Ever wonder how long will HoLEP last (that is when will one need another operation again)?
Here is the answer: at year 5, 3% chance and at year 10, a 5% chance. See the following abstract. I have no access to the full paper.
J Endourol. 2015 Jul;29(7):797-804.
Reoperation After Holmium Laser Enucleation of the Prostate for Management of Benign Prostatic Hyperplasia: Assessment of Risk Factors with Time to Event Analysis.
Elkoushy MA1,2, Elshal AM1,3, Elhilali MM1.
Abstract
PURPOSE:
To determine risk factors of reoperation after holmium laser enucleation of the prostate (HoLEP) .
METHODS:
A prospectively maintained database was reviewed for patients undergoing HoLEP. Baseline and follow-up data were compared in terms of International Prostate Symptoms Score, quality of life, peak flow rate, residual urine, and prostate-specific antigen (PSA) at 1, 6, and 12-months and then annually. Perioperative and late adverse events were recorded. Reoperation was defined as the need for any surgical intervention to relieve bothersome LUTS after HoLEP.
RESULTS:
A total of 1216 HoLEP procedures were performed between March 1998 and October 2013 with a mean prostate volume of 94.8 ± 52.7 cc. Catheter time and hospital stay were 1.4 ± 1.9 and 1.3 ± 1.6 days, respectively. After a median follow-up of 7.6 years (1-14 years), 52 (4.3%) patients needed reoperation for recurrent LUTS, including 13 (1.07%) for residual/recurrent adenoma, 14 (1.15%) for bladder neck contracture (BNC), and 25 (2.05%) for de novo urethral stricture. In multivariate regression, smaller prostate size (
Here is the answer: at year 5, 3% chance and at year 10, a 5% chance. See the following abstract. I have no access to the full paper.
J Endourol. 2015 Jul;29(7):797-804.
Reoperation After Holmium Laser Enucleation of the Prostate for Management of Benign Prostatic Hyperplasia: Assessment of Risk Factors with Time to Event Analysis.
Elkoushy MA1,2, Elshal AM1,3, Elhilali MM1.
Abstract
PURPOSE:
To determine risk factors of reoperation after holmium laser enucleation of the prostate (HoLEP) .
METHODS:
A prospectively maintained database was reviewed for patients undergoing HoLEP. Baseline and follow-up data were compared in terms of International Prostate Symptoms Score, quality of life, peak flow rate, residual urine, and prostate-specific antigen (PSA) at 1, 6, and 12-months and then annually. Perioperative and late adverse events were recorded. Reoperation was defined as the need for any surgical intervention to relieve bothersome LUTS after HoLEP.
RESULTS:
A total of 1216 HoLEP procedures were performed between March 1998 and October 2013 with a mean prostate volume of 94.8 ± 52.7 cc. Catheter time and hospital stay were 1.4 ± 1.9 and 1.3 ± 1.6 days, respectively. After a median follow-up of 7.6 years (1-14 years), 52 (4.3%) patients needed reoperation for recurrent LUTS, including 13 (1.07%) for residual/recurrent adenoma, 14 (1.15%) for bladder neck contracture (BNC), and 25 (2.05%) for de novo urethral stricture. In multivariate regression, smaller prostate size (
—-So it could be more than 110gram was removed. Or Dr. K was thinking about an average prostate size
I have often thought the same. I think the numbers are correct since they came from the operative report and the biopsy report. I have long suspioned that Dr. K likes to use medically PC terms to gloss over details. For instance at the consult she kept using the term leakage instead of incontinence, even when I pressed her.
It might be possible that during the healing process it could shrink beyond what is cut out due the heat of the laser damaging good tissue. Just a thought. I know during the first 3 months I felt like I had lots of electrical sparks running through my prostate. I assume that was the nerves healing during the “reforming” process.
It seems to me that both aquablade and FLA-BPH are superior techniques in that the both use a precise guidance system to reduce damage to good tissue.
Also HoLEP does cut away part of the prostate that is adjacent to the bladder. I am assuming that is part of the prostate capsule. Am I correct?
BTW during the first week I had more than leakage I had a gusher. There was absolutely no control. I wet my pants three times the day I was released. (That was the day after surgery) By the second week control was returning. If I stayed in one position, such as driving, I had no problems.
Sorry about the randomness of this response.
I have often thought the same. I think the numbers are correct since they came from the operative report and the biopsy report. I have long suspioned that Dr. K likes to use medically PC terms to gloss over details. For instance at the consult she kept using the term leakage instead of incontinence, even when I pressed her.
It might be possible that during the healing process it could shrink beyond what is cut out due the heat of the laser damaging good tissue. Just a thought. I know during the first 3 months I felt like I had lots of electrical sparks running through my prostate. I assume that was the nerves healing during the “reforming” process.
It seems to me that both aquablade and FLA-BPH are superior techniques in that the both use a precise guidance system to reduce damage to good tissue.
Also HoLEP does cut away part of the prostate that is adjacent to the bladder. I am assuming that is part of the prostate capsule. Am I correct?
BTW during the first week I had more than leakage I had a gusher. There was absolutely no control. I wet my pants three times the day I was released. (That was the day after surgery) By the second week control was returning. If I stayed in one position, such as driving, I had no problems.
Sorry about the randomness of this response.
Ever wonder how much prostrate is removed by HoLEP?
Here is the answer: ~ 50-85%.
This is from a paper, HoLEP has come of age by GIlling in 2015. I have no acces to this paper. However, tables in that paper are free.
semanticscholar.org/paper/HoLEP-has-come-of-age-Vincent-Gilling/b9bc47142fb6b6b8b84da14742fbe265adc6575d
(Supply the usual header to the above link)
Here is the answer: ~ 50-85%.
This is from a paper, HoLEP has come of age by GIlling in 2015. I have no acces to this paper. However, tables in that paper are free.
semanticscholar.org/paper/HoLEP-has-come-of-age-Vincent-Gilling/b9bc47142fb6b6b8b84da14742fbe265adc6575d
(Supply the usual header to the above link)
I am new to and ignorant about BPH and am struggling to learn more,so plse don't take what I said seriously.
I did a lot of research just in order to answer ur questions.
To my understand, 214cc prostrate is a super large prostate. It is way beyond TURP (only work if prostate
I did a lot of research just in order to answer ur questions.
To my understand, 214cc prostrate is a super large prostate. It is way beyond TURP (only work if prostate
Part of my reply to u somehow was missing in my previous post and my reply is given below.
I am new to and ignorant about BPH and am struggling to learn more,so plse don't take what I said seriously.
I did a lot of research just in order to answer ur questions.
To my understand, 214cc prostrate is a super large prostate. It is way beyond TURP (only for prostate
I am new to and ignorant about BPH and am struggling to learn more,so plse don't take what I said seriously.
I did a lot of research just in order to answer ur questions.
To my understand, 214cc prostrate is a super large prostate. It is way beyond TURP (only for prostate
Not sure what happened, part of my reply to u did not show up. I give up.
DL0808, The same thing happened to 2 of my postst a couple of months ago.
Thanks! See full text during compose, but after "send" only partial text appears in reply.
Yes it is extremely large. HoLEP or FLA-BPH are the only treatment that could handle it. Possibly PAE? I might have been able to get into a clinical trial for PAE. They were looking for men with a very large prostate. I found about it after my procedure.
And super large prostates can produce very high PSAs even with no cancer present as in my situation (why a PSA alone can never be relied upon for a cancer reading). My prostate was 150cc+ and my PSA was 24 (!!) just before my HoLEP. I have not had another PSA since, but I have my annual physical in December and I will be real curious what my PSA will be.
Yes I had extremely high PSA readings. That is why it is not the sole test to determine cancer. My biopsy confirmed there was no cancer. I had a 6 month postoperative checkup and the PSA was .042. A very dramatic decrease. I believe that the expected reading should be 1 or less.
Does anyone know if the bladder sphincter ever heals after HoLEP?
I found a critical paper which hopefully will answer ur question. I am working on it by extracting the key results from the paper. it will take me a lot of time.
Hi Dl,
Why don’t you pm me the URL and I can take the time to read it.
Why don’t you pm me the URL and I can take the time to read it.
The journal requires subscription and I had someone helped me to get it. I need two more days to work on it.
The info is of general interest to readers of this thread.
The info is of general interest to readers of this thread.