My HOLEP Experience, Chronic Prostatitis and BPH

Edited , 3 users are following.

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.

1 like, 10 replies

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10 Replies

  • Edited

    Thanks for sharing. Congratulations on the successful outcome. You chose the best procedure out there all things considered. Where did you have it done ? Hank

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    • Posted

      Christopher DiBlasio in Bethpage, NY

      He has been doing HOLEP for 9 years and has done over 1000 of them.

      He also does aquablation but did not recommend it for someone with prostatitis like me because he felt it was important to remove as much tissue as possible.

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    • Posted

      Just curious, did you do good research or you are just plain lucky to stumble upon the best procedure and one of the best doctors for such procedure ? Hank

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    • Posted

      I have been researching solutions to my problem for 25 years on various sites and forums including this one. I have been following this forum for a few years and this is where I learned about HOLEP and Christopher DiBlasio in the NY area for treatment of BPH. I found out that DiBlasio had success with treating prostatitis only after I went to see him.

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    • Edited

      I'm in the US in Connecticut and am on medicare because I am 65. Medicare covered it fully. Prior to turning 65 I had private insurance that also would have covered it but only for doctors in my local network in Connecticut. There was only one doctor in Connecticut who did HOLEP but he just started doing it and had only done 20 at the time I saw him. I had decided upon Dr. Diblasio in New York because he had been doing HOLEP for 9 years so I waited until I turned 65 to go on medicare to have it done by DiBlasio. I should also mention that I am on original Medicare with a supplement plan. Original medicare doesn't have a network and it will cover any doctor in the US that accepts medicare. Medicare Advantage, however, which is cheaper than original medicare only covers people in your network. In my case it would not have covered DiBlasio who is in New York. That is why I went with original medicare with a supplement plan G. With this plan there is only a $200/year deductible.

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    • Posted

      Thanks so much for the detailed response. I am Medicare Advantage. I will look into doing what you did, switching to original Medicare with supplement G. Btw, how much does it cost for supplement G ? Hank

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    • Edited

      about $200/month

      I believe you could also get supplement N which costs less.

      Supplement G differs from N in that it will cover more in the case that a medicare provider charges more than the standard medicare approved amount. Apparently, medicare providers in some states are allowed to charge up to 15% more than what medicare allows.

      If your provider is in one of those states then with supplement N you would have to pay that extra 15% out of pocket. Supplement G covers the extra 15% if the provider charges it.

      My provider in New York isn't allowed to charge the extra amount because New York state prohibits it for medicare providers. So I could have gotten away with supplement N without additional expense.

      Also plan N requires some additional copays for office visits.

      With original medicare you would also need a separate plan for prescription drugs, part D. In my case it costs me about $40/month.

      The plans offered by AARP are good choices. I happened to go with Anthem for my medigap and part D plans.

      Good luck.

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  • Posted

    You have had an awful time - hope things continue to improve.

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