Best doctors for HOLEP surgery

Hi Ken in Dayton Ohio

   I was wondering how you are doing since your last post? 

I just celebrated  4 months post surgery with Dr Lingeman.  Very pleased with the outcome.  

just me

Hi Just Me:
As far as an update on the "infection", according to the local urologist, the urine sample was sent for culture and there is no infection.
I also called Dr. Lingeman's today and was informed the prostate was about 100 g and they enucleated about 70 g.

Best of luck to you.
Bill in CA

I just had a six week post holep visit with he local urologist. Holep was with Dr lingeman on Jan. 30, 2013. The bladder is working well--voided with only 18 ml. Four weeks ago it was 109 ml.

The recovery has been very good-no problems.

 

Barry
Thanks for your willingness to share so much of your HOLep experience.

Are there any pre-op questions that in hindsight you wish you had asked at the Mayo Clinic?

Could inflammatory foods have an impact on your post-op discomfort?

Lastly, I'm not conversant with the workings of the bladder, but unless mistaken, the urge to pee strikes me as similar to a car gas tank turning on a dashboard light to signal the need to get more gas. It seems that if mechanical work were done to the gas tank some time in the past and the float signalling gas remaining in the tank was affected, the signal to refill could give incorrect signals. Is there a possibility whatever method of indicating urgency was affected by the procedure?

I have a fold in my bladder (invagination?) thus retaining a 1/3 of a liter and requiring rising and retiring catheterization.

Thanks again,
JD
200-cc and visiting Dr. Humpreys at Mayo-Phoenix in May

Guest
How large was your prostate pre-op? How much material did they remove?

Thanks
JD

The mayo states that the holep is good for 5-7 years. Is this true? If so, what happens after this period of time? I read that the holep had durability beyond ten years and it was unlikely a second procedure would be necessary.

so, which is It?

I'm doing very well, thank you. I'm now about 10 weeks post-op. Minor discomfort sometimes, but it is definitely getting better. Retention is virually zero - vs 110 ml pre-op. I'm no longer seen as one of the "old guys" at the urinals. Ten seconds or less, and I'm finished and on the way to wash my hands, whereas the "old guys" are still standing there wishing and hoping.

Dr. Miller at Vanderbilt Medical Center in Nashville performed the HoLEP procedure on me Nov 7, 2012.  She is a wonderful doctor! Great medical staff.  No pain with the procedure  and very few minor complications -- one night stay in hospital.  I would recommend it to ANYONE with an exceptionally large prostate such as my self.  I returned to a normal life in less than two months.  I get up maybe one time each night to urinate and many nights I don't get up at all -- My life has been positively changed  forever.  My sex life is normal and I am 76.  I hear the green light laser procedure will not last as long.  If I had a choice, the HoLEP gets my vote 100%.

Jack in Nashvill, TN

hi does anybody here with any experience with HoLEP in India? if so, can you please share some information? my father needs to get this done, and with doctor's experience/competence being a critical part of HoLEP, I would like a positive unbiased referral before trusting a doctor with him.

Hello Barry...your post indicates 11 months ago., but here is some info. My husband suffered for 3 years and after we learned about the HoLEP and researched it..we chose Mayo Clinic Az with Dr. Mitchell R. Humphreys .. Dr. Humphreys trained one year with Dr. Lingeman at Methodist Urology. Surgery was done Aug 2012. Mayo Clinic was great..Very excellent outcome. T date..No side effects..urinating the next day!! But first.... we visited Center for New Medicine in Irvine, Calif to prep for the surgery. Outcome from the preparation reduced the total bleeding, and greatly and quickly improved the healing..

No side effects? What do you call Retrograde Ejaculation? I think that is the worst "side effect" ever.

What did the surgery preparation involve?
How can total bleeding be reduced apart from stopping ay blood thinners?
Urology nurse told me that most of the bleeding comes from the urethra as it takes a lot of punishment during surgery.
She said that the urethra swells to double its size and is then like a blood soaked sponge. I had not heard that suggested previously.

Well guys, I am sorry to report that I just now contacted the Urology department at Mayo Clinic via telephone today, 10/31/13. Here it is guys: DR KRAMBECK IS NOT ACCEPTING NEW PATIENTS!!! She is so far booked out with the HoLEP, and the scheduler/csr didn't even tell me how far out, that she is just not taking new patients. So...mark her and Mayo clinic off your list! This really blows!!!

I have had prostatitis issues, a negative TRUS biopsy from the head of the Vattikuti Urology at Henry Ford in Detroit in Dec 2009(where I worked at the time as an MRI tech), and 2 PSA labs in 2012 were half of the 4.3 I had the month before my biopsy. Now, a PSA in late July was 4.1, and another last week, and I am at 5.13. Alarms!!! So...upon investigating Urology at Univ of TN in Knoxville, which is close to where I am currently residing, and where my current insurance is in network(Vanderbilt is not), I found a Dr in urology who stated he had interest in HoLEP. I had no idea what this was, and my research led me to Dr. Amy Krambeck at Mayo. But, as I said above, she's not in the picture any longer. 

I have an appt with a U of TN internal med Dr next Weds the 5th, then I see the best urologist at the U of TN in Knoxville on Nov 12.(Cornell and Duke Univ credentials) UNLESS...my Dr at Henry Ford's Vattikuti Urology in Detroit, who did my workup and biopsy can get me in sooner. I faxed the Henry Ford urology csr my labs for the last 2 years on Tues, and am waiting for them to contact me back to see if I make the trip there, they can see me, do imaging, and any further treatment depending on what is found, or I go to the U of TN. I am praying that the rising PSA is just due to my level of BPH, just as before in Dec 2009, when my PSA was 4.3, and a biopsy negative. I have not been taking Flomax in almost 2 yrs. It already has caused my pupils of my eyes to no longer dilate as necessary in low light. So my only other option medicinally is Finesteride(Proscar), which actually acts to try to shrink the prostate hyperplasia, but it can take from 3-6 months to do anything, and even then, some get no results, and with any medicines there are side effects. But, if I don't have a tumor or cancer, I would try this to attempt to get some reduction in my prostate before going for any surgery. If I can then delay any surgery for at least 2-3 yrs if not until age 65, then I am done working and I will go through whatever surgery for prostate reduction is available at the time, and hopefully not a TURP!!! 

MRIGUY,
I wonder if Dr Krambeck not accepting new patients has anything to do with the new healthcare laws? Strange things have been happening with all that. Hold off as long as you can. There are new and better treatments coming. Gat Goren & Urolift are two that I am aware of and I think HoLEP should be modified not to cause RE. If I was going to do it again I would not do it. I would take another route. But if you going to have HoLep as far as I am concerned I would just have just had them take out the whole Prostrate. The results are about the same and then you never have to worry about cancer later. Good luck with whatever you decide. (And don’t believe them if they say RE feels almost the same as a regular Orgasm. It is nothing like it and is very unpleasant as far as I am concerned)

Jwb43

Perhaps consider Dr. Lingeman at Indiana Univ.-- he is one of the best if not the best. I do not know if they are accepting new patients; but, that is where I had the HoLep and am quite satisfied. He has done about 2000 of these procedures and has excellent bed side manners and is warm and personable.
Also, he trained most of the other doctors performing HoLep in the US.