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I am researching surgical options for BPH for my Dad (86cc, 76 years old). He lives in the USA, in Louisiana. His 75 year old surgeon recommends a suprapubic open prostatectomy, but my reading suggests we should explore HoLEP as an option.
I've called numerous urologists and have talked to larger medical centers, but could not locate anyone who performs HoLEP. I contacted Lumenis, a medical device/laser company that manufactures a holmium laser, and they were able to point me to only 2 surgeons in the entire state of Louisiana that use their product for HoLEP.
My questions are:
1. Does anyone know of other methods to find urologists who perform HoLEP? Possibly other laser companies? When I Google, Lumenis is the only one that comes up, but there must be more?
2. It seems like HoLEP is the standard procedure in Europe and Asia. Does anyone know why the adoption rate here has been so low, given what seems like superior outcomes? It's been around for 20 years!
3. For those of you that have had HoLEP - were you able to have it done with just a spinal block? My Dad had a near death experience which under general anesthesia and is very, very concerned about that option. He prefers a spinal, if possible.
4. Are there other methods that we should also consider? Bi-polar? I don't know enough about that. We've ruled out Urolift and Greenlight/TURP. Someone posted about iTIND which sounds interesting, but it is in clinical trials, I believe?
Thank you very much for any pointers.
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