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Thank you for the information. I found some place in Pennsylvania they offer HoLEP, like Jefferson Health in Philadelphia, there are many doctors can do HoLEP. Also some individuals, in Harrisberg, Allentwon, and somewhere in Delaware. I am not able to get the detailed information about them. I believe that some of them are new and some are got well trained. I need to do more research to choose one. Or, do you think I should just go ahead to travel far to get the best doctor. The only inconvenience is in case I need to go for follow up visiting.
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Yes, you should travel for the best doctor. There are usually only three visits at most (preliminary work up; actual surgical date; & maybe a follow up).
For example: I live on the east coast of Florida and I found it well worth it to travel to see Dr Miller @ Vanderbilt University in Nashville. They are all set up for people who come from away.

If you come up with names that you are unsure of, then post them on this forum page, or the other similar page on this web site ("Experiences With Holmium Laser Enucleation Of The Prostate, HoLEP, Laser Surgery") and ask for opinions as to peoples experiences with them. The HoLEP patient crowd is a very informed group that is full of valuable information.
For example: Personally I wanted to go to a recommended doctor at a university teaching hospital; & I wanted one that was trained by one of the original HoLEP surgeons, since they had top notch reputations; & I wanted a doctor that had a personable relationship with his/her patients. I did almost all my research on these two extensive forum pages and I found exactly what I was looking for.
Take you time and do your research and you will not be disappointed.

"Experiences With Holmium Laser Enucleation Of The Prostate, HoLEP, Laser Surgery"
"Best Doctors For HoLEP Surgery"

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I got all test and exam results. I have a prostate size about 120 ml, increased from 80 ml 3.5 years ago. There is no reason to wait for a procedure. My doctor give me two options that he can do, TURP and Robotic Simple Prostatectomy. Since the prostate is too big, he said if do TURP, it need to two surgeries few week apart, or Robotic Simple Prostatectomy will get better outcome. He didn't mention HoLEP since he is not able to do it. Anyone has comments?

I searched doctors around my area, the closest one is Dr. Das, used to be in Philadelphia, but seems he has moved to California. Dr. Bandi in Whashington DC, Seems ho do the surgery one Wednesday every month. Then more further distance, they are Dr. Miller, Krambeck, Dr. Lingeman, and Arizonna.
Anyone has recent experience of those doctors? Do they still do surgery them self instead letting the trainee to do it, (in near by locations, I do find some doctors are doing it but apparently they are either new trained or not doing regularly). If those famous doctors do, normally how soon they can arrange me the procedure. Since I have to travel to other states, and try to do once and get the best result for any reason, get a right doctor is most important. Please share the recent experience and updated doctor list, if there are any other name you can recommended.

I am keep searching for doctors and all related information, will make decision very soon, any comments will help.
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I believe that all the doctors that you mentioned are still in business, because I have seen comments about them occassionally on the two HoLEP pages on this web site.

I think that any doctor associated with a teaching institution (ie: university hospital) would be a good choice because they are well vetted and are in an educational environment with lots of support. Also any doctor that was trained by one of the original doctors (ie: Dr Lingeman) should be a good choice.

I personally can only speak for Dr Miller @ Vanderbilt. She was excellent and she & her appointment system scheduled me in a very efficient manner. They even arranged the hotel to stay at with a discount (Holiday Inn near the clinic with free shuttle service). Communicated by email Appt made my recent test results sent pre-op visit operation & overnight stay in hospital follow up visit (which probably is not necessary if you are having no problems). It was all done within 2 or 3 months.

To be clear: HoLEP is only a one time surgery unless something develops years down the road.

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I Started communication with Dr. Miller, and started the processing for the details of procedure. Dr. Miller respond to my email quickly, and guided me how to start the processing. Thank you Philip, for all your valuable information, comments and suggestions. Next week, Dr. Miller may go over my medical history and review all my BPH information, then decide if I am the candidate for the HoLEP. She said, after the review, she will have the sense of where the procedure need to be done whether that is at the main hospital or can be done at their outpatient surgery center. If it can be done at their outpatient surgery center, that means mostly would be same day surgery, you don't need be stay there overnight. Also it means done at outpatient center mostly will be shorter time, and shorter wait time. I hope that can apply to me. Just want to know normally how long the can schedule for a surgery after review and decision, and normally how much time the surgeon will take to finish the surgery. I will post the progress.

By the way, after surgery, how long I can come back to normal daily activities, such as some heavy physical work, long distance driving, etc.
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Glad to hear that you had positve results with Dr Miller. Her quick responses to my emails is one of the many positive attributes that sold me on her.
Very interesting that they are now doing some cases at their outpatient care surgery center. I had heard of that happening at other places.
I believe I had to wait about 1.5 - 2 months for the surgery (not sure). The surgery itself only took and hour or two.
You are pretty much back to normal immediately as long as you do not overdue it. No heavy physical work for a month or so. I drove home from Tennessee to Florida the day after I was discharged from the hospital --- that said, I stopped at every rest area and got out and walked around.
Be sure to also read the other HoLEP page on this website --- It is full of good information about experiences and what to do or not do for best outcomes.
Also -- start Kegel exercises Now and do them several times every day. One easy way to incorporate them into your daily routine is the periodically stop and hold your stream for short periods when you urinate.
Best of luck to you. Update everyone of your experiences so that others can benefit.

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Hi,I have heard that HoLEP is the best procedure among TURP. But, I have an insurance with Kaiser Permanente. It only has TURP specialists. May I know how is your prostate so far? What insurance do you have? Thank you.
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I now have Medicare. However, when I had HoLEP I had Florida Blue (Blue Cross) under the Affordable Care Act. I had the pay between 7 & 8 thousand with that plan because it had a very high deductible. However, there are some things in life that are worth paying for and this was one of them!!! Just remember that in America you can get any procedure done as long as you are willing to pay for it. I think that often people forget that in their quest to always get something for nothing.
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Hi Philip, I have an appointment with Dr. Miller on mid January. I have Medicare, and Medicare Supplement N, if all services provided in Vanderbuilt are Medicare approved, without excess charge, I may only pay for the deductable.I heard some place charge the excess charge up to 15% of the total cost. Hope they only charge what Medicare approved amount without charging extra. The Medicare Supplement G covers B excess charge. I am thinking if I need to switch to G from N.

Also I noticed that you had some post surgery issue months after your procedure, did it get taken care of finally?

Thanks
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Yes Medicare Supplement G is the most comprehensive plan and in my mind the way to go if you wish to limit your surprise expenses --- that is what my wife (she actually has "F" which was the precursor of "G") and I have had, and every year we appreciate it. We strongly recommend it!! United Health Care has great service but the coverage is the same regardless of what company you go with, due to regulations.

I don't recall any major post surgery issues. That said I find that my bladder tends to be rather sensitive which gets me up at night more than I would like but I found that the cure for that is two Tylenol before bed.
Also, I find that I generally void much better standing up, which caused me to adapt my traditional way of sitting when peeing (I find men who sprinkle when they stand to pee disgusting). But at night I always stand and use a urinal (which I saved from my hospital time) in order to guarantee total emptying and therefore less times to the bathroom during the night.

Hope these "tips" help.
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Philip, Thanks. I am scheduled for Holep with Dr. Miller this Tues (1/18/23) Appreciate the referral. Will let you know how it goes. Nate
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Best of luck to you. You are in the best of hands. Looking forward to an update. Best wishes
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Hi. Day 2 following HoLEP with Dr Miller. Still have foley. Scheduled to see her PA tomorrow morning. Hope to get the catheter removed. But still have urine that looks like Hawaiian Punch. And I’m drinking lots of water. You think that’s going to be an issue on removing the foley? Thanks
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I would think that you will get it out. If you were having big blood clots then that might be a different story. Drinking water is important. Hang in there. If they give you a urinal save it as one often does not shoot straight for a while after surgery and catheter removal --- just makes life easier.
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This is Nate by the way. The forum keeps rejecting me even though I’m registered. I do have a urinal. In post-op she told my wife that they would “flush my kidneys” tomorrow at my visit. Sounds like they are going to have me drink a lot of water to see if I can urinate. Is that normal procedure? Thanks in advance
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