TURP versus HOLEP in the UK

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NHS have agreed to book me in for a TURP but i am also considering HOLEP privately at Addenbrookes at about £10000 cost. 2 days in hospital for TURP compared to one day for HOLEP. Is it really worth it? Would love to hear from anybody who has been in this situation. I am also having my PSA monitored as it is fluctuating between 4 and 7 and I think HOLEP they can take a biopsy for screening.

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11 Replies

  • Posted

    Both procedures provide tissue for histology.

    Recovery is definitely faster after Holep and Addenbrookes is one of the best hospitals for urology. £10K seems higher than the £5-6K I've seen while browsing forums and you may have to stay longer if anything goes wrong. I was booked in for 2 nights, actually stayed three due to post-op fever. The day after the surgery was the worst one and I can't understand people who walk home once the catheter is out.

    Ask if they have a Moses laser or a Thullium laser which can shorten the procedure time.

    If money is not an issue - then I can't think of any advantages of Turp vs Holep.

    I guess you had an MRI, PVR test and flow rate test before deciding on a surgery.

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  • Posted

    You WILL lose the ability to have erections , ejaculate, and attain orgasm with TURP.

    If those are of concern to you, highly recommend tge Rezum Procedure, where you will not lose those functions, but will decrease the size of your prostate. Ask your doctor if you are a candidate for Rezum.

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    • Posted

      I don't think it is proven that all patients undergoing TURP will lose erections and orgasm. Just don't think that is correct. Dry orgasm yes but already have that after being on Tamsulosin for many years.

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  • Posted

    I was considering Nuffield Health in Cambridge but finally had it closer to me in London. Addenbrookes was not Covid-safe at that time.

    You can google Tev Aho in Cambridge. I can also name several top surgeons in London if you are interested.

    Regarding other posts: Rezum had been my preferred surgery until an initial consultation and reading through this forum. I wanted a procedure with the shortest recovery time and shortest time with Foley catheter. This turned me away from Rezum and towards Holep. Yes - orgasms are not much different from Tamsulosin times, but even after Rezum the probability of retro is between 5 to 30% according to different sources.

    However, catheter was removed next day after Holep, a week later bleeding pretty much stopped and any burning sensation and minor incontinence were gone soon after. It would take longer after Turp.

    BTW, you consent to a surgeon switching from Holep to Turp midway if he finds a reason to. Just like a pilot changing the route at his discretion in emergency.

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  • Posted

    Thanks Al, that's useful info. Yes I have researched Tev Aho's team and they come up as one of the best and highly regarded.

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  • Posted

    My local NHS trust does not offer HOLEP. NHS North Essex ( Colchester) have offered it to me and am on the list to be done. I wanted the least invasive/fewest side-effects procedure. My prostate is too large for Rezum. Urologist also notes I have a "stiff" bladder. Poor flow and approx one third urine retention. No UTIs in a a few years. Have had 12 years of medication and monitoring. Scans/ultrasounds/biopsies - nothing malignant. My symptoms are moderately inconvenient and I could live as I am. However, for a few years all the urologists have urged surgery and stressed the possible longer term complications, ie bladder failure, kidney disease and this might occur at an older age when surgery is more difficult (I am 71). That said, I am very concerned at the possible side-effects. Particularly do not like the references to longer-term incontinence in offcial leaflet. "Incontinence settles down in 80% of cases". What about the other 20% I asked. Was told the other 20% of cases can be "improved" by intravesical Botox injections or further medication. Seems to me improvement is not the same as total curing. So, I need to decide fairly soon but still uncertain whether to go ahead. Would appreciate comments.

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    • Posted

      Any surgery causes side-effects. I guess their severity depends a lot on a proficiency of a surgeon, condition of your bladder and your overall health. It is a very hard dilemma: to keep on medications or to have a surgery. In my view, medications do not offer a life-long solution and cause other undesirable side-effects.

      After Holep I experienced a very minor incontinence that resolved within a month. Yes, I was informed about possible complications but gave my consent as quality of life was miserable otherwise.

      There is a lot of feedback from the US and Russian patients, where Holep seems to be more popular. I came across very few stories of long-term side-effects, especially when compared with other prostate surgeries.

      Can you meet your prospective surgeon and hear his evaluation based on your history and any examinations he elects to perform?

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    • Posted

      Thanks for the feedback. Experienced a severe UTI last week, urination reduced to a painful dribble for two days, quickly followed by "Acute Urinary Retention" over several hours. Taken into A&E for emergency catherisation and three days in hospital for observation. Worst experience ever. Now firmly convinced I need to have surgery so will have HOLEP asap.

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    • Posted

      You were lucky to get to A&E and be admitted to the hospital. Learn to self-catheterise if you do not fancy this experience again.

      After the first retention I was put on medications and hoped to stay on them despite all the side effects. It had to happen again to convince me into the surgery. My research led to a firm conclusion that in the hands of a good surgeon HOLEP is the best procedure at present.

      Best wishes and let us know your experience.

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