Prostate Surgery, HoLEP or Green Light laser?

I'm writing from Saskatchewan, Canada. I'm scheduled for green light treatment on May 11th, but after further research, I'm wondering if HoLep isn't a better option particularly with my large prostate with a large median lobe pushing up into my bladder. My urologist says she can remove the median lobe being very careful not to damage the bladder, but I'm wondering which option I should elect, green light or HoLep. One problem in Canada is that I don't know where Holep is offered... I can't seem to find many, if any, references to it here in Canada. Thoughts?

Well, my vote is for Holep, I had a 114 mg prostate with prominent third lobe protruding into the bladder. My surgery was done by Dr Humphreys at the Mayo in Phoenix and the result was beyond any success i had imagined although I expected a good result as I had done my homework and knew that a combination of the Mayo Clinic and Holep performed by Dr Humphreys was very likely to be a favorable result.

I am now 5 months post op and I have been stabilized since 7 days after surgery. I had NO pain, VERY little pink urine, and have had a flow like a teenager since immediately after surgery. here's something to realize; if you have a prominent third lobe protruding into the prostate that did not happen overnight. For a decade or so that lobe has been acting as a plug in the bladder neck and has allowed the bladder sphincter muscle to atropy. When the third lobe is suddenly removed, or cored out, the urine flow has no valve to stop it and you will be incontinent until the sphincter regains its strength. This may take a month or several depending on your skill or whether you just let nature take its course.

You can read all my posts at patient.co.uk when I pursued urolift until I found that my prostate was too large, I disregarded both turp and green light as being too unreliable and risky. The truth is that these two methods are performed by the great majority of uros, the learning curve is acceptable to them and the results are usually acceptable to the patient. I didn't care much for that "usually" part as i didn't want to be plagued by a disastrous result for the rest of my life.

They call turp the "gold standard" and it is for them, it is not for the patient in too many cases, Holep is documented to be a more precise, more complete and more permanent method and can be used for any size prostate which is not true of the others.

The downside to Holep is that the learning curve for the surgeon is very steep, requiring much more supervision and training before a surgeon can perform the procedure on his own. Because of this difficulty in becoming qualified there are no more than a dozen or so Doctors in the US who perform the procedure and they can be found in only the very best medical facilities in the country, such as the Mayo Clinics, John Hopkins and a few huge regional University Hospitals.

That's the unvarnished truth, good luck!!

I flew from Texas to Az on Wed, went thru tests and interviews that afternoon and thursday, had the surgery Fri AM stayed in the Mayo until Sat AM, checked out and stayed at the Hotel on campus until Monday AM and flew home. An unbelievably beneficial experience from any viewpoint.

Keep it simple: go to the best: Dr. Lingeman at Indiana University. Holep is the way--mine is over 2 years ago and I never had any incontinence- great results and I am very pleased. Bill in CA

All BPH sufferers owe a tremendous debt of gratitude to Dr Lingeman who brought the Holep procedure to the US from New Zealand 15 years or so ago. If I'm not mistaken every one of the Holep surgeons in the US were trained by him. I had waited too long to have a procedure done and when I finally became desperate I was unable to get an appointment with him for several months. I checked with all of his protegees and was able to get Dr Humphreys to slot me in at the Mayo in Phoenix. As I have stated the whole experience was beyond belief if you are accustomed to treatment in the medical wasteland of the state of Texas.
I have since had surgery for skin cancer in Texas and my experience has been that I wish to hell I had gone back to the Mayo.
Never again, if I need a splinter removed I'm going to the Mayo, the difference in the surgeons' support staffs are the difference. I have come to understand that a surgeon's skill is just not enough and staffs are severely lacking in proficiency. This is very dangerous and is the reason for the current epidemic in infections and error found in our medical industry.

I think we have not yet seen the further degradation of our health care that will result from Federal control with the "Affordable Care Act": politically correct medical decisions made by bureaucrats , general incompetence prevalent in any and every action taken by the Federal government. I can hardly wait for the administrators of Amtrac, the Post Office, the Veteran's Administration, the FHA, Fannie Mae, Freddie Mac, the Federal Reserve, etc, etc (I could go on) to get their hands on one sixth of our entire economy. They are well aware that if you have control of a population's access to health care then you have total control of his mind and body. That's the entire point of the ACA; total control.

We deserve what we will get, we voted for it, didn't we? ,

Dr. Jennifer Liu is a Holep surgeon in the Long Beach, CA area. She comes highly recommended.

Well, I went with the green light laser at City Hospital in Saskatoon, Saskatchewan. ...and I'm very pleased! Yesterday, I went to the hospital @ 6:30 am, was prepped and under general anesthetic @ 8:15 am. I opted for the general anesthetic vs. a spinal which the anesthesiologist seemed to be pushing. l'm glad I did as I woke up in recovery with no after effects. The procedure took 1.5 hrs as I had a large median lobe pushing into my bladder. Had a sandwich and was discharged @ 1:30 pm with a catheter on my leg and a night bag for over night. My wife drove the 2.5 hours home. I drank a lot of water and generated 3 leg bags full throughout the evening and 1700 cc's overnight! The urine got progressively clearer as time went on. At 7 am this morning I removed the catheter myself as directed. Only one blood clot, and the first few times of trying to urinate I experienced a burning sensation at the tip of my penis. This has now completely dissipated, and my stream is strong and complete. I realize this is only 30 hours since the procedure, but so far, so good!

I was considering Dr. Humphreys like you did. Can you tell me how things went for you? Thanks so much. Rick

I am in Manitoba and have the same issues as you. I actually had the PAE in a trial in Regina a year ago,but it helped only a bit .It seems the median lobe bulging into bladder doesn't shrink much from the PAE.
After another referral to a Winnipeg urologist I am getting Holep from a Dr.Glezerson in sept.
I believe he is only 1 of three in Canada to offer Holep.
My prostate is about 90 g and I am looking foreward to not taking any drugs for BPH.
Good luck in your quest

I know you were asking someone else about results with Dr. Humphreys, but I'll chime in. It's been 18 months since he did my HoLEP, and I am every so grateful that I chose to go to him. Every day for a whole year I felt that way. Still do, but now I kinda forget that I went through 4 months of being catheterized, and years of worrying if I'd make it to the next bathroom. Everything worked well. Never any pain. Usual things -- some bleeding for a short time. I have a small amount of leakage, to the extent that I shouldn't wear the same underpants two days in a row, but even before HoLEP that was the case, I think. The only problem with going to the Mayo was that I had to make two trips.

Dear BPHMike:
My uro wants to schedule me for GreenLight. How are you doing with it now?
Darryl

Dear IMAGO,
How are you doing now, 2 months later with the GreenLight?
Thank you.
Best regards,
Darryl

Has anyone has experience with Dr. Ananth Annamraju who performs Green Light PVP in SW Ohio, or Dr. Bodo Knudsen who performs HoLEP in Columbus? Thanks.

I had Holep 14 days ago, I would like to know:
1-When do scabs start coming out? and are they dangerous in the sense that they are difficult to expel?
2-When will I stop leaking?
3-Why is it that in the night I have to pee in order to reduce my erection which causes me a burning pain in the prostate area?
Thank you to anyone answering my questions
Propinor

I had Holep 14 days ago, I would like to know:
1-When do scabs start coming out? and are they dangerous in the sense that they are difficult to expel?
2-When will I stop leaking?
3-Why is it that in the night I have to pee in order to reduce my erection which causes me a burning pain in the prostate area?
Thank you to anyone answering my questions
Propinor