Experiences with Holmium Laser Enucleation of the Prostate, HoLEP, Laser Surgery

PLEASE CONSIDER NON RE CAUSING PROCEDURES:

There are a lot of good folks writing on this forum. Just Me and Stevein have helped me a lot. But I want to make sure the below information is also shared.

On July 23th of this year I underwent HoLEP surgery at the Mayo clinic. Prior to this surgery I meet with several different Urologists to discuss options. During these discussions Retrograde Ejaculation (RE) was mentioned and I was told it was a “dry orgasm” in which the ejaculate would flow back into the bladder and not out of the penis as it normally would.

I asked how this would feel and was told it would feel about the same as it currently does. After my surgery I have discovered that RE is not anything like a normal orgasm. It is very unpleasant and it is very devastating to my emotional and mental outlook on my future life and sexual experiences. It is also permanent and cannot ever be reversed. I feel I have made a terrible decision and that my sexual pleasure for the rest of my life has been ruined. I do not know if I will ever adjust and comes to terms with this tragic event.

I realize that every patient responds and will adjust differently. However there are hundreds of comments in health forums all over the internet from men who feel as I do. Some want to take their life and others have actually killed their doctor. I only mentioned this to make a point about how devastating this “side effect” can be to some men. I feel the RE condition is downplayed way too much in discussions with the doctors.

Had I received more information regarding the possible feeling, adjustment to and outcome of this condition I would have chosen a different treatment option and not be totally devastated by my current condition? Your situation may be completely different but I just wanted to post this to balance out all the positive experiences posted on here. Just be very sure you considered the risk before you take the have the surgery.

I had the Holep with Dr. Lingeman in January, 2013--yes, there is RE and Dr. Lingeman made certain that I was aware of the RE>

 However, an orgasm is exactly the same-- only 'dry'-in fact, since the Holeo I am larger ( the blockage has been removed).

The prior post is rather drastic--

Overall, I am amazed at the procedure and am delighted witht he out come.

After released from the hospital, I never -ever- used or needed a pad--no leakage and no issue--.

I had the best possible outcome and am glad I flew from CA to Indianapolis. IN contrast, read the TOPIX about Greenlight & TURP.

 

I have financial question. My employer insurance covers "out-of-network" which in their interpretation includes "out-of-state" providers at 50%. And nobody does holep in WA. That means I will be stuck with a large bill. Can somebody tell me what was the cost?

I am 65 and enrolled in Medicare part A. My guess Medicare should step up as a second payer. Does anybody had experience like that? 

Sleepless, mine was $27,000 total with everything combined. The surgery was $15,000.

Guest,

Truly I am very happy for you. I wish my orgasm was the same. But I have lost the best part. That calm relaxed afterglow feeling that comes from the release of the endorphins afterward. Now it just makes me tense and nervous and I am hyper all week. Before I used to be calm and relaxed for days after. Now I feel like I am stuck in high gear all the time.

I have to go to the gym and ride the exercise bike for an hour just to calm down. I would give just about anything to have what you have. Everything else about the surgery I am happy with. I am hope that the feeling comes back someday. I understand for some it does not. I don’t like the thought of living the rest of my life like this. I just want people to know that not everyone has a happy ending.

was it covered by medicare or private insurance?

Private insurance. I am still working but I am blessed to be at a great company with good benefits.

I am working too for a great company with good benefits, but foolishly selected a plan with only 50% out of network coverage. That means I should pay 13,500, or even more because my insurance doesn't have contract with Arizona Mayo clinic, ouch:-( Does anybody know if Medicare part A would pick up some of it?

The costs of Holep at Indiana University with Dr. Lingeman (from my prior post): $20,000 to Hospital; $5,000 to Dr. Lingeman; $1700 to Anesthesiologist; plus misc. (lab work at the end)= approx. $27,000.

I have private health insurance and Dr. Lingeman is "out of network"; however, I fought with the health plan including an appeal to the CA Dept of Health care, and the insurance finally paid in the end.

I also spent our of pocket a few thousand for  travel and staying in Indianapolis for about 5 nights.

All of it was worth it---

Thank you Guest

I definitely should try to bargen with my insurance, so WA isn't CA, we don't have so aggressive Health Department.

Did you try Medicare (if you had one) to pay for the procedure?

I have Medficare Part A and Supplemental with New Era. 100% of the operation was fully covered. I had my operation in Philadelphia with Dr. Das

I did not have MediCare--however, my health insurance has a relationship with a third party who negotiated for them.

The 3d party negotiator helped alot in reducing the billing...I would ask your insurance company if they have a 3d party negotiator and get them to wrok for you (just a thought). (I used every

'angle' I could).

I also asked the Indianapolis Hospital to waive the $1000 plus in  copays and deductible, and they agreed.

I went to the "best" (Dr. Lingeman)--- it was worth it --and if I had to I would pay out of pocket (as a last resort).

Best of luck

 

You should have used Rapaflo Rx. It is a medicine that provides the same RE as the result of HoLEP. That is you can find out how it feels for you and then decide on the HoLEP surgery. I did this and I am completely satisfied with the results. I had the HoLEP surgery and there was no surprise with RE.

In hind sight I can see I should have tried longer to use the Rapaflo. But it had other side effects that I could not tolerate. If I knew then what I know now I would have tries harder. Best wishes to you. Thanks for the info.

Hi guys! Hope everyone is doing okay (report in). I know a few of you are knowledgeable about the SteadyHealth site so maybe you have an answer. Last night I talked with my neighbor about prostate issues and he told me he had surgery done (NOT HoLep) at a different hospital (that doesn't do HolEP) and apparantly it solved his prostate issue but his Kidneys had expanded so much over time that they don't contract at night and he has to self-catheterize himself TWO TIMES every night so he can't sleep through the night. I suggested he see my surgeon Dr. Das here in Philly but he wasn't sure that any propstate surgery would releave this. I'm guessing he is 69-71 years old. Anyone know if there is a thread here that he could join to get opinion of other guys who may have this problem?

Steve