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jyuhanick
@jyuhanick

Posts: 1
Joined: Jan 02, 2017

Holep laser for prostate

Posted by @jyuhanick, Jan 3, 2017

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

REPLY

Hello @jyuhanick, and welcome to Connect. Thank you for posting your question regarding HoLEP vs TURP procedures for an enlarged prostate.

I would like to introduce you to @predictable, one of our active Mentors on Connect. Predictable has gone through a TURP procedure and may be able to offer some incite on what to expect if you were to choose this procedure.

I would also like to invite back @krunch who spoke in April about the success of having a HoLEP. While we wait, you can find his post here, http://mayocl.in/2iIxPqY.

Jyuhanick, have these two procedures been offered to you by your physician and you are weighing the benefits in order to choose? Has your physician discussed which procedure he or she thinks would be a best option?

Hello, @jyuhanick. I hope to be of some help to you in deciding about how to address benign prostatic hypertrophy (BPH). I had the condition and my urologist performed a transurethral resection of the prostate (TURP), under anaesthesia in a hospital, about 10 years ago. I had two prominent results:

First, my urinary incontinence ended promptly and remains out of my life to this day. Second, removal of prostate tissue that was protruding into my bladder exposed a tumor in the bladder lining, which turned out to be a low-grade malignancy. Without the operation, I suspect that tumor — and a dozen more that appeared within the following year — would have taken my bladder (if not my life) by now. Instead, I’m in pretty good shape. The tumors all were growths in the superficial lining of my bladder; they were readily removed with a follow-up transurethral resection procedure. I would not hesitate to recommend that you choose a TURP if your urologist believes it is appropriate and that is reaffirmed by a second physician’s opinion, preferably one from Mayo Clinic.

As to a HoLEP, I have no personal experience with it. However, I recently came across an article from Prevention magazine that you may wish to read and consider. Find it at http://www.prevention.com/health/health-concerns/morcellation-surgery-when-cutting-edge-kills. If the procedure would include morcellation of prostate tissue, there may be a risk of spreading diseased tissue around the inside of your bladder or along the urethra carrying urine outside your body. In my case, morcellation might very well have sliced up the hidden tumor in my bladder and seeded more tumors in my urinary system. In this case, as in connection with TURP, I recommend that you get a second opinion from Mayo Clinic before undergoing a HoLEP.

I’m scheduled for a HoLEP procedure at Mayo (Rochester), in February. Just wondering if someone has had this done recently and would be willing to share their experience.

@tlk1951

I’m scheduled for a HoLEP procedure at Mayo (Rochester), in February. Just wondering if someone has had this done recently and would be willing to share their experience.

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Hello @tlk1951, welcome to Connect. I merged your post about HoLEP in to an existing discussion that was started on the same topic. If you are replying by email, I suggest clicking on VIEW & REPLY so that you can read the few posts that were made before yours. In particular, Predictable’s experience with a TURP, which is not the same thing but similar. I’d also like to invite @jyuhanick back to the discussion to share what they have learned about HoLEP since their original post. I would also like to invite back @krunch and @bigthumbs who discussed having a HoLEP procedure to share their experiences.

@tlk1951, you mention you are already scheduled for the procedure. If you don’t mind sharing, what in particular are you wondering about from the other members?

@tlk1951

I’m scheduled for a HoLEP procedure at Mayo (Rochester), in February. Just wondering if someone has had this done recently and would be willing to share their experience.

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I’d like to know what their recovery was like, which doctor performed the procedure and a little bit about their condition before surgery.

@predictable

Hello, @jyuhanick. I hope to be of some help to you in deciding about how to address benign prostatic hypertrophy (BPH). I had the condition and my urologist performed a transurethral resection of the prostate (TURP), under anaesthesia in a hospital, about 10 years ago. I had two prominent results:

First, my urinary incontinence ended promptly and remains out of my life to this day. Second, removal of prostate tissue that was protruding into my bladder exposed a tumor in the bladder lining, which turned out to be a low-grade malignancy. Without the operation, I suspect that tumor — and a dozen more that appeared within the following year — would have taken my bladder (if not my life) by now. Instead, I’m in pretty good shape. The tumors all were growths in the superficial lining of my bladder; they were readily removed with a follow-up transurethral resection procedure. I would not hesitate to recommend that you choose a TURP if your urologist believes it is appropriate and that is reaffirmed by a second physician’s opinion, preferably one from Mayo Clinic.

As to a HoLEP, I have no personal experience with it. However, I recently came across an article from Prevention magazine that you may wish to read and consider. Find it at http://www.prevention.com/health/health-concerns/morcellation-surgery-when-cutting-edge-kills. If the procedure would include morcellation of prostate tissue, there may be a risk of spreading diseased tissue around the inside of your bladder or along the urethra carrying urine outside your body. In my case, morcellation might very well have sliced up the hidden tumor in my bladder and seeded more tumors in my urinary system. In this case, as in connection with TURP, I recommend that you get a second opinion from Mayo Clinic before undergoing a HoLEP.

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@predictable Has any doctor from the Mayo Clinic commented on this article as it might relate to a HoLEP procedure? The article focuses on morecellation of the uterus with pieces floating throughout the body. In the case of HoLEP, the pieces are pretty contained in the bladder and are immediately flushed out. Might that make a difference?

@JustinMcClanahan I’d like to know about their recovery process, what doctor performed the procedure and a little about their pre surgical condition.

@tlk1951

@JustinMcClanahan I’d like to know about their recovery process, what doctor performed the procedure and a little about their pre surgical condition.

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Hi @tlk1951. A year ago, I posted a message above about removal of excess prostate tissue with a TURP performed on me, and I hope I left the impression that it was a positive experience — at the time (over 9 years ago) and ever since. In that same message, I cited literature that raised warnings about “morcellation” of bladder or prostate tissue, because that process could result in cancerous tissue spreading elsewhere in the body.

To be clear, there was no morcellation in connection with my surgery, and as I understand it, morcellation is not a factor in laser surgery on the prostate or bladder. HoLEP uses a laser to “cut” free bulbs of excess prostate tissue which are then cut into smaller pieces and removed through the urethra (much like the TURP performed on me). You may wish to have your urologist/surgeon confirm that morcellation is not going to be performed. Otherwise, I wish you the best of fortune with your surgery and remain confident that you’ll be glad you had Mayo do the job.
Martin

@predictable

Hello, @jyuhanick. I hope to be of some help to you in deciding about how to address benign prostatic hypertrophy (BPH). I had the condition and my urologist performed a transurethral resection of the prostate (TURP), under anaesthesia in a hospital, about 10 years ago. I had two prominent results:

First, my urinary incontinence ended promptly and remains out of my life to this day. Second, removal of prostate tissue that was protruding into my bladder exposed a tumor in the bladder lining, which turned out to be a low-grade malignancy. Without the operation, I suspect that tumor — and a dozen more that appeared within the following year — would have taken my bladder (if not my life) by now. Instead, I’m in pretty good shape. The tumors all were growths in the superficial lining of my bladder; they were readily removed with a follow-up transurethral resection procedure. I would not hesitate to recommend that you choose a TURP if your urologist believes it is appropriate and that is reaffirmed by a second physician’s opinion, preferably one from Mayo Clinic.

As to a HoLEP, I have no personal experience with it. However, I recently came across an article from Prevention magazine that you may wish to read and consider. Find it at http://www.prevention.com/health/health-concerns/morcellation-surgery-when-cutting-edge-kills. If the procedure would include morcellation of prostate tissue, there may be a risk of spreading diseased tissue around the inside of your bladder or along the urethra carrying urine outside your body. In my case, morcellation might very well have sliced up the hidden tumor in my bladder and seeded more tumors in my urinary system. In this case, as in connection with TURP, I recommend that you get a second opinion from Mayo Clinic before undergoing a HoLEP.

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@tlk1951, you raise a good question about whether morcellation might be used in your laser surgery using HoLEP to remove excess prostate tissue. The answer must come from the physician who knows — your Mayo surgeon.

In my case, a large piece of my prostate was cut up and removed through my urethra in a TURP procedure over 9 years ago. A small malignant tumor on my bladder lining (hidden by the excess prostate tissue) also was removed, and six weeks later a dozen more small tumors on the lining of the bladder were removed in a TURB procedure. Since then (over 8 years) periodic cystoscope examinations of my bladder and urethra have detected no new tumors, and those exams are now performed once a year.

I don’t know of any comments by Mayo physicians on the Prevention article, but I’m confident that no medical teams are better than those at Mayo to answer your question. I know that your urologist will provide any information you feel the need for before you undergo the HoLEP procedure in February. Best wishes for a successful procedure. Please remember that we’ll be rooting for you.
Martin

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