Had a HoLEP three weeks ago, Dr. Knoedler at Penn State Hershey. Two thumbs up so far. Healing is pretty much same as everyone else, rarely any blood now, some sense of pressure down there, some feeling of like a bladder spasm at the end of urinating, an incredible flow rate. Continence is almost 100%, but it is *not* yet 100%, so you can’t get careless and thought-free, unless you have a light pad in.
Orgasms are retrograde, but they almost were before due to BPH anyway. Flip side is erections are better.
The only thing I am not doing that I did before, is biking. Doctor told me to give that a month, due to where a bike saddle puts pressure. Life is back to normal otherwise, but with no fear of retention.
I had PCa going in, favorable intermediate G7. The pathology shows it was likely sampled at the margin in some tissue showing crush and cautery damage, otherwise the rest is clean. That’s good news!
Orgasms are retrograde, but they almost were before due to BPH anyway. Flip side is erections are better.
The only thing I am not doing that I did before, is biking. Doctor told me to give that a month, due to where a bike saddle puts pressure. Life is back to normal otherwise, but with no fear of retention.
I had PCa going in, favorable intermediate G7. The pathology shows it was likely sampled at the margin in some tissue showing crush and cautery damage, otherwise the rest is clean. That’s good news!
Contributor
149 posts
Hello:
Has anyone heard of anyone having repeat HoLEP down the road after original surgery?? I have noticed a decline in function since I had HoLEP several years ago. Good news is the PSA is staying down. It would be reassuring to know a repeat procedure is an option in the future.
BE careful w/ that robotic surgery. My brother in law had Divinci Robotic prostate surgery to take out a small spot of cancer. It has ruined his sexual function. He is no longer able to get an erection. He was only 55 y/o at the time, was a colonel in the Air force, and hence was in excellent physical condition. nevertheless, the robotic surgery ruined him.
Please do not confuse "radical" prostatectomy to treat prostate cancer with "simple" prostatectomy to treat BPH (enlarged prostate.) Both are typically performed using robotic techniques but are very different surgeries. Radical prostatectomy removes the entire prostate gland and seminal vesicles, is often used for localized prostate cancers and can result in erectile dysfunction. Simple prostatectomy removes the interior prostate gland tissue, is not associated with erectile dysfunction and leads to retrograde ejaculation. The Divinci robot is a tool to perform many different surgeries, is not the cause of post-operative issues (the surgical techniques are) and has led to fewer complications compared to older "open" techniques. I hope this helps clear up any confusion.
Hi My name is Baichun. Seems that Dr. Knoedler is the one near my location. Can you share ore experience with me? Does Dr. Knoedler do the HoLEP often and regularly? How can I get more information about Dr. Knoedler. Thank you and will be appreciated if you reply to me.
Hi My name is Baichun. Seems that Dr. Knoedler is the one near my location. Can you share ore experience with me? Does Dr. Knoedler do the HoLEP often and regularly? How can I get more information about Dr. Knoedler. Thank you and will be appreciated if you reply to me.
The published papers indicate the need to repeat a Holep is rare, but a repeat procedure can be done. Most prudent course would be to consult with a good urologist and get an evaluation to determine what's going on.
Contributor
149 posts
Hello uforum 2022: I am not familiar with that doctor. Where are you located?? For another chance of gaining good information I suggest that on this same Steady Health web site you look for a forum called: "Best Doctors For HOLEP Surgery".
But ask your question also on that forum and also look through the pages. People are very helpful on both these forums. Please report back what you find out so that others may benefit.
Dr., do you have any experience or knowledge with the Soltive laser Thulium fiber laser. My Urolologist, who has done over a 1000 TURP procedures, would like to do his 1st or 2nd laser surgery on me. i am aliitle worried about how traing vs real life experience could effect the outcome. Any suggetions?
Contributor
149 posts
I personally would go ONLY with an experienced HOLEP surgeon who comes with many recommendations and a good track record. Don't be someones guinea pig.
Objectively you'll BOTH be learning. Not my cup of tea, sorry. Take Philips advice and find a experienced HoLEP surgeon.
I would like to remove some misconceptions here. MD here
Prostatic urethra cannot be spared in HOLEP, simple prostatectomy, greenlight, TURP etc. It is just a lining of the passage (not a separate organ). It is removed and then the lining is reformed
HOLEP and simple prostatectomy best for 80g prostate
HOLEP is outpatient, incisionless, painless, and relatively bloodless. The catheter is typically removed within 24 hours. Why would you cut if you can do the procedure without incision. Robotic simple has more pain, bleeding, complications, catheter time, hospital stay, pain medication requirement etc
Both cause retrograde ejaculation (permanent) and can cause temporary incontinence, permanent is rare 1%
Only go to an experienced surgeon
I got mine done by Dr. Bandi at Georgetown, great guy!!! They call him "PROSTATE MAN" around here
Prostatic urethra cannot be spared in HOLEP, simple prostatectomy, greenlight, TURP etc. It is just a lining of the passage (not a separate organ). It is removed and then the lining is reformed
HOLEP and simple prostatectomy best for 80g prostate
HOLEP is outpatient, incisionless, painless, and relatively bloodless. The catheter is typically removed within 24 hours. Why would you cut if you can do the procedure without incision. Robotic simple has more pain, bleeding, complications, catheter time, hospital stay, pain medication requirement etc
Both cause retrograde ejaculation (permanent) and can cause temporary incontinence, permanent is rare 1%
Only go to an experienced surgeon
I got mine done by Dr. Bandi at Georgetown, great guy!!! They call him "PROSTATE MAN" around here
I would like to remove some misconceptions here. MD here
Prostatic urethra cannot be spared in HOLEP, simple prostatectomy, greenlight, TURP etc. It is just a lining of the passage (not a separate organ). It is removed and then the lining is reformed
HOLEP and simple prostatectomy best for 80g prostate
HOLEP is outpatient, incisionless, painless, and relatively bloodless. The catheter is typically removed within 24 hours. Why would you cut if you can do the procedure without incision. Robotic simple has more pain, bleeding, complications, catheter time, hospital stay, pain medication requirement etc
Both cause retrograde ejaculation (permanent) and can cause temporary incontinence, permanent is rare 1%
Only go to an experienced surgeon
I got mine done by Dr. Bandi at Georgetown, great guy!!! They call him "PROSTATE MAN" around here
Prostatic urethra cannot be spared in HOLEP, simple prostatectomy, greenlight, TURP etc. It is just a lining of the passage (not a separate organ). It is removed and then the lining is reformed
HOLEP and simple prostatectomy best for 80g prostate
HOLEP is outpatient, incisionless, painless, and relatively bloodless. The catheter is typically removed within 24 hours. Why would you cut if you can do the procedure without incision. Robotic simple has more pain, bleeding, complications, catheter time, hospital stay, pain medication requirement etc
Both cause retrograde ejaculation (permanent) and can cause temporary incontinence, permanent is rare 1%
Only go to an experienced surgeon
I got mine done by Dr. Bandi at Georgetown, great guy!!! They call him "PROSTATE MAN" around here