I am getting to the point where I want to consider surgery. BPH is getting worse and Tamsulosin has so many side effects, particularly on libido.I am considering HOLEP, Urolift or FLA but I know more about these procedures and the pros and cons than my Doctor, mainly due to this brilliant forum.
Considering HOLEP at Addenbrookes but is FLA or Urolift available in the UK and is there an unbiased Consultant ( some will say they don't exist ) in the UK to give advice on options or an independent report or paper that has reviewed all of the current surgical options in the UK. Look forward to your replies.
Andy sorry that you are having a problem. If you do not want any side effects the only procedure is Urolift 100% no side effects. I had my almost 4 years ago. Orgasm are very intense got better after the procedure. Ken
If your prostate is not too big, try Urolift first. It can be undone if necessary and is the least invasive. There is a Urolift site and you should be able to search for UK doctors who are doing the procedure.
Rich. I pose the same question. It has only this Spring been approved by NICE for treatment under the NHS so I guess practioners in the UK may be not that experienced. I had mine done 6 weeks ago privately in Poland (cost c £2500). It has I think solved the urine flow problem though it is too early to say if has adversely affected ejaculation. Alan
I was in exactly your position until my recent HoLEP.
My flow was getting weaker and weaker, so I had to make a decision, the Tamulosin wasn't working anymore.
I had been to many urologists in the UK. I had a PAE which didn't work for me.
Eventually, I researched into the options I had access to me in my area of the UK and based on my research I decided on a HoLEP. I then spent a long time searching for the best surgeon I could access. I then spent a long time talking to him, I took all the reports from all the consultants with me, scans, MRIs, results from the PAE. I looked at the risks of the HoLEP but also looked at the surgeon's performance stats.
I then spoke the surgeon again, about all the options I had available to me. And I went for the HoLEP, early days but all is going well.
I haven't seen a complete independent report or paper that reviews all of the current surgical options, but there is a huge amount of research and findings online.
I think most consultants have their procedure of choice, the one they can do, so fully independent of a procedure might be difficult. There are huge number of helplines, I called a few and spoke to prostate nurses about procedures and the risks, they see all the post op recovery, so have a lot of experience.
My advice, take your time and use this forum to bounce ideas around, we all want to help each other. I would never promote HoLEP because I had one to someone else as there are so many variables and we have to live with our own choice.
The urologist I used, Marc Laniado, can do both urolift and holep (or turp). However, not at cambridge. Urolift is not fully reversible as they can only remove the inner tab, not the outer tab, and the tabs being metal do cause a permanent 16mm obscuration to any future MRI you may need if you have a P Ca scare. I believe if your prostate is poking up into your bladder causing a frequency issue urolift is unlikely to cure that. It stands a fair chance of improving flow but for some men is a fail or can need re-work. Holep has a very high success rate and is believed permanent, lifetime fix. It usually causea retro. Laniado now advertises a retro sparing holep but he didn't at the time I had mine done so never discussed. I would guess that the retro sparing holep would entail leaving top of prostate alone and that if you have a frequency issue it would be less likely to cure that, but still give the reliable very high flow rate that is the holep outcome. It is easy to find men on the net for whom urolift failed, but not for whom holep failed. However, I have never seen the overall urolift success rate neither initial nor endurance.
The best source is still the NICE web site as they have a wealth of data. At one time they did nor recommend PAE due to lack of data from the company.
Overall the best results now seem to come from HoLep. As others will say the Freeman in Newcastle are probably the leaders in it whether NHS or Private.
If your overwhelming focus is orgasm quality and not bothered about risk it doesnt work or longevity, then urolift is best choice and also even quicker, outpatient job. From what I read PAE doesn't always work, causes stroke for 0.5%, and occasionally is painful, but if it does work, neat cure. FLA sounds grand when it works but the swelling seems to leave some people with or needing a catheter for up to 2 weeks. If you're already into catheters 2 weeks is nothing long term. Shame there isn't a reliable enduring retro-free miracle cure that works for all men curing both frequency and flow rate issues. One day.
The urologist I used, Marc Laniado, can do both urolift and holep (or turp). However, not at cambridge. Urolift is not fully reversible as they can only remove the inner tab, not the outer tab, and the tabs being metal do cause a permanent 16mm obscuration to any future MRI you may need if you have a P Ca scare. I believe if your prostate is poking up into your bladder causing a frequency issue urolift is unlikely to cure that. It stands a fair chance of improving flow but for some men is a fail or can need re-work. Holep has a very high success rate and is believed permanent, lifetime fix. It usually causea retro. Laniado now advertises a retro sparing holep but he didn't at the time I had mine done so never discussed. I would guess that the retro sparing holep would entail leaving top of prostate alone and that if you have a frequency issue it would be less likely to cure that, but still give the reliable very high flow rate that is the holep outcome. It is easy to find men on the net for whom urolift failed, but not for whom holep failed. However, I have never seen the overall urolift success rate neither initial nor endurance.
Looks like spire health cambridge will do urolift for you. That would be private. The named consultant also works at addenbrooks. You could try and get a free NHS referral?
More information about your condition is needed to offer useful advise.
What is the size of your prostate?
Do you have an enlarged median lobe, and how big is it?
Is the median lobe obstructing flow? (Is it a flap or ball valve)
What is your post void residual?
If you don't know these things you should get a Urologist to do the necessary tests. That may determine what procedure you go with. If your not ready for a procedure you can try CIC, self catheterization. I was able to stop Tamsulosin when I started CIC. If you want to try CIC get a Urologist's office to show you how to do it.
Ken, also I was told by one surgeon that the results could be short lived. Urollift does have side effects, the surgeon I went to explained them in great detail. I don't think you can say 100% no side effects.
Side Effects of the Urolift
These are some of the more common side effects that may occur following the procedure:
Sensitivity when passing urine
Urinary frequency
Strong urge to pass urine at times
Minimal bleeding
General pelvic discomfort/pain
Urinary leakage (relatively uncommon) but linked to urge
Urinary tract infection (occurs in approximately 5% patients)
Good afternoon Paul. There was just a 5 year study that came out on UROLIFT and all the men have been fine. There was 2% of re procedure. That they had to had more clips. I had mine done all most 4 years ago. and I have never felt them at all also 2 MRI last year and there were no problem. You just have to tell them you have it. All the information on having a MRI done is on the back of my card that I carry with me If you have a issue with retro ( There are still a lot of us that do not want to give it up ) having your prostate cut out is not for them me. I have been on this site for many years and there have been some issues with men that had Holep procedure and it is not a fix all there are men on here now that have had to had 2 or 3 procedure over a 10 year span. I think a lot of the problems were with the doctor because you have to have a skilled doctor for the best results. I hope you all have a great day Ken
I was attracted to Urolift because it seemed to offer less chance of complications. However I finally decided against it because I don't like the idea of an implant which is not totally reversible. My only other option was gyrus turp which I had done four weeks ago at an NHS hospital. I presume it will take some time for the wound to heal completely but so far I have been very happy with the result. The operation didn't cause me any pain and only slight discomfort. The post operative problems have been very slight. Best of all my flow rate has increased dramatically. I know it is a worrying thing to commit to and I put this off for as long as possible but in my experience the reality has been far less problematic than I envisaged. I am now pleased that I won't be left with any implant.