HoLEP vs TURP: Looking for guidance

Posted by jyuhanick @jyuhanick, Jan 3, 2017

I have enlarged prostate, I have read great results with HoLEP, vs TURP. Looking for guidance on which procedure

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@fredunger

It shrinks in all directions and therefore puts less pressure on the urethra. Believe me it works well if you have an enlarged prostate. They only found one of my two arteries and I now urinate normally, though I still have to get up 1-3 times during the night. I am also 85 years old and would probably have that problem anyway, even without an enlarged prostate.

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PAE sounds like a good procedure and I understand has been arount a long time for treating prostate cancer. What is risk profile? That is my big concern with it if they miss the artery etc?

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They only found one of mine. That's probably the worst case. It's probably less risk than putting in a stent and it's done by the same doctors who put in stents for the heart.

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@pablo81

Thank you for your response.

Do you have any side effects i.e. incontinence, retro ejaculation, erection? What was post recovery like i.e. how long with catheter?

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Had the Holep.....they removed catheter after 12 hours.....now I have a great stream, but having to urinate often.....I cant seem to hold urine as well, but it is getting better. I have the fealing to urinate and that is a great blessing. Erections seem not quite as good, but again each day becomes a little better. Bigest concern is trying to hold my urine better. Highly recommend Hotep.

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@cent66

Had the Holep.....they removed catheter after 12 hours.....now I have a great stream, but having to urinate often.....I cant seem to hold urine as well, but it is getting better. I have the fealing to urinate and that is a great blessing. Erections seem not quite as good, but again each day becomes a little better. Bigest concern is trying to hold my urine better. Highly recommend Hotep.

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Hi ... out of interest. were you catheterised before your Holep and if so, for how long? I had Aquablation on the 13th November this year but I was catheterised for some ten weeks before that and while I am now catheter free ( removed on the 24th November ) I now suffer frequent bladder spasms and urine urgency and research tells me that was entirely due to the length of being catheterised, pre-op. I have also been given a target time of two months minimum for my overactive bladder to calm and encouraged to do the pelvic floor exercises and bladder training. Apart from that I am glad to be catheter free and have a urine stream to be proud of!

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Hi Pablo81, Yes…retro ejaculation is with me from now on….but I consider myself extremely fortunate. The feeling of achieving orgasm is very satisfying, and for me the sensitivity of it all is intense and gratifying. I am very thankful and satisfied with that as I know that I am fortunate. No problems whatsoever with erections. I have it in my head that sensitivity is greater for me now than ever. The catheter was removed the day following surgery, and I have no problems urinating. I am blessed…for sure, and could not be happier given that 75 percent of my prostate was removed.

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@snoopy48

Hi ... out of interest. were you catheterised before your Holep and if so, for how long? I had Aquablation on the 13th November this year but I was catheterised for some ten weeks before that and while I am now catheter free ( removed on the 24th November ) I now suffer frequent bladder spasms and urine urgency and research tells me that was entirely due to the length of being catheterised, pre-op. I have also been given a target time of two months minimum for my overactive bladder to calm and encouraged to do the pelvic floor exercises and bladder training. Apart from that I am glad to be catheter free and have a urine stream to be proud of!

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Sounds similar to my experience. I had the Foley in and out for a period of 1 1/2 years. I would have the catheter for about 7 weeks, go in for testing to see if I could urinante/pass urine...I made about 4 trips home without the catheter only to run back to the ER with stopage...very painfull. After about 1 year of this in and out craziness, I had Green Light Laser treatment...something that is suppose to open the bladder to urinary tract. I was able to go catheter free for about 5 weeks, then slowly but surely experienced stopage again....and yes the Foley back in. Very depressing, and painful.. Urologist then refered me to Hotep surgeon....in October 2023. Everything great....I have frequent urination, and when it's time I have to literally RUN to the restroom....But, I know when it's time which is a positive. 7 weeks out, still have frequent urination, but so far I am able to keep up with it. Urologist said the length of time having the Foley Cath...makes me a candidate for Learning how to uriniate all over again. A long , long journey...hopefullly day by day and I can get to some type of normalsy?

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What is Holep? I know it's when a man can not get an erection? Is there medication
for this?

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@michael42

What is Holep? I know it's when a man can not get an erection? Is there medication
for this?

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Hello @michael42, Welcome to Connect. I think you may be referring to is the holmium laser prostate surgery procedure (HoLEP). This Mayo Clinic video describes the procedure:

There are also a discussion you may be interested in on the procedure here:
--- HoLEP procedure experiences?: https://connect.mayoclinic.org/discussion/holep-procedure-experiences/

Are you considering the procedure or have you discussed medications with your doctor?

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Hi. I had HOLEP 5 weeks ago. Nighttime incontinence went away after the 1st week. Daytime dribbling only happens when I get off my office chair for some reason. I have urgency to go when my bladded reaches about 125ml (I measure how much is let out and then I am empty). But, my big problem still is stress incontinence when doing vigorous activity. Where it's in the gym with weight, vigorous walking, playing tennis, etc. I leak enough to fill a medium pad in 1 hour, probably 250ml of leakage. I do kegels but I am not sure they are doing anything. I am 58 and in great shape.

Thx

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Dr. Chandler Dora at Mayo in Jacksonville did mine. With the exception of a piece of prostate that got stuck in urethra and was easily removed by straight catheter procedure in minutes, this procedure was so easy. No cutting needed. I'm urinating freely with no side effects.

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