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My HoLEP prostatectomy

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ianC
ianC

I thought I'd report whilst things are still fresh in my memory.

Well, I got home this afternoon (Thurs) after the op Tues @ 7 p.m. And things seem to be working OK. No more Tamsulosin needed, so that's one benefit right there. I'll update after a few days as the the other possible effects.

The anaesthetist chose a spinal anaesthetic, which I was somewhat chary of, prefering to be totally knocked out. Later I remembered that there'd been some research that found that older people who had anaesthetics died earlier, so he was right on that score. He also told me that this way I had a smaller number of anaesthetics (general meant 14!, this way 1 to 3).

I didn't like the thought of being awake and watching the op, but he assured me I wouldn't feel a thing; I wouldn't see anything; and I'd be able to feed and drink more or less straight afterward rather than many hours later. And so it came to pass. Just numb legs for a while. I really didn't feel anything. All over in about an hour. I even dozed a bit on the op table.

However, that night (Tues) was not good. I had a constant feeling of wanting to sh*t. However, no matter how hard I tried (and I used two laxative suppositories), virtually nothing happened. I later found out this is a side effect of the somewhat larger catheter and balloon that was put in place.

So I found it hard to sleep. But just when I did doze off once, the nurse came in for the fourth time to take my blood pressure (2.00 am?). I was really upset and told her not to do any more (all the previous ones had been OK anyway). But by then I couldn't get back to sleep. So I was wretched all the next day (yesterday).

However, last night I got to sleep about 8:30 pm; and slept right through to breakfast. Bliss.

The surgeon had come in on Weds; told me about the defecation urge origin; said I could go home today if my urine was pretty clear by then and the catheter had come out. I see him again in a couple of weeks, when the result of the biopsy will be with him. He also said only 10% need the op again in 10 years; most are fixed for good. Here's hoping.

I was apprehensive about the removal of the catheter. In the end though, it wasn't too bad. I did most of it myself, easing it and rotating it a bit when it seemed to stick. Whew! Great. Then I pee'd  a couple of times to test things; told I was OK to go. I left.

Home by 3 pm today. Then did a good walk (4 miles) and all's well. Still some blood and bits, but most clear. Good flow. Now to see how I am at night.

 

2 likes, 171 replies

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  • roy79542
    roy79542 ianC

    Posted

    Holep now done with a GA asthe prostate was very large and the op took three hours. Two nights in hospital has become three as Consultant wants to get me peeing before letting me home. A bituncomfotable but paracetamol helps.
  • SailorSteve
    SailorSteve ianC

    Posted

    I am not a doctor, but I can read. I do not trust everything I read on the Internet. I do trust Mayo Clinic, National Institute of Health, Canadian Cancer Society, Health Canada, National Health Service. My reading is that Holep is the new gold standard, and  TURP is only a good choice if you cannot get a Holep. Better surgery, better outcomes, fewer complications,...
    • bill20925
      bill20925 SailorSteve

      Posted

      I had green light (complete waste), TURP (also a waste, lasted maybe 12 months), and HoLEP. HoLEP worked great, no problems peeing after ~4 years. However I am fairly certain it dropped my libido by a solid 50%, and it does essentially removed most of your prostate.

      If I had to do it all over again, there is no doubt I would seek out the best Interventional Radiologists (IR's) and try that first, because it is non-invasive. And if it didn't get the job done right the first time I would still seriously consider it again because the IR doctor may not have reduced blood flow to a key area but would probably figure it out the 2nd time. I would favor PAE over HoLEP because of the impact to my libido and because PAE is non-invasive.

    • bob120
      bob120 bill20925

      Posted

      I had two Greenlights and a Turp. The turp was 19 months ago, but I also started taking dutasteride 14 months ago to shrink the prostate. All of those were supposed to decrease my libido but none did. I think in terms of lbido, the less active you are in that area, the less you have. Being sexually active seems to increase it. I don't think the prostate controls the sex drive or sexual enjoyment.

    • reg52510
      reg52510 bob120

      Posted

      It must because when the prostate is removed, impotence is usually the result.
    • bob120
      bob120 reg52510

      Posted

      But you don't need an erection to give or receive orgasms.

    • bill20925
      bill20925 evan70088

      Posted

      PAE is “Prostate Artery Embolization”. PAE is not performed by Urologists. You need to see IR’s, Interventional Radiologists. This may be the best tip anyone can give you.

      A little background here. I had 3 procedures done. Greenlight (a complete waste), TURP (only last 1 year, then major problems reoccurred), and HoLEP (has been quite effective, done by the top HoLEP dctor in the US, James Lingeman). While waiting for my HoLEP surgery I had to have a catheter for ~2 months. I did not realize it till a few weeks after my procedure, but I got a nasty infection in my ball sack (for lack of a better medical term). It resulted in essentially losing 1 testical. Roughly 5+ years after my HoLEP surgery I still pee great. I do get erections fine, but not as intense, and nothing comes out, sperm goes into my bladder, non optimal or optimal depending on how you look at it! smile I also do not know if there are any long term incontinence concerns. So far no, but I wonder.

      I have been to 6++ Urologists, several emergency room visits, and 3 procedures. I simply do not trust most Urologists to give you the best advice. In fact, NONE of the Urologists told me about HoLEP! Why? They only make money off of you for procedures they do! Very few have invested the time and energy to learn HoLEP. I found out about HoLEP on the web (probably this site!). After researching it, I asked a few Urologists why they never mentioned it. Both doctors tried to discredit it.

      But in conclusion, if it were me, without a doubt, I would try to go see the best IR, Interventional Radiologist, and get a PAE procedure. Why? MANY reasons: 1) no surgery, 2) No removal of body parts, they just redcue blood flow to the prostate to help it shrink back to normal size, 3) if the first procedure was not completely successful you can go back and do it again and again, and 4) I personally trust IR’s a lot more than I do Urologists. This is based on real experiences with many Urologists and many IR’s.

      I don’t know where you live, but there are very good IR’s who have done lots of PAE procedures across the US. Boston, Chicago (where I am from), denver, probably in every major city in the world. Just type in search “city name and Interventional Radiology and PAE or Prostate Artery Embolization”. Some combination of those things and you will find IR’s in your area. For anyone in Chicago I can make recommendations.

      Good luck!

      Bill

    • bob120
      bob120 bill20925

      Posted

      Bill, I also had three procedures in 3 years. Two Greenlight lasers and finally a TURP 3 years ago. The last procedure has worked the best so far. Maybe it takes 3 tries for the uros to get it right? One thing I found out was my prostate grew back quickly each time. I couldn't see going back once a year for another procedure so about 5 months after my TURP I asked my uro to prescribe dutasteride. He wanted to give me Finasteride but my reasearch said the dutasteride was better so I asked for that. I've taken it for 2-1/2 years with no side effects. I haven't been back to my uro since and am hoping I won't have to. I'm more than willing to take the dutasteride for life if it keeps me from needing another procedure. Three was more than enough.

      Regarding the PAE, I was considering it, but there's few long term studies on it indicating whether it is also just a temporary fix. It works for some but not for everyone. Like all the other procedures. In my experience the GL was the worst, the TURP the best. But maybe only because of the two prior GL's. I have yet to read of any procedure that works for everyone.

  • CaptainCall
    CaptainCall ianC

    Posted

    I am considering Holep surgery with Dr El Tayeb in Texas.  He did his urology fellowship in Indiana where Dr. Lingeman teaches/practices.   I was wondering if anyone on this blog has used Dr El Tayeb for their Holep procedure and can comment on their results and experience.  I am in my early 50's so I am concerned about sexual side effects and incontinence. 

    • hank1953
      hank1953 CaptainCall

      Posted

      " ... I am in my early 50's so I am concerned about sexual side effects and incontinence... "

      You should look into Urolift, PAE, or FLA. Hank

    • patrickky
      patrickky CaptainCall

      Posted

      i know this is an older post, but i had Holep surgery with Dr Tayeb in Temple,TX on Dec 4, 2020.

  • anibal17
    anibal17 ianC

    Posted

    I was lucky to find Dr. Hemendra Shah at the University of Miami with over 1000 holep operations experience. I had the surgery four weeks ago and I am doing fine. I think he is the only one in Miami that does it.
  • don80103
    don80103 ianC

    Posted

    I am 77 and had Holup about 10 days ago. Everything was fine. I'm wondering how long I'll have to expect to wear diapers. I control my peeing at night but during the day I just seem to drip or whatever in the diaper i never really feel the urge to go like I do at night. I have an appointment with my doctor in 4 days but just thought I'd research a little information on here since I found this forum. I'm from Louisville, Ky. so if I can also help anyone just hit me up. Thanks in advance.

    • hank1953
      hank1953 don80103

      Posted

      Some people had it for months. Some had it less. Hank
    • Bruno59
      Bruno59 don80103

      Posted

      I had HoLEP done 8 month ago, at the age 59.

      I didn’t have any problem with incontinency or anything else after the procedure.

      The initial healing took about two weeks. I don’t have to take any medication.

      I can sleep most of the nights through, and sometimes I have to get up once.

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