HoLEP and PCa

Hi Roger, welcome to this site. It is the best place to be for getting all the info and advice, good news on your PSA result.

As far as HoLEP goes, there is an American medical facility offering treatment that supposedly can remove all the inside tissues of the prostate, then the capsule is pushed into the bladder and somehow reduced then this can be removed and tested for PCa. This is supposedly a better option than a TURP (Trans Uretheral Resection of the Prostate) but is done under general anasthetic with only one day in hospital.

Apparently there are no adverse side effects apart from retrograde ejaculations, which happens in the majority of cases.

I would have thought that there would be the chance of cancer cells being spread around the bladder and further afield and quite probably this would be the reason for it not being offered as a treatment.

Someone else may come up with a better explanation or reasoning but agree with you that the possibility is there if the surgeon is experienced that it could be, maybe, trialed somehow. Who knows what will be available in years to come with research producing new treatments all the time.

Regards Chris/Woody

Life seems different upside down,take another viewpoint

Thanks for the response Chris/Woody and hello Lyn.

I have been keeping tabs on everyone from time to time and it makes a change to be "active" again, in the sense that I am contributing again albeit in a limited way. Some of the old timers on here may well recall my concerns in respect of biopsies and TURP being a potential risk of PCa spread and it was for that reason I avoided both like the plague after my initial biopsies 10 years ago and regular offers of a TURP.

The HoLEP for me was a way to resolve my BPH, massively enlarged prostate and all that goes with that i.e. retention, frequency, bladder stone formation and not risking PCa spread via the venous system, as the laser zaps everything and cauterises at the same time.

I'm happy that I now have a definitive diagnosis as it makes it easier to plan ahead which was something denied to me when in a constant state of not knowing if anything lurked within.

It is pleasing to see that much support is still available on the forum particularly to the "newbies" who join the forum but saddened that the ranks of the "knowledgeable" advice givers have been whittled down over the years which is inevitable given the nature of PCa and I wonder if the forum will ever find replacements of the calibre we had on here in previous years. One can only hope!

I would raise a glass of red wine to everyone on here who may be facing a tougher battle than others on here but it seems alcohol is getting a bashing of late, something that would have Old Al turning in his grave. Now there was a character!

Roger, thanks for that do not get under the parapet just because of me, Injust wondered if you knew something that was worth sharing.

Cheers Chris/Woody

Life seems different upside down, take another viewpoint

Thought I'd give a brief update on where I am on the PCa front since my HoLEP some 20 months since the procedure.

The latest MRI shows no new features since the last one carried out in April 2016 and PSA appears to have plateaued at 1.1.

Still urinating well with no hesitation, retention, urgency or dribbles and best of all no sign of any UTIs whatsoever.

I'm not taking anything for granted though and shall continue with my modified Jane Plant diet plus organic pomegranate juice, saw palmetto, vitD3 and selenium.

Best wishes to everyone and keep up the fight.

Hi David.

Yes, I'm still lurking in the forums corridors.

All good from my point of view with my PSA at 1.6 where it has stayed for over a year.  Having discussed this slight rise with the Uro he puts this down to normal prostate cell regrowth and nothing more sinister and I concur.

All the issues I experienced with BPH are history and no sign of UTIs, bladder stones, nocturia, hesitation or frequency.  It's great to be in total control and not be limited in where I go and how long I can travel.

There has been one issue that may have some bearing on the HoLEP and that is a stricture near the bladder neck that a Uro encountered when passing his laser equipment up my urethra to a kidney which needed an amalgamation of calculi removed which was done so successfully.  

He told me he had had some difficulty getting the catheter that allows access for the laser, camera and irrigation system beyond this stricture which he believed was as a consequence of the HoLEP which in my case had removed the apex and some of the two lobes with the apex being closer to the bladder neck.

I'd never heard of this "side effect" and have not read about it on any of the forums where HoLEP is discussed.

It can only be that when procedures such as the one I describe above are carried out, this issue is discovered however, the affect on my flow from this stricture has been of no consequence whatsoever and I could still stand in for "Niagara Falls" should a film company so require.

Go for the HoLEP David, it's the Gold Standard as far as I'm concerned but don't forget to do plenty of pelvic floor muscle exercises for at least a month before the procedure and like myself you should have great bladder control with just a small amount of dribbling for a day or two.

As for AS, I shall remain monitoring the situation and should it look as though I may need further treatment for my PCa I'll make that decision then.  There is still the possibility to be consider that the HoLEP removed all the PCa but that only happens to other people not me, so I'll live with the other possibility that it shaved some off and left some behind which is currently behaving itself.

Good luck with your decision whichever way you choose to go.

I found your profile Dave under your previous forum name but not all your conversations (all 77 of them)😊

When I find the old forum I'll commence Chapter One. 😃

Hi Roger

If you search 'davewill' and read conversations you will find my first post in April 2005

David

Hi again

I meant to say for the benefit of anyone reading this conversation that I spoke to 'Mr A' last year in reference to the danger of my prostate confined cancer being spread by the HoLEP procedure and he was confident that the surgery did not have that effect.

David

Now I know what to put on my Christmas list!

David

Hi

I don’t know if anyone is still following this very old thread, but here goes;

Following my H0LEP surgery last November my three-month review in February was cancelled and I finally had my review appointment last Monday.

I had a brief but productive chat with Mr A, the lead HoLEP surgeon at Addenbrookes and left him with a copy of the ‘diary’ which I have kept since the day of the surgery. I hope he will find it useful as my recovery process has sort of followed the text-book pattern with one or two interesting variations which I will not bore you with.

The most important aspect to mention for anyone contemplating this procedure is that, at no time have I suffered any pain. During the healing period urinating was, on occasion, a little uncomfortable but that passed fairly quickly. Blood in my urine also ceased after a while, as expected.

It took nearly six months for my system to settle down. Frequency and night-time urination have not altered dramatically but hopefully, acute urinary retention is unlikely to re-occur. My PSA dropped after surgery from an average of 4.0 (really 8, as I was on Finasteride) to 0.4.

Mr A recommended a course of tablets to help my still over-active bladder which he assures me should offer a marked improvement over the next two – three months.

David  

Hi Roger

I am not displeased with the outcome of the surgery but perhaps I expected more improvement in flow and frequency. Still, after the past eighteen months one should be glad to be well and active.

I only saw Mr A briefly on the day of the surgery and we had a ten minute 'chat' on Monday, he said he was pleased with the results of the procedure and I felt he was professional and willing to listen.

David