James, I hope you are doing well.
I'm looking forward to your updates.
jeff
My understanding is that with PAE once the blood veesles are blocked they can not be unblocked. I'm curious what happens if they block the wrone vessles. I'm also curious about the longevity of PAE and Urolift since they are fairly new procedures. ( HOLEP has been around sice the 90's ) Seems to me with Urolift you're just pinning back the prostate so its out of the way. What stops it from continueing to grow?
Thankjs for the update
what was the size of your prostate before surgery, did you have any incontinence after procedure.
Well, it depends how large your prostate is. Any prostate larger than 80 gm is considered too large for most surgeries. The AUA recommends HoLEP or Prostectomy for those larger than 80 gm. I’m not sure about PAE.
Urolift can have problems also. If you want a HoLEP later, the metal clips can ruin the blades in the morcelator, and another morcelator has to be inserted after the clip is removed manually. Sometimes clips can become a problem (not sure about the percentage). A median lobe makes Urolift more problematic (check with your doctor on this).
With HoLEP, retrograde ejaculation affects 90% of men, according to Dr Amy Krambeck. Strictures affects 1 out of 200. Premanent incontinence affects only 1%.
My ultrasound showed my prostate to be 102 grams. I’m thinking HoLEP is the best choice for me. I will know more after the surgery. I’m over 70.
Agreed! Huge variable: the competency of the urologist/interventional radiologist performing your procedure! If I need such a procedure, it’s off to the Cleveland Clinic, Mayo Clinic, Northwestern Hospital, in Chicago or Cedars/ Sinai in LA. Can’t fool around!
I’m 59 from the USA and had the HoLEP procedure (100g’s) done here in South Korea July 1, 2025.
The cost was less than 2 grand. It is now 8/04/2025. I hesitated but I have to say… this was the best decision I’ve ever made. I can Urinate like I’m 20 again. I was getting morning erections 4 days after surgery and they continue. I can also ejaculate normally. This is a miracle procedure. If you are hesitant in getting this procedure, …don’t. You will not regret it. Do what they tell you after surgery and you will have your life back again. Totally worth it!
Why didn’t you have it done in the US? Thanks.
Who says Rezum doesn’t cause retrograde ejaculation or sexual dysfunction? While the accepted rate is 15%, the reality is closer to 50%