Rezum or HOLEP in the UK

Men's health
1

Fed up with the side effects of Tamsulosin and waking 3 or 4 times during the night, dribbling etc, so have decided to go for either Rezum or HOLEP. Like the idea of Rezum as there is a good chance of retaining ejaculatory function, particularly if Professor Hindley was doing it. He has done well over 100 surgeries and with good results. If anybody has had either procedure done in the UK could you please let me know the outcome. Many Thanks.

2

Good afternoon Andy

In a way you just answered your own question

You said you like the idea of retaining your ejaculation function. Holep you have no choice. I am in the US and I had a Urolift done 4 years ago but I have heard good things about Professor Hindley.

Good luck...Ken

3

Good afternoon Andy

In a way you just answered your own question

You said you like the idea of retaining your ejaculation function. Holep you have no choice. I am in the US and I had a Urolift done 4 years ago but I have heard good things about Professor Hindley.

Good luck...Ken

4

i say avoid rezum.

5

i say avoid rezum.

6

Andy,

You might check out Aquablation using the Aquabeam system. They reported clinical trail results at the AUA 2018 conference. Their results were far better than with using Rezum and with a much better side effect profile. They currently have an ongoing clinical trial in the U.K.: https://clinicaltrials.gov/ct2/show/NCT02974751?term=Aquabeam&cond=BPH&cntry=GB&rank=1

Aquablation uses water preasure to ablate tisssue instead of steam. This paper will give you a little more information: http://www.io.nihr.ac.uk/wp-content/uploads/migrated/Aquabeam-aquablation-system-for-BPH.pdf

Best,

Henry

7

Can some of the Happy UK Holep patients please add their tuppence worth :-)

8

If you want to keep your ejaculations, Rezum is the choice. Its also the less invasive of the two and doesn't preclude something more invasive if it doesn't work. But if BPH is your problem (not your bladder for instance), Ruzum has a really good success rate. No anesthesia, RE is possible but rare.

9

Derek

I'm not say that it is bad but if he has concerns about his ejaculation. Rezum is a place to start. And if it don't work he can always have something else done.

Have a good day....Ken

10

Retaining ejactulatory function would be great but not absolutely essential if HOLEP is more effective.

11

What do you consider as 'retaining ejaculatory function' ? With Holep, you still can ejaculate, just not much coming out because semen goes into the bladder instead. In a way, retro ejaculation is proof that the procedure or medication did its job: opening up the bladder neck. One poster recently posted that his uro would suggest a redo of a Greenlight procedure if it did not result in RE. 😀 Re effectiveness and durability, there is no comparisons to Holep, except for TURP, if you're willing to accept RE. However, if your symptoms are mild, you might get by with less invasive, yet less effective procedures. Hank

12

I'd like to hear from some unhappy HolEp patients as well. Hank

13

Hello

To me that I would consider a failure if I had a procedure and ended up with retro. To me it's just as important.

We should not have to give up anything just because we want to pee better.

But we do what we have to do.Ken

PS. All you need is to take the pressure of the bladder neck. If you damage it you will end up with more then retro.. I can't see leaking and wearing pads for the rest of my life. No way........................Ken

14

John, why do you say that?

15

If you don't care about retro ejac, go with Holep - best surgical procedure out there in terms of efficacy and safety when done by a well-trained surgeon. Rezum is a hit or miss proposition, and it's hardly non-invasive. Patients should never be awake for it unless strongly and heavily sedated. Procedures like Rezum were not created for patients but rather, created for Uro's to line their pockets with high volume $$$ without money lost to surgical centers. These procedures like Rezum or UroLift may or may not work. Holep will almost assuredly work. Holep and GLEP = the best - all enucleation procedures are superior in results, barring the retro ejac that is likely with them.

16

Thanks guys, I am leaning towards HOLEP. More important to me that the surgery is effective and fully proven, rather than retaining full ejactulatory function with a surgery that is not so effective.

17

Hi AnduO,

I had a PAE , as my PG was 100ml,in January - 11 months ago - its effective- ejaculation is like a 20 year old The volume of urine I pass isnt big though - about 250 ml - so this means peeing more often .To minimize having to get up at night to pee, I dont drink anything after say 8 pm (bed time is about 10pm) I think the PG is displacing bladder volume, even though I manage to empty it.

Urologist - Mike Nicholls Radiologist who did PAE - Gareth Bydawell

These Drs are really good Medical Aid (Insurance ) paid for the entire procedure - which cost about ZAR50,000

I live in Durban ,South Africa - maybe you need to get here - its cheap with our weak currency R13.7 to the USD

Regards

18

Mr. President

Hello I am happy you are having some improvement.

Did your Urologist or Radiologist tell you that you may get more improvement as time goes on I know that it has been 11 month's but you never know.

Take care and happy healing.

Ken

19

Remember he is in UK where to a great extent NHS patients have less choice much of the time. If he has a Rezum they will not fund a later HoLep shortly after.

20

Henry and All Men that have BPH

Aquablation is good to a point if you don't care about keeping your ejaculation. Talking with some of the doctors I don't like the fact that the mapping is not done while you are awake. It is done after you are put to sleep.

It is just another way of doing a Turp. There is no variation on the sitting. The doctor told me that you can move the mapping down some from the bladder neck to try to save the seminal channel but that would be it. The whole prostate is eliminated. He said that if retro ejaculation is a concern try something else.

They have had some men keep there ejaculation per say because they do not touch the ejaculatory ducts but with no prostate and the connection to the seminal vessel there will be very little or none

Have a great day...................Ken