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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@nicky6969

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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There is a lot of information on this online. My research told me that 1. One and done. No redo after 5-7 years. The reason is HoLep takes all of almost all the prostate tissue vs turp that just takes out enough to open the passageway. It will continue to grow and need to be opened up again with a Turp. 2. The laser used for HoLep vs microblades for Turp has less bleeding and faster recovery time. My cath was in for one day.

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Day 2. I went in at 8:15am and I had the catheter removed. They told me to drink 24 ozs of water right away. Then limit to 40 oz total before my next appt at 1:45 for a PVM. I had a decent void in a few hours. But after that mostly nonevents. I went in for my appt at 1:45 and had PVM of 380ml, the nurse told me to try to void again, which I did and got it down to 180ml. She was hoping for better and reset me an appt for Monday morning to recheck me. She said if I do not void to go to the Mayo ER. So I continued to pound the water bottles but didn’t get much coming out except a constant drip. I ended up going to the ER around 6:30pm worried I was retaining. They checked me and I was below 200ml so they told me to go back to our hotel and see if my bladder would wake up. The ER triage nurse said your bladder can sometimes take time to wake up after surgery Especially since I had a lower spinal block. I continued to have a constant drip and had to change my padded briefs every hour. I woke up at 2am with the urge to pee. I was expecting a nonevent again but was pleasantly surprised when my bladder decided time to go. I had the velocity of a Saturn Rocket..WOW. Same thing again when I woke up at 6am. I had heard that this was what to expect and was not disappointed.
My incontinence also seems to have subsided. I am up and about no problem walking but Still sore, so I am taking it easy. I am feeling much better than yesterday. So I am hoping that my recovery is now on the right path.

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@tlehman

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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Sorry for the late reply Tom. I take all the botanicals separately and not as a formulated dose.

I’m now 3 months after getting PAE and I could not be happier. Forceful stream, no pain, and best of all no more urgency. Also, another strange benefit is no hair loss in shower drain anymore. I told the doc and he had no answer but I could not be more delighted.

I will probably continue my prostate supplements because they do work on inflammation so I guess it can’t hurt.

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I had a HoLEP in 2020. Worked great. At that time I understood HoLEP was for larger prostates--mine was 135 ccs, and TURP was for smaller prostates. Nor sure what the demarcation point in terms of size was. Also not sure if this is still the consideration or not. At my time HoLEP was considered the 'gold standard' for prostates my size, according to the research I did.

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@panacea15

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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Great news Panacea15! You’ll be almost as good as new soon! I did pass some blood for about 10 days, some bloody scale! Don’t be alarmed unless it goes on for awhile! Rest and be happy! You will be very surprised at your flow rate!

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Any success when having an enlarged bladder (due to Prostate) coming back? I had a Euolift and it did not work - now I was told they want to do a Turp but also had concerns about an enlarged Bladder....

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@nicky6969

Any success when having an enlarged bladder (due to Prostate) coming back? I had a Euolift and it did not work - now I was told they want to do a Turp but also had concerns about an enlarged Bladder....

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I thought that an enlarged prostate caused a thickening in the walls of the bladder due to it having to strengthen to push harder to void due to obstruction. I would suggest you look into HoLEP as an alternative to a TURP.

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@kayak461

Great news Panacea15! You’ll be almost as good as new soon! I did pass some blood for about 10 days, some bloody scale! Don’t be alarmed unless it goes on for awhile! Rest and be happy! You will be very surprised at your flow rate!

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I am a week out and still have a little blood but it subsided substantially on the 4th day after my surgery. My flow is really good along with strong velocity. I get up maybe once a night but sleep much deeper now than I did when I was getting up several times a night. I am also not looking around for the closest bathroom all the time. All in all a major change for the better in my quality of life.

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@panacea15

I am a week out and still have a little blood but it subsided substantially on the 4th day after my surgery. My flow is really good along with strong velocity. I get up maybe once a night but sleep much deeper now than I did when I was getting up several times a night. I am also not looking around for the closest bathroom all the time. All in all a major change for the better in my quality of life.

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That’s how I feel about it as well. A definite change for the better!

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