Best doctors for HOLEP surgery

Hi Ben. I don’t do the Kegel exercises. I started out doing them and it seemed to make incontinence worst for me. So I stopped. And I’m improving without them. When I’m home, I wear regular underwear with no problems. I only wear something when I go out. I bought a couple of PROTECHDRY - Washable Urinary Incontinence Cotton Boxers from Amazon to wear when I go out - just in case. These are regular looking boxers with built in pad that you can’t see and don’t change. They are pricey ($25) each but worth it for me. I hate the pads. Wear these boxers and put in washing machine and hang dry. If you check them out get a size larger that you wear.

Hi Ben. I tried to respond and now I can’t locate my post. I’ll try again. I stopped Kegels. I seemed to get worst and since I stopped I seem to be getting better. I still pass a clot occasionally and have the strange sensation at the end of urinating. But all this well worth the the process to healing. Wonder what happened to Philip? Just curious if he got his answer about the the possibility of repeating HoLEP. Dr Miller specifically told me that HoLEP was “one and done” and I would never need another procedure. Hope he figures it out. Nate

I remember that Philip used to ask Dr. Miller the question for himself, he got answer said "you are set for life", means he should be all set for the BPH. I also talked with Philip, he said: "To be clear: HoLEP is only a one time surgery unless something develops years down the road." So normally, or for most patients, do once HoLEP and it's done, especially to you, the tissue was removed 110 grams, almost all removed. Dr. Miller told me that in past 17 years, she didn't see her patients came back for redoing the surgery.
I am doing fine except little dull pain when urinate, and little burning feeling , but is getting better these days. Also the bladder works little too much, make me feel little urgent to go the bathroom with less volume. I believe it should get better over time with the healing processing.
I don't see blood and clots in my urine since 3 week after surgery. Seems you are little different. It might be because you had previous procedure of "Urolift", made the situation little more complicate. If after 8 weeks you still see blood or clots, you may send message to Dr. Miller though the portal. Hope it stops completely soon.

Hi Ben. I’m glad that Philip got his answer. I thought that’s what she would say. I can’t imagine it growing back enough to occlude the flow again. And I’m sure you are right about why I am still seeing blood. Dr Miller stated that it took an hour longer because of urolift. It had created/caused a lot of fibrosis too that had to be removed. She also told my wife she never saw anything good coming from that urolift - all bad. Wish I had known about HoLEP about four years earlier. Dr Miller said I would be 13 weeks to healing for me, so it’s a test of patience. By the way, does it bother you at all to sit in certain chairs that press into the perineal area? I hope that resolves too. And I hope you keep making progress. You think you will return for the six months appointment? All my best, Nate

Nate, It doesn't bother me to sit on any chairs, I am more focusing on how to improve the bladder work, and reducing the sensitivity when it's only small volume in the bladder. I can't expect the urinate pattern and habit will change to very normal after years of BPH. As long as it improves gradually, I am happy.

Hi Ben. I send message to Dr Miller and the PA responded for her. She basically said it’s going to take me an extended period (12-13 weeks to heal). She didn’t discuss why. But, if I’m not any better at that time she said I could come back to Vanderbilt for a CT. But she gave me every indication that she expected it to heal by then. She told me I didn’t need to limit my activity at this point. So, I went out on consecutive days and watched my oldest granddaughter play in a high school golf ⛳️ tournament. I estimated I walked 4 to 5 miles each day. It felt great to know I didn’t have to always be worrying “where’s the nearest bathroom!” Remember that whole process. Years of BPH., I think, is responsible for something akin to PTSD. I feel like Dr Miller helped me escape from a prison.

I had HoLEP surgery performed by Dr Michael Dusing at St Elizabeth Edgewood (Northern Kentucky, Greater Cincinnati area) on March 9.  I went home that night (procedure started around 1PM).  Monday I had the catheter removed, and went back to work (computer programming, work from home) on Tuesday.  The pain was minimal - I took Tylenol 3x day for the first 2 days after surgery, and nothing since then.  I've got some leakage, but as long as I pay attention to my bladder urges and respond quickly there's no incontinence.  I felt better on Tuesday after the surgery than I had in months (catheterized since November 16 due to urinary retention).  I highly recommend Dr Dusing.  He told me he does about 150 HoLEP procedures a year; mine was the second one he did that day.

Has anyone taken a plane flight after HoLEP? I am flying to Vanderbilt for surgery next month and a 5 hour plane fight back. Any suggestions for making the return flight easier? Thanks in advance.

Hi dcbrown, this is Ben, I had my HoLEP surgery on January 19th in Vanderbilt, and flew back to New Jersey on January 21st. It's less than two hour flight. You have longer fly time. The best way is prepare few Depend underwear, with maximum absorption. I used one on the way from hotel to the airport (I couldn't control the urinating when I fill the gas for the rental car, and couldn't find a restroom) . I changed a new one in the airport, and never get wet until I got home. So as long as there are restroom around, you should not have problem.

Hi Ben, Thanks for getting back to me and the reassurance. Getting a little nervous about the upcoming surgery. Wondering if you were able to figure out a way to consume the 8 to 10 glasses of water while traveling? Also, how long did you wear the Depends? I read you still have some leakage after 3 weeks. Are you using pads now? Thanks again David

Hi David, it's Ben here. The surgery was not that scary, it's much simpler than I thought. There's almost no pain. My only concern was that I saw more bleeding than I expected. My urine was in red color during the first week after the surgery, sometimes the color was dark, mixed with clots, but after the first week, the urine color became lighter, and lighter. The bleeding stopped right after three weeks. I also stopped wearing pads same time, the main purpose of wearing pads was I had little leaking and mixed with some color. The small leakage and minor incontinence got much improved recently, I think the kagel excise helps. In my case, it got me normal in less than three months. For drinking water while you're traveling back, it shouldn't be a problem, it's only few hours, just try to drink more and go to the restroom more.

Hi DC this is Nate. I had my HoLEP surgery with Dr Miller at Vanderbilt the day before Ben (1/18/23). This surgery changes your life. I didn’t fly after surgery but I did have a two + hour drive. I want to recommend that you investigate condom external catheters. If I were flying, and I use to make eight flights/month for years, I would wear one of these hooked to a leg bag. All you would need then is go to the plane bathroom and easily empty. It saved my trip home. Also, if I had it to do over I would not have drank so much water before the trip home. I way over did it.

You can find these external catheters online. This site want let be share the link below to a company that has these with and without the adhesive (I recommend without adhesive but with the Velcro band) and they will send you samples. Their name is Liberator. Look up external catheters. You can try beforehand to see how it works. I think this provides more confidence than depends alone. But you can also easily wear depends over the condom catheter with tube to leg bag - for added confidence.

Whatever you choose to get you home, in a few weeks your life is going to be changed forever. You will heal in time and think you’re 18 again. Let us know how it goes. And if you have more questions.

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Hi Nate, thanks so much for sharing about the external catheter. I had not heard of these. I will definitely check them out. It is so good to read you and Ben are doing well after the surgery. I have been getting up 4 to 6 times a night to pee. So exhausted. This surgery holds a lot of promise. I hope it can make things better for me also. Surgery on May 18; I'll let you know how it goes.

Got my Surgery date at University of Michigan (Dr. Casey Dauw) June 28th, and have the same apprehensions that some of you did. I'm 82 have a prostate of 125g and have been cathed since December totally blocked. What have I got to look forward to? Dr said about 3 months recovery time. Their routine is to keep you, at least, overnight.

Hi John. This is Nate. My prostate was 147g. They removed over 100g with HoLEP (1/18/23). The three months they told you is standard for total healing. Everyone seems to progress at different speeds given our ages and the specifics of our condition. But the second day post-op I was told that “everyone” recovers, that is, there are no outliers. Being told that really encouraged me. Because six weeks later i was still a bit incontinent, and passing blood and clots. I was told 13 weeks. And eventually the incontinence reversed and so did passing clots. And On week 13 (last week) I realized I was well.

Suggestions: 1. Get a calendar and mark in the 13 weeks. Keep a log of your progress/setbacks But tell yourself no matter how you may seem to be progressing, you want let it bother you until 13 weeks passes. 2. Drink the recommended glasses or ounces of water each day. Space it out throughout the day. You will urinate like a racehorse but it will help with the blood and clots. Plus it’s kind of fun to stand back and let it fly. I eventually scaled the water back about week 10. 3. I found information online from several HoLEP surgeons’ offices and their discharge instructions about foods and fluids to avoid. For example, no carbonated drinks. True to form these irritated and seemed to cause more bleeding. You can research it online. 4. Once I was off the Depends, I bought these really great underwear on Amazon called “Protech Dry”. Made for incontinence and Everything is built in. Wear them, wash them and ready to go. By the way, get a size larger than you wear. I ordered them in black. A bit costly but you save it in not using pads. And they look like regular underwear. In all you should not be discouraged as you progress. They say there are no failures and it’s “one and done”. Glad to chat anytime or answer questions . Let us know how it goes.