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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@kayak461

How did you make out with Dr. Dora? I would bet that you are scheduled!!

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I am scheduled for June 1st. Dr Dora performs 30 +/- HoLEP procedures a month. I feel like I am in good hands with him.

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I agree….you’re in good hands with him and everyone at the Mayo! Congratulations! It will be very helpful to others if you will write about your experience! I look forward to hearing from you!

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How much does it cost for HoLep procedure?

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Look at PAE ... same resuts as Rezume. No catheter or anesthesia

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@bill5letsfixthis

@rfherald I knew it was a matter of time before someone would ask. After searching out the few studies that were done and after Googling “What botanicals mimic Finasteride” I have come up with the following. All from high quality US manufacturers with independent ratings. 500 mg Saw Palmetto, Stinging Nettle Root (not the leaf) and Pygeum Bark Extract if you can get it, if not the Pygeum Extract will do.

The Pygeum is what came up as mimicking Finasteride, only it does not shrink the prostate.

I must tell you, between my BPH symptoms and most recently Chronic Pelvic Pain Syndrome I became a new man after about 2 weeks. CPPS is totally gone. BPH symptoms much reduced where I am now close to normal except for the occasional urgency. I am a former athlete/firefighter and avid cyclist doing 100 miles a week so my prostate does get a bit of a hammering but split seat helps. I don’t sit a lot which I think is helpful, I use a standing desk for my part time job.

I am doing my best to avoid any lasering , steaming, slicing, clipping, or tearing procedures which sound too medieval to me, that’s why I think if I need to do something I may do the PAE.

As a side note, I did the same with my damaged rotator cuffs and avoided operations. I’m a believer in botanicals and therapy, almost 70 and not giving up.

Also, when I asked my Uro about the botanicals he said he knows nothing about them. But he knows all about all the other medieval procedures.

Good luck, let me know how you do.

Bill

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Thanks this is interesting. To clarify, you took all of those botanicals or just one?I’ve heard of the Saw Palmetto but not the others.

Tom

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@rfherald

I may be missing something already mentioned here, but I think Mayo will NOT accept
UHC Medicare Advantage Plans
but WILL accept
AARP United Healthcare Supplemental Plans.

It might just be me, but this is one more example of how things are changing too much, too fast for my aging brain.

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I have regular Medicare and the aarp / UHC supplement. They covered audiology and a MRI at Mayo in January with no issues. Advantage plans can be a problem not just at Mayo, or so I’ve read and heard. Just providing a data point on this question.

Tom

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@tlehman

I have regular Medicare and the aarp / UHC supplement. They covered audiology and a MRI at Mayo in January with no issues. Advantage plans can be a problem not just at Mayo, or so I’ve read and heard. Just providing a data point on this question.

Tom

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Tom, I agree with you. When I first wrote my comment, I didn't have the original Medicare and the Advantage plans straight. I now believe that Mayo accepts Original Medicare plans, but not Advantage plans. If anyone understands this better, please straighten me out.

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@rfherald

Tom, I agree with you. When I first wrote my comment, I didn't have the original Medicare and the Advantage plans straight. I now believe that Mayo accepts Original Medicare plans, but not Advantage plans. If anyone understands this better, please straighten me out.

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I agree. My understanding is that Mayo no longer accepts Advantage Plans. I think that this is because Advantage Plans have high deductibles! Just my opinion…..may not be the case at all!

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I am Day 1 after my Holep surgery. Dr Dora at Mayo performed the procedure yesterday morning. My prostate was 106cc, Dr. Dora commented in his notes that it was “impresssive” (my wife got a charge out of that). Procedure started at 7:30, I elected to go with a spinal block and lower level anesthesia. They did not use an airway tube with this anesthesia. Also after effect was lessened. I was in recovery around 9:15, although I have no recollection until around 10 am. I was able to drink water/soda and eat some crackers and pudding right away. The spinal block was effective until later in the afternoon. That was good and bad. Good in that I had no feeling from the waist down so no pain. Bad that I had to stay in recovery until I could get some feeling in my feet and climb into a wheelchair. Around 3 pm I was moved to the Care Hotel across the street. Very comfortable and the food is excellent. The apple cobbler with ice cream was just what I needed. I am pretty sore in the area where Dora did his work and sore from the catheter. I have been taking Tylenol for pain. I go in to get the catheter out at 8:15 am. Hopefully once removed the pain will be less. Pain is not bad just uncomfortable when I move around. I walk up and down the hall at the hotel every hour or so. I was told by Dr. Dora and nurses to take it easy for 6 weeks - No exercise, bike riding, rowing, fishing, golfing or sex (not much left to do). No driving for a week. Just take short easy walks. I will be counting the days….
I will add more as things progress..

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i had a Urolift and completely failed - i asked about REZUM and said it's not an option. My question is - HoLEP vs TURP? which is better? What are the pro's / Con's?

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