For two years I have researched the many different treatments for BPH. I went to the Mayo Clinic to schedule a HoLEP (Holmium Laser Enucliation of the Prostate). I was told my prostate was a little small, and the HoLEP expert recommended a HoLAP (Holmium Laser Ablation of the Prostate) instead. As I understand it, in HoLAP a laser wire through a cystoscope is used to ablate all the prostate tissue. My HoLAP is scheduled for July. A few questions: is this essentially the same procedure as the green light laser, (though a different type of laser is used)? Has anyone had any experience with HoLAP or the Mayo Clinic for prostate treatment? Any knowledge of whether or not Medicare will cover this treatment? Thank you all for your response.
What size is your prostate? My Uro wanted to do a Holep on my 28g prostate but I went for urolift instead. Urolift has not been entirely successful so if he comes back with wanting to do the Holep, it would be good to know what size prostate the Mayo Clinic thinks is too small. Thanks.
Jerry, You need to ask the folks at Mayo Clinic those questions, especially whether Medicare will cover the procedure. Since you've been there already, I would hope (but wouldn't be certain) that they would have told you if they proposed a procedure that your insurance (Medicare) wouldn't cover.Regarding questions about the proposed procedure, make a list of all your questions and send it to the Urologist.
The big one I would ask is this: To the doctor who will do the procedure, how many of that particular procedure have you done, and how many have you done in the last year?Then ask, what has been his experience with adverse outcomes such as serious and enduring incontinence. (Retro ejaculation is fairly common, and would be lower on my list of concerns.)
Glenn
No surgery is ever guaranteed and the patient has to sign a statement that he is undergoing voluntary surgery at his own risk. As for coverage call your insurer directly. Asking anyone else may get you a surprise bill.
How large is your prostate ? Mine is 60g. I also did my research and hoLEP is my only choice.
How large is your prostate ? Mine is 60g. I also did my research and hoLEP is my only choice.
Have you seen the you tube video by Dr. Dora. I was impressed. To answer your question, mine is 45 gms.
And, Hank, I saw Dr. Dora to schedule a HoLEP. He decided that my 40 gm prostate was a little small for HoLEP (increased risk of bladder sphincter damage resulting in incontinence) - I think that's what he said. So he advised me to have HoLAP. But if my prostate was 60 gms, I would definitely have a HoLEP.
Thanks Jerry. Did the doctor tell you the lower limit of prostate size for hoLEP ?
What video ? I saw the 2:36 video. Also, probably a year or more ago, someone posted the same thing, prostate too small for hoLEP so he went for holAp. You might want to go back and check his posts.
What Mayo clinic did you go to ?
I'm referring to a video by Dr. Chandler Dora on HoLEP. HoLAP is for smaller prostates. HoLEP is for larger ones - generally greater than 40 to 50 ml or gms.
Jacksonville Florida. An impressive place.
Interesting that they noted your prostate was too small for holep. mine was 37g and I had holep done at the mayo in AZ last month. very happy with the results. in my case, they only took out the median lobe
jon Who did the procedure at Mayo? I am looking into that for the near future. Did you end up with RE? What was recovery time? Thanks
dr Humphreys did mine. I was pretty much back to normal and exercising regularly after a couple weeks. had the procedure on a Friday and was back to work on monday. my flow was a dribble before and now it's like a race horse. best of all, no RE. guess I may have been one of the lucky ones
Jon, dr Humphreys at Mayo clinic in Arizona ? What tests did you have before the HoLep ? Thanks.
yeah, dr Humphreys at the mayo in az. he never brought up a holap to me only holep and glad he only did the median lobe. I had a failed PAE in december and was cic 5 times a day before the holep. had all kinds of tests in the last year, 2 MRI's (pre and post pae), many cystocopies, and a urodynamics test. my primary issue was the median lobe, which had made it nearly impossible to pee on my own and made my bladder wall quite thick. very very happy with the outcome!
Good to hear of your good outcome, Jon. I just wonder what tests are needed for hoLep. I am afraid all of those tests. 🤐
jon:
My biggest problem is frequency. Was that also a problem for you, and did the procedure help?
Thanks.