Prostate Surgery, HoLEP or Green Light laser?

Good relevant question.


Prior to the procedure the amount of residual varied depending on the amount of patience I had to wait for it to literally dribble out. In one test, a so called "Uroflow" test where I had to wait until I had a very full bladder, I had 300 or 400 ml remaining but I don't remember the exact amount. Usually, without waiting for a very distended bladder, it was much less, I am thinking around 100 ml but I just forget. It has been checked twice in the past month and it seems to now vary between 20 to 40 ml.

Barry,

I think you might be right. Perhaps we are from two different galaxies because you claim I am reading into your posts what I want to hear instead of what is actually there. I would counter by saying that you are writing whatever you want to write instead of addressing the specifics of whatever I had just written to you. Oh well, I guess we'll just have to agree that we are not communicating on the same frequency. I hope you will keep posting too because you are a very prolific and informative writer even if your posts go off in directions that are detours from what was asked of you. :-D  I inserted one of those obnoxious emoticons because I don't mean that in a nasty way !

Best of luck in your recovery and I sincerely hope that your optimistic expectations are justified.

I live in the South of England and I refused to have a TURP in 1995 when my prostate was 35 grms as I knew better methods were in the pipeline. Much later I read on a news group a posting from one of the first PVP patients in America. It seemed the ideal procedure.Unfortunately it took a long time to cross the Atlantic and longer to be taken up by a small number of NHS hospitals..By the time I had my PVP in the North of England in June 2005 my prostate was 75grms. During the watching/waiting time I had been taking Saw Palmetto. I tried Finasteride and an Alpha blocker but soon stopped because of the side effects. The procedure was no problem and my catheter was out the next mornng. The following day I travelled home by train and the next day went to the races and unusually for me did not need to visit a toilet all afternoon! My recovery was incident free with no retro ejaculation or retention but my flow was never all that good and I still had to get up to the toilet three times a night. I assumed apart from that my troubles were over until I began to have signs of my original symptoms in 2008. A urologist said that my prostate was 100 grms and being one of the old school said that PVP was no good and that was why my prostate had regrown and that I shoiuld have a TURP. I asked to be referred to a NHS hospital in another area where they did PVP. The consultant there thought that my symptoms were not too bad and that my prostate was probably growing outwards and not causing much obstruction to my urethra. By last year my prostate had grown to 130grms. I could not do much about it at that time as I was waiting to have my aortic valve replaced. By now my local NHS hospital is performing HoLEP so that is the way I will go. I keep in contact with the urologist who did my PVP and he says that while some surgeons at his hospital prefer the latest Green Light Laser equipment the consensus is that they will take the HoLEP route although both methods are good.

Please forgive the dumb question, but you guys keep referring to how many grams your prostate weighs. How do they assign a weight to something that is still attached to the inside of your body ?

There is of course a fairly accurate medical method for determining the prostate weight . Its done using echo cardiograph where they determine the volume and therefore the mass (weight).

That would be fine if all prostates had the same density, but I'm sure they do not. So in other words, they actually measure the volume and then multiply that by an assumed density ? That's fine. I'm sure the weight they come up with is pretty close. It just seems odd that they wouldn't measure the prostate by its volume. Thanks for your answer.

 

I was told that for the purposes of measuring, cc's are interchangeable with grams.  Not sure if this is accurate.

It is assumed that the density of prostate tissue is 1gr/cc, the same as water. This is not accurate but works out to be a good approximation, at least per the urologist who responded to the same question. He also said it is indeed more accurate when referring to volume(cc's), but clinically it is weighed so the terms are used, albeit inaccurately, interchangeable. In the big picture it really makes no difference.

Admittedly, this is a trivial issue, but oddities like this just make me curious. Thanks to all for your answers.

Yes, The local doctor recommends to me the Laser treatment for enlarged prostrate. I am looking for a second (or more) opinion. Statistics are one thinbg, but I am just one. I want the best for me. I am glad to read the success stories, but am still bothered by the other outcomes. Any help you can provide would be appreciated.

HAD holep . it was done by doctor lingerman.had no problems .its the best

I have Holep scheduled with Dr. Lingemand at the end of the month.My prostate size is 78 grams . How did your surgery go?? bleeding afterwards? We plan on staying 2 extra days following surgery just to make certain all is well before flying back to CA.
Thanks

Has anyone here had any experience with TUMT or TUNA? Would you please share it? I am 54M and the meds are starting to lose their efficacy, so I have to determine the next step. Should I just skip these and go right to HoLep or GreenLight?

Thanks.

dave

Just had surgery with Dr. Lingemann--outstanding results. I am quite pleased and it was worth the flight from CA to Indy for the surgery. Dr. Lingemand is warm, personable and has done about 2000 HoLeps--he knows his stuff and his staff knows the HoLep.
I am grateful we ttok the extra effort to have 'the best' perform the surgery.
There are no issues: no leakage, no blood in the urine, nothing.

I had the holep surgery from Dr. Humphreys at Mayo Clinic in Scottsdale. He did a tremendous job. It took 4 days for bleeding to completely stop and 10 days for all blood to disappear from urine. Now everything is working fine and I feel like a new person. The surgery took almost 3 hours and the care at Mayo was superior.