if and when to have the HoLEP procedure

Posted by kitlund @kitlund, 6 days ago

I'm 82. Stage 4 PC (Gleason 3+4, and one local lymph node). WITH a 100 cc prostate. Been on Orgovyx for 2.5 months. Up 4 times/nigh to pee. After a year of nocturia, I'm almost used to the getups. They're so regular. My urologist, whom I consulted ONLY for nocturia (until all the scans and biopsy proved the cancer), is still thinking probable HoLEP for me.
I am reading, however, that Orgovyx may probably reduce the size of my prostate by up to 30%. And I don't know what impact the size reduction will/would have on my nocturnal urgencies. But in any event, all sites I consult suggest that a HoLEP procedure would have to be done BEFORE radiation. That would postpone radiation (which I understand SHOULD go hand in hand with the relugolix) for up to 6 months.
My dilemma, you see, is whether to just live my remaining years with the 4 nightly pees (which I have to say I'm almost used to now) or let my urologist do the HoLEP , hope for a speedy complication-free recovery, and THEN do the radiation...or to start the radiation as soon as my medical oncologist and radiologist deem it time to proceed with that.
Best,
Kit

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Profile picture for dribbles @dribbles

I finished my SBRT about 6 weeks ago. I started on Orgovyx in Feb. with my prostate at 77 ml. I had a PAE at Mayo ,Mn on 3/27. When I started my SBRT on 6/18 my prostate had shrunk to 37 ml. Prior to SBRT my Urinary issues disappeared and I was totally impressed with my pee stream. Since SBRT my pee stream has weakened some and I am taking a flowmax every other day . My DR says I'm still healing and he expects it will normalize .
Not everyone does the PAE's but I believe its interchangeable with a HoLep. It was an easy recovery . Check it out as you weigh your options. Best of luck

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@dribbles excellent summary of your events. I had never heard of the PAE.. thanks

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Profile picture for kitlund @kitlund

@dribbles excellent summary of your events. I had never heard of the PAE.. thanks

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@kitlund
The PAE had a couple advantages that suited me. It’s non- surgical( through an artery) and also may preserve sexual function. I believe there are far more Holep procedures being done but more COE are doing them now. From what I researched the outcomes run very close . Another one of many options you need to consider

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Profile picture for dribbles @dribbles

@kitlund
The PAE had a couple advantages that suited me. It’s non- surgical( through an artery) and also may preserve sexual function. I believe there are far more Holep procedures being done but more COE are doing them now. From what I researched the outcomes run very close . Another one of many options you need to consider

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@dribbles thanks again!

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