My HoLEP prostatectomy

Glad to hear all went well.  10 days is early in recovery, but you'll likely find progress is noticeable in the days and weeks ahead.  I had HoLEP last January, was totally recoverd after about 2 months, and am thankful to my uro every time I relieve myself!  So nice to have that one aging issue behind me.  Just wish everyone could have the benefit of the knowledge we have all gained going through these various procedures.

Hello D. Stewar

Great story, glad things went well with HOLEP, I'm also suffering from BPH and wearing a catheter now for the past 4 months and still waiting for my HOLEP operation which hopefully will happen by the end of the month, I have a complete blockage and my prostate is 100 grams. I just hope the operation will go well for me too. 

All the best to you

John

Hello John-T

I am honored you wrote me; thank you.  I'm sure you are on some sort of 'cancellation list' and hope that you can get in earlier than the end of the month but if not, then most certainly by the end of the month.  For what it's worth, 93 grams were taken out of me, so our coinditions are similar.  

You will have relief and a new segment of life.

        I sincerely hope those words give you encouragement and strength as you near the finish line of this segment of your life.   Take care. Continue being strong.  You can do it.  You have no choide, of course.  Continue being strong.  Relief is on its way.

Dave

Thank you so much for your reply, Paul 20443!  For me, every day is a sign of encouragment and healing --less blood, less pain, less discomfort.  And yes it's now a real time of gratitude every time I relieve myself. Glad it worked for you and of course am glad it's working for me.

Thanks so much for your encouragement, much appreciated, you know when you wait that long with a catheter my mind can`t help wondering if I will ever get well and be able to urinate again normally but I keep a positive attitude and cross my fingers that it will happen on that date at the end of the month. I`m still debating if I should go for anesthesia or spinal for the operation, any thoughts on that

Thanks

John

Hi John,

Yes, I understand.  As for the "choice", I had anesthesia but my Doctor made the decision (and so shouild yours). I am glad I had anesthesia, by the way, though coming out of it is a real experience as is the complete loss of time during it.  My suggestion is to totally trust your Doctor, and I am saying that because it takes a lot of stress off you.  You made the choice (a correct one, in my opinion) to have HOLeP, leave everything else to the Doctor and follow what you're told.  No more wondering 'what did I do to deserve this' or 'what can I do to correct this'. I hope it does not sound corny or bed-side conversion stuff, but prayer helped in my situation and still does.  I've never been part of a 'support group' and don't think I'll monitor this site all the time because I'm going through my personal version of this and have to focus on me.  I think your statement: "if I keep a positive attitude and cross my fingers" is the correct one, the only one.  Please don't take it wrong if I'm not 'here' anymore...I'm no expert and only wrote in because I took great solace from the others who wrote.  Now I have to get back to being selfish.  I'll probably check in a couple of months because Paul's positive comment REALLY helped me.  After the surgery there is the Recovery but it's a MILLION times better than prior.  Best wishes, my Brother(s).

Cordially,

?Dave

Hi Dave

Thanks for getting back to me and share your experience, it's much appreciated, yes I tend to be partial for anesthesia since I'm the hyper type so pretty anxious, I think waking up when all is done will be a big relief for me. I understand about the recovery period I'm sure it will beat what I went through in the past 4 months.

Thanks for being there and sharing your experience, and yes just like you I will aslo be selfish and only come here from time to time, lot's of great people here sharing their story and helping others go through it.

All the best

John

Hi D stewar. I commented here for months about my research about methods, why i chose Holep, why I chose the Mayo and Dr Humphreys in Phoenix and I'm sure I sounded much like you; satisfied that the Holep method is the best but it is still surgery and outcomes are not always predictable. I am almost two years post surgery now and I have had no recurring problems. Dr Lingaman is the most experienced of all the surgeons who perform Holep.

You made the right decisions and the results will therefore be very favorable. Now enjoy the rest of your life free of BPH forever. Congratulations!  

RonTexan 

Hi Fred,

Since then I've had a couple of GAs, where I discussed this with the anaesthesatist v. spinal and each time they convinced me to stay with GA. Their argument was that the evidence in favour of spinal is not clear cut; that 'cos it effects the legs much more, it means you have to stay in hospital overnight ('cos walking is too hazardous).

The spinal was good in that I was awake all the time, especially afterwards. But the extra night wasn't really worth it. As to memory problems (my reason to have spinal), I haven't noticed any difference - but by the nature of the 'problem', I wouldn't, would I?

Oh, I'm 80 by the way.

A lot depends on the size of the prostate. During the morcellation part of the procedure(the part after the laser where the prostate chnks are chopped up within the bladder and sucked out) it is important to have the bladder distended to avoid sucking in the bladder and causing damage- this is usually best achieved with a GA so there's no discomfort from a distended bladder that the spinal hasn't reached and avoids sudden straining or changes in bladder distension, for example if a patient coughs. Having said that, experienced surgeons will often consider a spinal for smaller prostates when the morcellation is more straightforward.

Roy.... after my Holep they didn't say anything about leakage/bleeding; you need to take some kind of incontinence pad/brief ..... you'll need it for a week or so, then it all settles down.  You'll be very glad you chose Holep!

I'd like to chime in here, my brothers, especially Ron Texan and John-T.

It's been around 3 months since HOLeP surgery (Dr. Lingeman, Methodist Hospital, Indianapolis) gave me a new start.

Yes there was some bleeding and leakage in the mending phase, but nothing bad and, of course, FAR BETTER than pre-surgery.

I'm "p*ssing like a racehorse" and back to my normal activities (I am 61).

I strongly recommend HOLeP to anyone and of course you must trust your Doctor/Surgeon.

I hope you got relief, John-T and my heart goes out to anyone of my Brothers who is presently having to endure the catheter.

Be strong, relief is on the way.   Over and out and am following (and repeat) the advice of Ron Texan --"enjoy the rest of your life".

Dave

Hi Roy,

It's now a couple of years since I had mine, so my memory is getting a little hazy. I recall the whole thing being quite easy and overall pleasant. The anaesthatist and surgeon were very attentitive and put me at ease. 

Later, it was difficult to get the surgeon to explain why it took me 14 months before all signs of the op to go away - just the haematuria and leukocytes. The catheter was, I think, removed by the time I left the hospital the next day - much to my relief.

My urine flow was immediately much better - back to normal almost. It is now not so good, but much better than before the op when I had high retention (now down from over one litre to 20-50mL). I get up once or twice a night now.

Hope that helps

Hello,

I am hoping some people that have actually had the HOLEP done can chime in with how the sex life is after? If RE is the big negative of this procedure, I would like to know what people that actually had this procedure done think of it. I have had RE from BPH medication, but have read that it might not be the same.

Also, how is the long term success? I haven't seen too much negative on this procedure, other than RE, and most of the people that comment on that haven't had it done. I have looked at all other options, so I am just looking for HOLEP stories.

Thanks

i am experiencing some urinary tract infections which cause some stinging and rapid rushes to the loo. However the flow is generally good which is a great relief. I am now able to get on with life reasonably nprmally and will be pleased to get over the UTI!s soon.

Hi

I supposse my HoLEP can be counted as a success. When I do pee, it's a good stream. However, I still get up in the night; at least once, often twice, and sometimes three times.

As for RE, it doesn't bother me - I still seem to orgasm as much.

I’ve been following this blog for about 10 months and have heard a lot about cathing, drugs, and the various BPH procedures including PAE, Rezum, Urolift, TURP, Green Light Laser and HoLEP.  The following summarizes what I’ve read as best I can.

Bottom line:  drugs may work for a while (for me it was about 3 years), but they are not a long term solution and can also result in damage the bladder from constantly being over extended/full.  I used tamsulosin (Flomax) and dutasteride which did help, but eventually as the prostate continued to grow, the effect was lessened. Plus I realized later the drugs zapped my sex drive.

Some procedures seem to work for some but not all.  Worse yet, some have reported total incontinence after their surgical procedures.  It’s hard to tell if it was a botched job or not.

The best answer imho is surgery, specifically HoLEP.  I did the research on all the procedures (except PAE….had not heard of it), and chose HoLEP.  It is the best surgical procedure because; 1) less time in the hospital and a on catheter (less than 24 hours), 2) less bleeding, 3) very small chance of needing a repeat procedure, and 4) they remove prostate tissue (instead of burning or otherwise destroying it), so they can biopsy it for cancer.  I have heard no reports of anyone having HoLEP and needing a second procedure or experiencing incontinence or needing to continue cathing.  I’ve heard way too many horror stories on this blog about TURP & GL.  My uro explained that they both burn the tissue out, and therefore leave scar tissue.  That tends to shrink over time, and hence the need for a repeat procedure. With HoLEP, they cut the tissue away, grind it up with a ‘morcellator’, push it into the bladder, and then wash it back out.

Yes, you have retro ejac, but sex drive returns, and since I don’t plan to have any more children (age 68), it’s not a problem for me.  I was retaining close to 800ml, and my prostate was 85 grams, PSA 3.8.  After it was 46 grams, PSA 0.2.  I had my surgery in January, and after two to three months had no problems at all.  I did have leakage for 3 or 4 weeks.  Some in the UK report they were told to do Kegel exercises for a few months before surgery to avoid this.

I have heard varied reports on PAE which is done by interventional radiologists.  It is an outpatient procedure and far less invasive.  However, I don’t believe it’s covered by most insurance, and because of the iffy results, don’t think I’d try it.

 Lastly, the experience & ability of the doc is critical, and often difficult to determine.  Hospital ratings for various specialties can be found in the US News & World Report evaluations.  Bios for docs may or may not be available.  For example, the Mayo Clinic was rated best in the nation, and they have the education and publications of their uro docs listed…… very helpful. Best of luck!

Thanks for the info. I am looking at going to Mayo in Phoenix, as it is the closest to me. I'm 53, and don't want anymore kids, so retro is not a problem to me. I have been ruled out for PAE, and I think I have ruled out most other options. Tried Itind, but doesn't seem to be working very good anymore. 

Only downside seems to be retro, that's why I am asking for people that have had the HoLep done to comment on what it is like. I don't care to read everyone else's opinion on this, as I have seen those comments all over this forum.

See if you can get Dr. Humphreys..... he's the top of the food chain when it comes to HoLEP.

That's who I am trying to see. He is pretty booked up. It's a few months before you can even get a consultation. 

Not too many people commenting here. I'm hoping that means it was successful and they have moved on from this forum.