When I was first diagnosed with prostate cancer in 2013, I made the decision to accept active surviellance rather than the radical prostatectomy which was offered. I thought I would wait to see if things developed. I first noted in 2019 i was a leaking a little urine at night. The GP put me on Tamsulosin then a year later after the usual urology appointment by phone, I had a bldder scan which showed 300ml retention. I was advised two things: It was down to my large prostate and I needed surgery for this, as it was not good for my kidneys to retain as much urine. I was put on intermittent self catheterisation (ISC) until surgery could be arranged. This would protect my kidney function. Was not too keen on the idea of it to start with,but soon got used to it, and managed ok. My PSA was stable at around 12. I did wonder then that a radical prostatectomy would be best for me as it would deal not only with the cancer but also the urine retention. After a bit of my own research, I discovered the HoLEP prcedure which had not been mentioned to me as it was not done at my local hospital. After 2 years on ISC I was getting a bit fed up with it and wanted a solution and this seemed to be it. TURP had been mentioned. The issue was that of increased risk (5%) of urinary incontinence afterwards because of my large prostate (300ml). The HoLEP alternative was preferred in my case as it could cope with my large prostate easily. It would not deal with the cancer however. My PSA was now 15. OK it was up but the rate of increase was not worrying. My local consultant supported me in this choice advising that due to my age if the cancer became a problem then radiotherapy would be the likley choice. I tried to arrange a referral to another hospital for HoLEP, but the local clinical commissioning group said it could not be done. So in May22 I arranged a private consultation regarding HoLEP. The consultant was helpful and put me on the NHS waiting list straight away. No questions about funding! The referral then appeared. Now I had to arrange pre op tests with my GP, which was tricky, but managed it in the end. They took my blood pressure which was 160 ish in surgery. Whitecoat syndrome was diagnosed and I was sent home with a BP measuring machine to record over the weekend. Now a bit more relaxed the figures were about 130, so I was set to go. Had the HoLEP in Nov22 and my last PSA in January this year was 1.1. Quite a drop which delighted me, also no more ISC. Free at last!
The big issue for me was the self catheterisation as I enjoy walking in the countryside. Also going anywhere made it difficult. I could manage the ISC at home no problem but going away stressed me. Stopping at motorway services for a pee meant ISC was essential as the stress makes retention even worse.
Yes
At the moment I am happy where I am, still on active surveillance. But now I have my life back with my outdoor volunteer group without ISC. Urinary urgency is also reduced, so no complaints.
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