1. < Men's Health

Benign prostatic hyperplasia (BPH) Surgery Options

Posted by wpasternak @wpasternak, Aug 4, 2020

I had a Urolift procedure last February for my BPH symptoms and it was a total failure. The implants are still in position though. I am looking for a different procedure to alleviate my BPH problem and Rezum seems to be a good alternative. Can it be done considering my prior Urolift procedure. If not, what would be your recommendation.

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delmar418 | @delmar418 | Dec 30, 2022
In reply to @cent66 "Urology explained to me after the Green Light, I would experience the "feeling" of ejaculate, but..." + (show)
@cent66

Urology explained to me after the Green Light, I would experience the "feeling" of ejaculate, but no fluid would possibly be released. I have not been in recovery enough to test this out . Will post some comments in a few weeks , hopefully it can be helpful.

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@cent66 Hi! Thanks for commenting. I was told that HOLEP is offered here in Spain, under the socialized health system. As I relayed in Kayak's update to me, I had stumbled on another aspect of the procedure, thought I would ask if anyone has heard of it, and if so, had mentioned it to their surgeon. I'm always looking for options, new things seem to be popping up (no pun intended) so I ask here. I'm from Los Angeles, California. I moved here to receive early treatment for liver disease that I could only get on a deathbed in California. I'm cured.
Now, this. Keep in touch, updated. And, no rush to "test" anything. Heck, I don't blame you.
Del

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delmar418 | @delmar418 | Dec 30, 2022
In reply to @paul55 "I had HoLEP surgery in September 2020 by Dr. Amy Krambeck at Northwestern Hospital in Chicago...." + (show)
@paul55

I had HoLEP surgery in September 2020 by Dr. Amy Krambeck at Northwestern Hospital in Chicago. She has done thousands of them and did some of her training at Mayo and did a fellowship at Indiana University, I believe. I thought she and her team did a great job, and everything was covered by my work related insurance at the time. Now on Medicare with supplemental, but I think still all covered if medical necessity--I could not urinate at all at that point. My prostrate was about 125 ccs, so very big. I think they took about half out. Solved all my problems with little or no problems after the procedure. I do have retrograde ejaculation, but that does not seem to diminish the enjoyment for either myself or my wife (or so she says). Has some advantages also. Not to get too graphic, but I probably miss the extra feeling of the semen coming out of my penis, but still feel the overall pulsing pleasure of the orgasm. And pre-ejaculate still flows and provides lubrication.
By the way, obviously this is not a procedure for someone still planning on having children. I wrote here about what caused my problem at the time, but if you are having urination problems, be very careful about your urine backing up into your kidneys and causing severe damage. That is what happened to me. As a result I am Stage 3 CKD. My urologist at the time did not do bladder scans at my regular office visits to monitor for this danger, which I blame for my problem.

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Not graphic at all. Hello! Yes, I too had retention and hydronephrosis. My eGFR went down to 55. I was catheterized 99cc prostate. Recently, my eGFR went up to 75 with some dietary changes and creatinine levels dropped into normal range. I don't have a nephrologist, yet. I see the Urologist surgeon? mid January when I will ask the list of questions I have prepared.
I don't plan on having kids. I'm surprised and glad that you still have pre-semen fluid, this is interesting and encouraging. I needed to know this, so it wasn't graphic, it is good information. Thank you!
Del

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hoppysing | @hoppysing | Jan 22, 2023

Help please. I had Urolift procedure several years ago. 2 clips are in place. I need further treatment. Can Rezum or Ablation be an option? I am told TURP can be done but I really don't want that.

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hoppysing | @hoppysing | Jan 28, 2023
In reply to @wpasternak "The census here in MA is that green light (HoLEP) is the way to go. I'm..." + (show)
@wpasternak

The census here in MA is that green light (HoLEP) is the way to go. I'm not convinced. Not too many urologists here do Rezum. Rezum seems the best post-surgery if it can be done with implants already in place (from Urolift) and causing a procedure problem. Looking for anyone who has done that.

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My urologist is telling me I that Rezum can't be done if urolift clips are in place. I am trying to get other opinions on it.

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1 reply
rfherald | @rfherald | Jan 29, 2023
In reply to @hoppysing "My urologist is telling me I that Rezum can't be done if urolift clips are in..." + (show)
@hoppysing

My urologist is telling me I that Rezum can't be done if urolift clips are in place. I am trying to get other opinions on it.

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Both Rezum and Urolift are meant to treat BPH. Prostatic ablation and several other procedures are meant to treat prostate cancer. Before I had my Rezum procedure I was confusing what the treatments were addressing. I don' think insurance will cover a cancer procedure if the problem is BPH. I haven't heard if Rezum can be done with Urolift clips in place.

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bill5letsfixthis | @bill5letsfixthis | Jan 29, 2023

I think this is a good place to jump in as I was planning to report my latest decision. I had been hoping to do an Aquablation at the Lahey Clinic here in MA, doc has a lot of experience. But since I had a 125cc size a few years ago he sent me for a CT scan to get a more recent accurate measurement. He doesn’t think Aquablation should be done over 160cc. Well, I hit the jackpot at 229cc, lucky me. I do manage it well with Tamsulosin but it’s time. He recommended HoLep or PAE, the latter was my consideration for awhile as I am not willing to risk the 2% incontinence factor with HoLep. I am going for an evaluation this Friday. BTW, the record for largest prostate goes to a guy in 1918 who came in at 706cc. No Guinness Book mention for me.

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1 reply
cgriffin3 | @cgriffin3 | Feb 9, 2023
In reply to @zygmund "Good YouTube vid about Rezum procedure https://youtu.be/TvTjREdHO0I" + (show)
@zygmund

Good YouTube vid about Rezum procedure

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This Rezum procedure is for me. What is the cost of this procedure?

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joenfl2017 | @joenfl2017 | Feb 9, 2023
In reply to @joenfl2017 "No I didn’t. I wasn’t sure another procedure could be done. My first urologist at a..." + (show)
@joenfl2017

No I didn’t. I wasn’t sure another procedure could be done. My first urologist at a different clinic wanted to do it. Also he did a TRUS biopsy and I developed an infection of the prostate. That’s when I started going to the Mayo Clinic. Best care anyone could give.

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Unfortunately Mayo will not honor United Healthcare Medicare Advantage
anymore. They are not a preferred provider. I suppose Mayo doesn’t want to
deal with them. Does anyone out there have a suggestion for the next best
facility?

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2 replies
nci911 | @nci911 | Mar 22, 2023
In reply to @joenfl2017 "Unfortunately Mayo will not honor United Healthcare Medicare Advantage anymore. They are not a preferred provider...." + (show)
@joenfl2017

Unfortunately Mayo will not honor United Healthcare Medicare Advantage
anymore. They are not a preferred provider. I suppose Mayo doesn’t want to
deal with them. Does anyone out there have a suggestion for the next best
facility?

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Can the Steam and Laser procedure be done anywhere else besides the mail when are others going to get aboard

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mazeppabob | @mazeppabob | Mar 23, 2023
In reply to @joenfl2017 "Unfortunately Mayo will not honor United Healthcare Medicare Advantage anymore. They are not a preferred provider...." + (show)
@joenfl2017

Unfortunately Mayo will not honor United Healthcare Medicare Advantage
anymore. They are not a preferred provider. I suppose Mayo doesn’t want to
deal with them. Does anyone out there have a suggestion for the next best
facility?

Jump to this post

@joenfl2017
We have United Healthcare Medicare Advantage and Rochester Mayo accepts ours. We just pay a copay.
I am supprised that not all locations are the same.

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2 replies
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