably because of pollen allergies that increase
inflammation). This year it did not happen.
Dr said that he had a hard time removing the prostate adenoma because
of the presence of extensive scar tissue due to repeated infections
over the years. The scar tissue made it difficult to peal away the
adenoma from the inside wall of the prostate capsule. Normally he said
it peals away easily. In the end he persisted and removed even more than
he normally would for bph. He also reamed out the ejaculatory ducts
because they tend to be sources of problems for prostatitis.
He removed about 90% of the prostate in my case as opposed to about
80% in the normal bph case.
Biopsy revealed no cancer but extensive inflammation.
I have retrograde ejaculation which is well worth it.
My main lingering complaint is increased burning and frequency after
ejaculation. It is much less than before the procedure but it is
still significant. Dr said if it is still there at 6 months he
will order a CAT scan to see if ejaculatory ducts are obstructed
in some way.
I just wish a doctor had recommended this procedure years ago.
The idea of suffering with an inflammed, infected prostate and
taking so many toxic antibiotics for so many years is mind
boggling. Knowing what I know now I would have done a simple prostatectomy
years ago if Holep wasn't available.
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