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

Posted , 6 users are following.

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

Report / Delete

5 Replies

  • 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?

    Report / Delete Reply
    • 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!!!

      Report / Delete Reply
  • 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.

    Report / Delete Reply
    • 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!

      Report / Delete Reply
  • 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

    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up