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Better Stream: HOLEP Laser Surgery for Treating Urinary Symptoms of BPH with Amy Krambeck, MD
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- Опубликовано: 16 сен 2021
- In this episode, we discuss a type of laser surgery called HOLEP as an option for men with urinary symptoms caused by an enlarged prostate - a condition called BPH that we discussed in a previous episode. Historically, when men either no longer benefited from prostate medication or could not tolerate the side effects of these medications, the next step would be a TURP surgery, otherwise known as the “Roto-Rooter”. Recently, however, new surgical options have been developed which are believed to provide results that are similar to or better than TURP and that are potentially safer and have less side effects. One of these newer procedures is a laser surgery called HOLEP which stands for holmium enucleation of the prostate. Joining us to help us better understand the risks and benefits of HOLEP is Dr Amy Krambeck. Dr Krambeck is a Professor of Urology at Northwestern Medical in Chicago, Illinois. Her Urology residency was completed at the Mayo Clinic in 2008 and she subsequently completed an Endourology fellowship at the Methodist Institute for Kidney Stone Research in Indianapolis, Indiana. Dr Krambeck worked as an endourologist at the Mayo Clinic from 2009-2016 at which time she joined the staff at Indiana University and ran the benign urologic diseases division until 2020. Dr Krambeck specializes in the surgical and medical management of stone disease and BPH and has performed approximately 3000 HOLEP procedures. Who better to help us understand this procedure. And now, without further ado, I bring you our conversation with Dr Amy Krambeck about HOLEP as a surgical option for BPH.
I just had this done at UofM Hospital in Ann Arbor, MI. I've had to self catheter for the past 10 months, and with HoLEP I was going on my own the next day. I'm only 3 days in, but this procedure was the one I was most comfortable with. No bleeding, very little pain thanks to the awesome team of Drs and Nurses at UofM.
Me - 70 yr old Cajun from Louisiana - BPH with repeated bleeding n infections; Moses 2.0 on 7/14/21 performed by Dr. Amy at Northwestern in Chicago on my 231 grams Prostate; Removed 177 grams of P and bladder stones; In at 10:30am - walked out Hospital at 4pm "without catheter"; Amazing Team Dr. Amy has put together and recovery (no bleeding, no pain, 20 yr old stream n volume)....Why did I wait so long?
Mike- I am considering seeing Dr.Amy. Could you walk me through the logistics of being an out of state patient flying into Chicago? Shuttle from airport to hospital, where to stay, etc? Thanks
I have had HoLEP. No pain no leaking no blood. Back to normal 👍
What Doctor did your procedure and in what state? Thanks
What doctor?
Just had this done 3days ago. I feel great. I’m working at my desk job. A small amount of leakage but tolerable.
I've heard from multiple sources, that there is an ejaculation preservation HOLEP. Basically they leave tissue untouched 1-2 cm from the verumontanum, area where your ejaculation ducts are located. The procedure has also been successful with TURP.
Not so easily done - rare to not have RE with most of these procedures - HoLEP, ThuLEP, TURP - some RE successes with Aquablation, but Aqua is difficult success for BIG prostates
Best bph education on internet by the host and the guest speaker
Thanks!
Outstanding and informative. I am looking to having HoLEP but reside in an area that has a less-than-stellar med rep. Good to know that Dr. Krambeck feels that a qualified surgeon CAN be found if you’re willing to travel.
Suggest Dr Miller at Vanderbuilt Urology in Nashville - she’s one of the best surgeons in the world at this procedure and you can do it in one day people travel to her from all over the world
I just watched 2 of her actual HoLEP procedures on uTube, excellent videos, a very confident and proficient doctor
I am going for a HOLEP consult this week and found this extremely helpful to prep me with questions.
Glad to hear it!
This is one of the best videos comparing HOLEP to other procedures. Dr. Amy was very accurate in describing post Rezum symptoms. I am looking at HOLEP after having a miserable Rezum procedure a year ago.
Thank you for a straight forward discussion.
Thank you for the feedback!
Gary, can you provide an update, did you have HoLEP?
@@ofcbob6391 😅
I had Rezum and I’m quite satisfied. The problem is that we know that it only lasts a few years. But it doesn’t give you a problem with retrograde ejaculation.
Just had Holep operation done in the UK . results are amazing. getting over the operation was very easy no problem with anything excellent flow now. I suffering from bph bad flow prostitius and infection of the prostate. 3 days later on I'm. Walking no pain passing very good slight incontinence but small . A little sore but mild now . Please don't hesitate to have it done.. I will answer any questions if anyone wants to
Please can you say why you chose this procedure over a TURP. Also, was this done on NHS, and if so where? I am also thinking about this procedure in the UK.
@@stevetop5970 yes I can actually explain.. Originally I was offered a turp the specialist told me I would or could become unable to get a erection after.. So I said that's a problem for me. So I left it.. as my symptoms became worse than before my doctor sent me to hospital so they could look inside via a camera and see what the problem was. Long story short the prostate was encroaching the bladder nearly growing into it.. I could see it myself on camera only option was operation.. Now prior to this I'd been taking supplements and prescription drugs tamulosin and expensive super drugs off the internet and only slightly improved.. About 6 weeks later I got a letter saying they would like to do a holep operation on me because less chances of nerve damage iE impotence.. So I accepted.. It was a brilliant operation to have one night in hospital and out next morning.. I has catheter in 2 days then taken out when I went to pass urine the flow was powerful and strong . Recovery I'd say 3 weeks easily.. Now I'm normal and perfect working erection . It was done free on the UK NHS and I can say the cost private was 7 thousand sterling. But I got free
@@stevetop5970 i have had turp done… Stay away from that! I had a horrible experience my catheter ended up stay in for 7 days and i was in chronic pain. Dr said I should have stayed in the hospital at least overnight, for draining but he sent me home hours after the procedure while still in pain i am looking at holep, and staying away from turp
We're you able to ejaculate or did you have retrograde or,dry ejaculation?
Excellent presentation and information, more confident that I have chosen HoLEP😊
Thank you!
Great video with clear infos, thank you
Glad you enjoyed it!
Absolutely wonderful video. This has helped lift my depression.. I take Finasteride and Tamsulosin and I feel that the side effects from these and other pills are no longer worth it. My wife works for Advocate Aurora in Illinois and I am unable to locate anyone in that network who does this surgery. Asking Advocate help line has been totally useless. I am not a wealthy man but could you tell me what Dr. Krambeck would charge without insurance please. I am 70 years old and my main source of exercise is now 3-4 nightly bathroom visits.
Great video, very useful information and comparisons. Thank you both!
Glad you found it useful!
Great interview.. great questions and great and informative answers.. Thank you both!!
Thank you!
When you train who does the operation the trainee , fellow or does the patient know who does what? And why?
Interesting info. However one would think a cystoscope would be used to determine besides just consulting or having a conversation with a doctor. The word stricture was used and the conversation changed. In just talking, how would the doctor know it's not the prostate but maybe a stricture and maybe a TUIP would be better? The answer changed with Dr. Krambek too. It went from nearly everyone but then changed to larger prostates. Did anyone notice the change of the answer in regards to a candidate. I noticed in the surgery video the patient's feet were on the floor and another surgeon lists the legs being in the air. Which way? I think after surgery there will be swelling and burning/stinging so antibiotics with pain meds would be helpful. Which would make me think at least 1 day with a catheter. What about scar tissue after surgery, a fistula, a stricture or even UTI or kidney/bladder stones. What rates are those. Then does the doctor do routine follow ups after surgery? Who does the surgery and how to find them? Is there a HOLEP directory? O'h yeah, what about on-call or an emergency try to get to a hospital? Surgeons should be more in-depth such as what medicine, how much, what it does and any refills. O'h, what about taking a bath or shower after surgery? What worse is when people have questions but can't reach the doctor after the consultation. One other thing is doctors should be open for interviews without charge. Even lawyers give you 15 minutes for free. I think if people want business they should do interviews without a fee. Everyone should get paid, of course that's not my point. But if life was the way of doctors, oh how much more expensive it would be! O'h is this a required referral?
Great 👍🏻 interview, thank you 🙏 so much. Awesome information
Thank you! Glad you found it useful.
Hi Amy-can you say approximately how many of these surgeries you’ve done thus far-2022?
Great interview and good information tq
Thanks!
Will Medicare cover this procedure?
I went to a urologist who was a real peace of work. He must have taken courses in being a jerk.
Great video.
My experience is very much similar to @allangreenley. BPH for 4 years with a good few retention’s with a 133cc prostate . Only I had the procedure done privately (Guys Hospital, London Brigde) which of course I am grateful for.
I’m now on day 8 and there is still a little blood in my urine but no way as much as previous. Everyday it gets lighter but still fluctuates through the day. No pain but a little discomfort. Haven’t yet had an erection. I’d be happy to assist with any questions.
Im doing it in August at the Denver VA
Toby- How did it turn out?
Thanks much to Better Man Clinics and Dr Amy for very excellent discussion of HOLEP. One other Question if I may: If you have a HOLEP procedure and happen to have undiagnosed Cancer in the samples taken or develop Cancer sometime later-----Can you Still have a Radial Prostatectomy surgery at that point?
Having a HOLEP does not preclude you from Radial Prostatectomy at some Later time does it? Thanks much!
Can the patient choose to have a spinal tab if he wish to or who decides?
I was told no spinal injection because they need u perfectly still for the holep.. I was knocked out for the holep.
When she is watching she is not doing and an error could be made by making a hole in the capsule or the bladder neck or sphincter and who gets the credit for the surgery and does the patient know who did what without his consent?
Thank you for posting this video. I have also just watched Dr. Amy Krambeck’s excellent surgical video on YT, demonstrating the HOLEP procedure. This interview, here, is very relevant as she refers to the development work being done in New Zealand. I live in Tauranga NZ where the City Hospital is the base for the consultants who are creating and performing these HOLEP techniques. It is a source of great pride that assistance to men around the globe is being provided through the local staff and their research. And to Dr.Krambeck, thank you for your dedication to this sphere of medicine. Whilst it may not seem glamorous, it is life changing and millions of men will be grateful to you and to your fellow urology specialist surgeons. You are all very much appreciated. 👍😎🇳🇿✨
ruclips.net/video/4Bk_uWuvBzc/видео.htmlsi=TUof5IHhRrjQG9bm
What about a damaged prostate from radiation treatments which closes up if a foley isn't used?
I had the Holup procedure no problem with ED , but I can’t have an orgasm I get close but then it is like the light switch has been turned off? After the Holup procedure I did get a stricture in the bulbar area. And had to get a urethroplasty. To get rid of the stricture. Which did cause Ed too. Could the stricture cause the no orgasm? I been taking Cialis 5mg daily which helps with the ED. 👍 I had the catheter in. For 3 or 31/2 week the last week the catheter was moving a lot which was cutting the end of penis. Now I think I have Stricture in the head of the penis ! Still have low flow and now I have a spit spilt stream, so I have to sit to pee! Unless I’m at a urinal. My next appointment with my urologist Is mid July.
Thank you for this video and thanks to Dr. Amy for her candid education on HoLEP. One question I would like to ask is that some Urologists in Europe reckons they can preserve retrogate ejaculation by 20%. Has this procedure changed since this presentation? Is this true that that there is a chance the urologists can prevent retro-ejaculation to 20% with this procedure? thanks
I found this very well done and informative. My husband is in the process of deciding which procedure to have done. Do you have a video interview with someone who does aquablation?
Thanks! We will be doing one about aquablation in the coming months.
Your video comparison with aquablation procedure would be greatly appreciated? Is Dr. Kramneck and her team practicing this alternative? Your reply would be much appreciated!
Sure! Here you go:
ruclips.net/video/OQhL2xK7f8I/видео.html
Hope it helps!
Contact info for Dr. Kramcheck ?
Hi! You can find Dr Krambeck's office contacts here: www.dr-krambeck.com/
Can a man get an all male team for this surgery at this center ??
Was there dry ejaculation afterwards?
Why no comparison with PAE ?
Please check out our PAE interview with Dr. Isaacson!
@@bettermanclinics8872 Dr Isaacson
After successful HoLEP procedure, is there any danger of incontinence or, ability to hold urination considering that a urinary channel is greatly widen resulted in uncontrolled discharge!
7/2021 HoLEP at 71Yrs old - no issues whatsoever - however, if I belly laugh I do feel a squirt! I'lll take that any day to be cured of this savage BPH!!!
I will repeat the question I have posted 8 days ago regarding comparison between HoLEP and aquablation procedures. Dr. Amy confirmed that HoLEP was first practiced in New Zealand in early 1990 resulting in large data base confirming statistically it's prednosti of other short term NIST.
Aquablation on the other side surface into.practice just two years ago. Main sdvatga seems to be very short procedure which relies on very sophisticated robotic method which result in typical 5 minutes intervention even for largest 300 ml prostate size. Claim made is that it does not depend on skill and special training and many surgeries experience needed for HoLEP method.
I am eagerly awaiting your feedback. I have suffered horrible for last 5 years of enlarged prostate and would considered to travel to Chicago and have Dr. Amy and her team perform HoLEP.
In case she does aquablation, I am flying to Chicago tomorrow to save me from the prese misery?
😊
Hi! Here is our latest video about Aquablation:
ruclips.net/video/OQhL2xK7f8I/видео.html
Did you have Dr Amy do HoLEP Moses 2.0 on you? Progress? I am 7/2021 veteran from her and living the life of a 15 yrs old peeing like a cow in the pasture! LOL........
Did you get the info you needed about HoLEP?