HoLEP big success 2 weeks on .....

Men's health
1

My hubby had his HoLEP procedure 10 days ago.  Apart from some stinging when they removed the catheter out (less than 24 hrs after the op) for the first 3 trips to the toilet, and he has had NO pain.  The bleeding stopped after 8 days.  We were led to believe it may be several weeks/months before his bladder would be sorted enough to not have to dash to the toilet, but this has not happened.  

I just wanted to let you know because there seems to be quite a lot of negativity around this procedure but we can only say good things about the surgeon (Tev Aho at Addenbrookes) and the outcome.  Everything is working as it should and hopefully will continue to do so.  We were told that the likelihood of him going into retention again is virtually nil, although they can't 'guarantee' it.  Also, the chances of him having to have a further procedure due to regrowth of the prostate is virtually nil because of the way the laser works, unlike TURP.

It is only 2 weeks since the op, we know that, but we're hoping all continues well for the future.

Relief for us both at last.

 

2

HoLEP now seems to be the laser option of choice and his recovery seems good although my bleeding stopped earlier after PVP (when 75grms) and Holium laser (130grms) At the time of the Holmium I had been taking Warfarin and stopped it for two days before and after the procedure.

I have had regrowth after each and don't see why HoLEP would prevent it.

When are you going on your cycling trip? 

3

It was explained to us that the laser effectively stops regrowth, but maybe that was a bit of a sales pitch  in any case, the %s he quoted all seemed very good.  What we were particularly concerned about was him going into retention again while in the dark depths of India or similar, but we are encouraged that that probably won't happen.  In any case, we will carry catheters as an insurance policy.  Sod's law dictates that the next crisis will have nothing to do with previous crises, so we're not going to worry too much about it!

We're hoping to be off Dec/Jan, just a small matter of sorting out/selling the house first.

4

I've had no problems apart from a dissapointing flow after each and of course it still growing. It is difficult to know how much tissue they actually remove. I commented when having a cystoscopy this year that my prostate had been 130 grams before the operation and that the surgeon had said that he had removed ‘a lot of tissue’. If it is now 50 grams how much has it actually grown. He regards 50 grams as not all that big. Looking at the operation notes he said that the surgeon had removed 36 grams. I queried how come 130 – 36 and it is now 50? He said that 36 was the tissue retrieved and sent for analysis but that a lot is vaporised by the laser.

Why sell the house when house prices are still going up if you are coming back.

5

We are selling a v. large house and we have already bought (and now rented out) a smaller house, 2.5 miles away.  It's been our retirement plan all along and in any case, this house needs a family now, not us.  It's a beautiful house in a lovely road and we've loved living here, but it's time to move on to our new, smaller house, also in a lovely road.  We're looking forward to retirement

6

We already had a flat to retire to when we sold our house in Surrey in 1994.

Now that I see that others in road have recently sold for over five times more should I have kept it or was I right to sell it and invest the money?

7

What is HoLEP?

8

Google is you friend.

9

Derek, you did right.  You can't put your life on hold because of house prices!  Oh, the retroscope is a wonderful thing but probably best not visited too often

10

At that time I still had six years to go until official retirement.

I put half of it into 8% Government Bonds and half into shares. At least one of the shares has still out performed house prices.

11

Those were the days Derek, 8%!!!!  OMG, we'd cut our right arms off for that kind of return.  No, we have thought long and hard about our investments; we were going to buy 3 smaller houses with the money we make on the big one, let them out etc, max out the yield, but after renting one property out for 3 years AND having had several deaths of friends/family over the past 2 years, plus our own health issues we've decided we have 'enough' money.  We want to keep it simple, so we can travel and live life doing the things we want to do now.  That's the 'plan' anyway.  Good luck Derek.

12

I'd travel if someone would insure me:-)  Problem is that so many countries we have been to are now on the danger list.

I'm getting a Pacemaker fitted next week.

13

When my BPH was originally discovered and I refused a TURP the worried consultant said when on holiday alwys make sure you are near a hospital in case you go into retention....don't go to any islands.

I said that I was thinking of going to Zambia at the end of the year. He shook his head sadly, 

14

We are having a problem getting insurance too.  Last time we travelled (2008/2010) we were able to get 12 mths with the British Mountaineering Council, to include cycle touring and would be fine for the over 55s, for approx £500 for both of us.  This time it's virtually impossible because of our age and the length of time we want to travel.  So, we're doing the sensible thing and only insuring ourselves in the US (we're starting our trip there, and will be there for approx 4/5 mths) and the rest we will make up as we go along.  They don't make it easy do they?  And from what I can see, it only gets worse as you get older.  Although I did hear of an insurance co called insurewith com who do good deals for people with pre-existing conditions.

15

I tried a few insurance brokers some years ago but they were surprised to be asked for travel insurance.

Some who advertise cover for over 500 pre existing conditions are laughable when you read the small print and find it includes things like athletes foot.

Even a year older causes a hike with some companies. When we went from 68 to 69 the company were were using asked for twice the ammount the next year because we were a year older and at the same time told me that BPH and GERD were no longer covered. That was when we went to Insureandgo. One thing to bear in mind is that many do not cover you for six montha after surgery. Insureandgo did not regard my PVP as surgery and more than I did. 

 

16

Thanks for sharing your successful outcome with the HoLEP procedure.  My wife is taking a week off in September to accompany me to Mayo Clonic Scottsdale.  I'm scheduled for the HoLEP at that time.  Since we have to trial several hours, the docs wanted us to stay in the area for several days beyond the procedure...in case of complications.  I've looked into the new interventional procedure by Radiologists but no one here can share where they have had the procedure performed and if they found a research hospital or University in clinical trial that is willing to pay for the procedure.  The one hospital I found performing the procedure in clinical trial will not help with costs and they say over 90% of insurance. Ompanies consider it experimental and will not pay....so what's the point?  I hear the procedure will not be main stream for another six years. If I wait that long, there's too much risk of developing full blown urinary retention.  We need success stories with the current, BEST, procedure espoused and discussed in a positive manner...thanks

17

I am 12 days on from my holep.  Removal of catheter through operation site was certainly a lively moment, but .... over very quickly.  The next 2 hours were vexing as I couldn't pee a drop, and my heart sank at the thought of it going back in.  Gradually I could pee 6 drops, then 50 ml, then 100 ml, then allowed to go home - I'd only had one night in.  Pee pain very bad first night at home; I learnt to keep drinking water overnight; everything lies in keeping the pee dilute, and to heck with frequency issues.  Blood in pee ceased within 1 day; I was wearing something in pants to catch leaks (thanks, wife) and noticed that was catching the odd reddish drop, and a little leaking pee (not much) but main pee into pan never noticeably red.  Mild leakage after each pee, but the urgency thing never led to my wetting myself.  Did find that at first, frequency was quite an issue, if sitting down, when got up, felt I almost had to run to loo.  Solution ironically is stand and walk around more; that helps you last longer between pees.  No idea why, just does. I found kegel exercises uncomfortable; had done some before op.  Last night, annoying spike up in pee pain, no idea what going on, but today, able to hold on for ages; hoorah, not going all the time.  And max flow rate must be at least 14 ml/second now, maybe more.  Able to void in one "go" mostly; it does slow down at end, but for so long I've needed to have 2 or 3 "goes" to empty. today I seem not to.  Feels empty once empties.  As of today I no longer feel obliged to drink 2 litres a day (+night) to stave off infection.  Almost normal now, except that pee pain comes and goes; sometimes (including today) just enough to make me shake a little in pain, but taking nothing for it.  The strong after-pain after some early pees - I remember one at day 4 especially well - has gone now; just some pain deep inside at beginning and mid-pee (varies from pee to pee, oddly).  I would certainly recommend the op, so far.  Not allowed sex for 4 weeks, so no ED test or RE test thus far - but there are some signs I won't have ED.  NB have seen no clots, no tissues, in pee at all; maybe that is to come, as was warned of it (I've read that there's a peak at 4 to 5 weeks, as some internal soft scabs come off).  For what it's worth : age 49, 11st5lbs, 22cc prostate.  That may make it easier for me than some, then again I've read of men with no pain ever post HOLEP, and I've read of men with what they say is bad pee-pain for 50 days, then it stops quite suddenly.  Void volume currently about 250 ml (I pee into a 210 ml paper cup sometimes, to measure it).  Urologist about my age claims to pee 750ml on a full bladder, assuming that's typical, am aiming to hold on for longer and longer now to stretch the bladder a bit, it'll be less muscly than before, and hope to make it more elastic so it'll maybe hold more.  Not that that really matters much.  Increasing capacity utilised, just might help me finally reach goal of sleeping through whole night, given no caffeine at all (only water now), no alcohol (most of time), and stop drinking ~7 pm (not yet, need to keep watering it a bit post-holep for infection control; but soon). 

18

Paul I'm scheduled for HOLEP in July 14.

How about a update on the procedure

19

Hi. How about a update on the procedure.

I'm scheduled in couple weeks.

I appreciate it.

Thanks

20

OK update : 2 weeks on (just after above post), I peed blood and clots for a day or two, alarming but it passes and from then on, no more pee-pain.  I found at first orgasms were pretty insensate (from 7 weeks on when first experienced), annoying at age 49, over the next 2 months they improved but a year on I guess, hard to be perfectly objective, but there is still a bit of sensation gone at that moment and I guess I won't ever get that back.  R.E. too (fine, was advised).  No ED, no other dysfunction.  Peeing : I can hold on a long time, go for hours in the day, overnight I tend to annoyingly wake up at 7:00 (gone to bed midnight) and realise I need a pee but not sure if that is why I woke up, and not really sure I need to "go" so very badly, just have the feeling no chance getting back to sleep if I don't.  It's a lot better than peeing 2 to 3 times a night like I was for a few years before.  I try to not go to the loo too often, I think it gives some people slightly overactive bladder if you do - often if hold on, the feeling of needing to pee goes, doesn't come back for a while.  Need to keep the thing calibrated. I like the thought that there's less prostate tissue left to get cancer in.  I do sometimes wonder what urolift would have been like, but there seem more people that doesn't work for, it obscures subsequent MRIs, only the inner tabs are removable, it obscures MRIs partly, and holep at least is a fairly reliable enduring solution.  I was relieved not to be in the 2% that get a stricture, that sounds annoying.  Do not panic if you cannot pee at first after the op, it is scarey if that happens but the swelling goes down and an hour later, maybe you can.  NB two month on appointment revealed no cancer in the HOLEP samples taken, PSA was 0.66 (had peaked at 17 during what is now thought to have been acute prostatitis that first took me to a uro 5 weeks before Holep).