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Please help…RASP vs. HoLEP and my pain (two questions)

Posted , 7 users are following.

TMM14526
TMM14526

Hi All,

Long story…but I will try to be concise. On January 10, 2022 I went into the hospital to have my chronic appendix and hyperactive gallbladder removed, and that went OK. But three days latter I was back with constipation and 100% urinary blockage. I was diagnosed with BPH likely accelerated by the anesthesia, opioids and gas introduced for the laparoscopic procedures. I have had a catheter in for 90 days and have had 4 UTI’s and finally had my consult with my Urologist yesterday. My prostate is 160+ cc (HUGE per the doc) with a median lobe. I am 63 years old at 6ft and 190lbs and active and otherwise mostly healthy (previous heart issue), and thankfully no signs of cancer, MRI and cystoscopy were done and no lesions. MY PSA is 7.4 and steadily rising over the years. SO TWO QUESTIONS BELOW;

My doctor said I have only two surgical options (TURP is not recommended) and I am way beyond using meds to help. I can have either Robot Assisted Simple Prostatectomy (RASP) done my doctor (he has done over 4k) or HoLEP done by his colleague (103 so far). Since my prostate is HUGE and my doc has done many of the RASP procedure, I am inclined to have that done. The doctor said I must decide. I like the idea of not having the penis/urethra involved. I am on anticoagulant (Eliquis) and realize that HoLEP is better in that regard for bleeding but I would have to wait months for that surgery, where I can get the RASP done in a few weeks. Has anyone else made this decision? If so, how did the RASP recovery and how is the quality of life afterwards?

Also, at this time I have some hip and right flank increasing discomfort/pain, from below the right-side rib cage to the groin area, but only on the right side. I asked if this is consistent with having a huge prostate and have gotten some mixed input that is shouldn’t be associated with my HUGE prostate and some input that it might be. Have other guys had this discomfort/pain and gotten relief after the prostate reduction?

My new mantra - You gotta be a tough guy to age gracefully!

HAPPY EASTER and THANK YOU in advance for sharing your experiences!!!

1 like, 5 replies

5 Replies

  • compiler
    compiler TMM14526

    Edited

    The HoLEP probably is the best for the large prostate, the larger, the better. The side effect may have retrograde ejaculation and urinary incontinence (can be improved by exercise). Have you tried taking 5-Alpha Reductase Inhibitors and rapaflo?

    • TMM14526
      TMM14526 compiler

      Posted

      Hi Compiler,

      THANKS for the reply and info, and yes I have tried meds and they delayed the inevitable. The local doc has done "only" 103 of the HoLEP procedures and specializes in kidney stone issues. Plus I think I really want to spare my penis/urethrae the trauma of a long reduction procedure.

      Appreciate the reply!!!

  • mike19110
    mike19110 TMM14526

    Posted

    Aquablation is the other procedure available for very large prostates. It has a much lesser rate of retrograde ejaculation than RASP and HoLEP, and very minimal risk of erectile dysfunction and urinary stress incontinence.

    • TMM14526
      TMM14526 mike19110

      Posted

      Thanks for the reply Mike19110,

      I have not spoken to a specialist that does Aguablation and wasn't given that as an option. My Urologist is one of the top RASP interventionalists in the country and has done 4.5k procedures and he very recently reassured me that given my situation having that procedure is a good decision. Be safe and well and THANKS again for the input!

  • Dogcajunatyahoo
    Dogcajunatyahoo TMM14526

    Posted

    Me - 71yrs old with 231 gram P size n bladder stones; I evaluated DaVinci Simple P surgery, HoLEP n ThuLEP due to BIG prostate. Did HoLEP 7/14/2021 at NWestern Medical in Chicago. I can now pee like a cow in the pasture and I luv it.......Hope y are doing well

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