HoLEP for BPH followed by SBRT several months later for 4+3 = 7 PCa. Is it preferable to do the HoLEP before the SBRT?

[Bourbon2024]

Diagnosed with BPH (80 cc prostate) and prostate cancer - Gleason 4+3 in 2 cores - less than 30%, 3+3 in 2 cores, benign in 8 cores. Stage T1c. PSMA-Pet no metastasis. PSA 8.8. Decipher 0.51. PSA density 0.11. Having HoLEP in May 2024 then SBRT several months later.

[witantric]

BPH handled first and then. SBRT. That is the sequence generally. The duration between the two should be discussed with your radiologist.

[Bourbon2024 in reply to witantric]

I appreciate your response.

[Tall_Allen]

You can only do the HoLEP first, otherwise you risk incontinence.

[Bourbon2024 in reply to Tall_Allen]

thanks much.

[lpol83712]

Same age essentially and had HOLEP first as doing it after radiation has higher risk of incontinence. Easy recovery except burning with urinating. I was started on ADT prior to HOLEP but my pathology was Gleason 8 at Mayo and 4 plus 3 at Hopkins. If you are only on short ADT it is generally better started at or close to radiation. You will have about 3 months delay after HOLEP to radiation. With 7 months delay to starting radiation you may talk to RO about ADT timing. The HOLEP also produces tissue for pathology and could change things a bit.

[Bourbon2024 in reply to lpol83712]

Thank you much and good luck to you.

[MBOY1]

the longer the better in between for healing post holep and later radiation. I speak from personal experience. I only had 6 weeks. Wished I took 3-4 months.

[Bourbon2024 in reply to MBOY1]

thank you. I will wait 4-5 months after HoLEP

[MBOY1 in reply to Bourbon2024]

good luck to you

[redonthehead]

Does anyone have a link to a study of HoLEP (or aquablation, etc) being done after SBRT?