¿HOLEP: Bueno? Malo? ¿Otra cosa?

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!

Tengo 59 años, soy de EE. UU. y me realicé el procedimiento HoLEP (100g) aquí en Corea del Sur el 1 de julio de 2025.

El costo fue menos de 2 mil dólares. Ahora es el 4 de agosto de 2025. Dude, pero debo decir… esta fue la mejor decisión que he tomado. Puedo orinar como si tuviera 20 años otra vez. Comencé a tener erecciones matutinas 4 días después de la cirugía y continúan. También puedo eyacular normalmente. Este es un procedimiento milagroso. Si estás dudando en realizarte este procedimiento, …no lo hagas. No te arrepentirás. Haz lo que te digan después de la cirugía y recuperarás tu vida nuevamente. ¡Totalmente vale la pena!

¿Por qué no lo hiciste en los EE. UU.? Gracias.

Who says Rezum doesn’t cause retrograde ejaculation or sexual dysfunction? While the accepted rate is 15%, the reality is closer to 50%