BPH Treatments: HoLEP, PAE, Surgical, TURPs, & More | Casey Dauw, MD & Q+A with
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- čas přidán 28. 08. 2024
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0:40 Complication of BPH
1:46 Treatments for BPH largely dictated by prostate size
2:38 Surgical options
3:06 TURP - Transurethral Resection of the Prostate
7:26 TUMT - Transurethral microwave thermotherapy
8:43 Urolift - Prostatic Urethral lift
12:32 REZUM - Water vapor thermal therapy
18:22 Aquablation
22:59 PAE - Prostate artery embolization
25:35 HoLEP - Holmium laser enucleation of the prostate
33:03 Conclusions
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Thanks for a great discussion. Saying patients undergoing Rezum experience discomfort is an understatement. General anesthesia would have been a welcome relief from the pain experienced during the procedure. I am scheduled for a HOLEP next week after BPH symptoms returned. I was not surprised Dr. Dauw stopped performing Rezum. It was very painful.
Very informative presentation. Had the TURP procedure myself in late July after being on Active Surveillance for 4 yrs or so. Finally off the pills (Flomax and Avodart) when discharged from the hospital and no issues of note post procedure. Late 60's age, prostate size roughly 70 gm, PSA pre-surgery 14.5
Pae is clearly the superior procedure for most men.
The most excellent professional and well explained video in CZcams about this topic and the guest best of the best 👍🏻
Excellent talk, very informative, thank you Dr. Casey Dauw!
Excellent… Every time I thought of something regarding this, it was Dr. Moyads next question… Great Job! I learned a ton! THANK YOU!!!
I can attest to the acute pain from a bladder obstruction. I can also attest to the acute pain from a kidney stone. For me, it's a coin toss. Both were extremely painful. Even worse, on both occasions I was on vacation and located ~40 miles to the nearest hospital. At first, I did not know my bladder was obstructed and unable to urinate. By the time I did, it was a full-on emergency. On a pain scale, they were both 10/10.
Can this procedure by given to people who have had radiation for prostate cancer?
Urolift was nearly worthless for me. After the procedure I had to continue on Flomax and Cialis and I am not getting much relief. After only 18 months I am now having to go to a doctor to talk about what my next procedure will be. i am very unhappy with the result
Exactly my experience with Rezum 2 yr ago.
@@spotonnls3538 nice. Who was your doctor?
I know I have BPH. My prostate is 80cc. I also have now have prostate cancer. Preliminary findings would place me in "Low Teal". At age 77 I don't have the stream of a 16 year old any longer, but I feel I do well at emptying my bladder during the day. And at night time I may have to get up once under "normal" circumstances. There are times at night when I have to get up more often or feel I don't empty my bladder. It's usually accompanied by spicy food I ate or just after a nocturnal erection...........where I think blood supply to the prostate is somehow constricting my urethra. As I contemplate treatment for my cancer I have a growing concern about my BPH somehow exacerbating what I expect will be some short term urinary side effects from whatever treatment option selected. Seems they all have similar urinary side effects short term..........either SBRT, LDR Brachytherapy, or focal therapy. I do not to find myself in a situation where I'm now in urinary retention and can't pee when BPH and treatment impact me at the same time. How does one resolve this concern? I watched Dr. Dauw's video. It sounds like HoLEP is the best procedure. But he's removing 60-70% of the prostates tissue. I then ask myself.............how does that impact or play into any treatment for my cancer? I'm very confused at this point.
I’m wondering, is there an approach with HoLep where there is a preservation of normal ejaculation post Op recovery?
I am currently in retention and having had my consultation, my problem is not nessararily strangulation of the urethra, but the folding over of the median lobe blocking the bladder outlet. An MRI scan showed that my enlarged prostate is 85g, which makes me a prime candidate for HoLEP as recommended by the consultant.The question I’m asking is, does this present a higher complication to manage?
the presenter keeps talking about how various procedures are "office based". What exactly does that mean besides the obvious that one is done at the doctors office and the other is done in a hospital. But so what? That they don't require general anesthesia in the doc's office, but in the hospital it does require general anesthesia?
Is this therapy recommended both before and after any radiation treatment for PC?
Any recommendations for HoLep specialist in NYC?
Ditto. A referral from Dr Dauw would be greatly appreciated. Alternatively, but not ideal, is traveling to Ann Arbor,
if you have a localized 4+3 = 7 Gleason 15% and 30% in 2 of 12 plugs can you have HoLEP
Stop using the "Gold Standard" cliche salesman phrase. The phrase is meaningless and old fashioned. No country in the world even uses a gold standard anymore.
Such a strange critique. “Gold standard” is an idiom that is well known and understood by most English speakers, so from that point of view it is effective communication. It didn’t land with you. Great. Do you rake your neighbor over the coals when he uses the phrase “the bees knees” because bees don’t really have knees and it’s a meaningless term, lol?
I'm not that old. My prostate is an issue & my urologist wanted me to have TURP (I also need a few bladder stones blasted). But I don't want that surgery or any that will mess me up afterwards & I'm scared of catheters😢
I'm curious about less evasive PAE.
Navigating all this crap is hard & insurance makes it harder.