Thanks Las, it was encouraging. I am on day 12 and still have blood. It was getting better over time but last night was a setback for no apparent reason. My hospital release note says "no restriction on sextual activity", but I think waiting would be prudent. My guess that stress of intercourse could increase bleeding. The urges are expected, after so many years difficult peeing the bladder becomes overactive. Somehow I don't have that problem, just leakage. Coffee should be OK, I am drinking two caps a day.
Last night (13 days since my surgery) the bleeding almost stopped, so I decided to try sex. It wasn't much different than before, except some pain at ejuculation (of course it was retrograde) and a drop of blood. My wife didn't mind, she was curious too.
I went to work yesterday and it was ok too, still have IC, especially in second half of the day.
I just called medicare today and they said the would allow up to $750 for the Holep procedure. I told them that is an insult and they may as well not cover it at all
Hi Sleepless: Sorry for delay but I seem to be getting only weekly digests. Anyway, You can go to You Tube to see samples of them (Basically you lay on your back and try to squeeze yiur buttotcks while trying to force an erection. (At least that's how I think of it.) you hold for 10 seconds and do five of these twice a day. But if you have insurance to cover it (I'm on Medicare) you should make an appointment with a nurse practitioner at your urologist to go through a biofeedbackl session. This way they can show you the proper way and you can actually SEE if you are doing right. I wasn't getting relief for the urges until used the biofeedback. Be aware that it may be 3-4 months before all the urges stop (the Kegels just make them less frequent) but they WILL stop. In meantime - get the shields and wear them. You WON'T feel them and probably won't actually have accidents but it's comforting to know they are there. And glad to see your attitude to sex. Many others were frustrared because they had to wait a few months. A few months is nothing when you have MANY years to come. In three weeks it will be one year for me and I feel great. Next Wednesday I go back to Dr. Das for my checkup. Feel free to ask any questions and I hope I can answer quicker next time.
Hi Sleepless: Sorry for the delayed reply but I seem to be only getting DIgests and I'm even having problems signing in as my own screen name. Anyway - for Kegels you can search Youtube for videos and may help. Basically it is lyining on your back in bed and squeezing your buttocks while attempting to force an erection and holding this for 10 seconds. Repeat 3-4 times twice a day. But if you have insurance (I had medicare), you should see the nurse practitioner at your urologist to get a biofeedback training session. By actually seeing on a monitor if you are doing it right really made a difference for me. Be aware that the Kegels will lessen the urges but not stop them YET. That will happen with time (think 90 days from operation). It makes them less often. Also, I highly recommend getting a pack of the shields and wearing them when you leave home. I never had an accident but they were there JUST in case and they are VERY comfortable. (I was surprised). A good safety net. As for sex, you are one of the few (like me) who realize that it is not THAT urgent to have it when after a few months you will be able to. You have a whole life ahead of you! Next Wednesday I meet with my surgeon, Dr. Das, here in Philly and in 3 weeks it will be ONE YEAR since the surgery. I'm so glad I had it. Many friends are up 4-5 times a night. Unless I have coffee after dinner I go all night without once needing to head to the bathroom. Feel free to ask any other questions.
SteveinPhilly
Don't you have supplemental insurance Ed? I don't remember which plan paid which (Medicare os Supplement) but I never paid one penny for any of it.
As I noted below. You will have IC for maybe 90 days. Get the shields as see if you can do Kegels. GREAT news on the sex!
LAS. I'm reading posts "backwards" and just saw your post. Go for the coffee if you want and get some shiekd (under $10 for about 50) Get CVS or Rite Aid Generics. and relax. See my post re: Kegels. As for sex, if you can wait another week for sex, fine. As Sleepless found out, it will come (pun intended).
Hi Stevein and All. Its 3 weeks today since my HoLEP and I'm doing well. Bleeding has stopped with none in the last 4 days or so. My biggest complaint was continued urgency after emptying my bladder - its drastically improved but progressively. I have no real IC except a few little dribbles occasionally. Flow is very good. I came close to having sex a couple of nights ago but we stopped before I was ready to climax. Will probably wait 1 more week until I'm 4 weeks out of surgery just to be on the safe side. I still have some minor occasional pain in my urinary tract. I will have a follow-up visit with the DOC's in mid-January with flow test, etc. My surgery may have been less intrusive than some as they only needed to do the Center Lobe plus some slits at the bladder neck from what I read in my report.
Thanks Steven. I will definitely do that. I am seeing my urologist in a couple of weeks and will ask for a biofeedback training session. I haven't done Kegels as I suspected it could increase bleeding, but I have very little now so it is time to try. My only concern is IC, it comes not because of urges, but rather leaks when I start moving around. Seems like my sphincter relaxes too much and lets it out.
I would say Medicare is generous. If my employer insurance counts it as in-network I will be responsible for 10%. For now they consider Mayo in AZ as out of state/network which means 50% out of my pocket. BTW Mayo takes Medicare, but not Medicare Advantage.
Here is my update:
Last night had sex second time. This time there was no pain or bleeding. It was ok, even my wife got some fun. But RE became some disappointment. Even it feels exactly the same (you can't tell RE from normal when it happen) the fact that nothing is coming out is frustrating. Sex is a mental as much as physiological process. Well, we have to live with it, just consider RE before deciding on the surgery.
There is almost no blood in my urine.
I still get up at night once or twice.
IC doesn't get much better. This is my major concern. It doesn't happen when I am sitting or lying down, but even slow walking caused some leakage on each step, mostly at the second half of the day. No uncontrollable urges so, it just leaks like from faulty vessel. Now when bleeding stopped I am going to start Kegel.
Steve, if you are reading this, do you remember what part of Medicare covered your surgery. I am 66, still working and have Medicare A. My employer insurance doesn't cover 100% and I am wondering if Medicare can pitch in as secondary insurance. For next year I have $1,500 + large copay with my employer insurance, so maybe I should drop it and enroll in Medicare supplement. Any thoughts on that?
I have a supplement but both Mayo and Dr Lingeman are out of the network and I thought I read a post on one of these boards that said we would be better off with straight because that would cover it so that is why I called medicare and the told me $750.
Mayo takes Original Medicare but not Medicare Advantage. If you are enrolled in Medicare Advantage you are out of luck. Mayo does Holep as outpatient surgery, so you probably need part B. But that's just my guess. I would like to hear from somebody who can clarify it.
Hi Sleepless. Agaion, I'm "subscribed " to this topic but not getting instant notice of replies. Sorry. Well In 9 days it will be ONE YEAR for me since HoLep. I had my appt with Dr. Das today and my bladder emptied perfectly. He did a digit exam and said prostate is fine. Next year I turn 70 (69th b-day is this Saturday!) and he said they don't recommend that after 70. Anyway, he doesn't need to see me for YEAR.
As for insurance. I never understood Medicare Advantage but I am also not on anyone else's plan. (I have female partner but we are not married). I chose Medicare and Suplemental Part B. I found New Era (on a recommendation and love it.). I have not paid ONE penny of deductible since I joined. My premium just went up to about $208./month and that's all I pay. So I can't answer anything about "networks. There are none in my plan. The only thing NOT covered is Home Health Care.
As far as the IC goes . as I said - if you figure 3-3 1/2 months from surgery before you have none, you will be fine. And with the pads (can I emphasize them again?) and Kegels, you will be fine. and kegels should not cause any blood,; you are laying down. As Justme showed me (well told me), when you sit you will always )(well almost always) be fine with no urges. The minute you stand you will get, until things are healed.
Sorry to go on so long. I'll try to check in more often if I don't get reply notices.
Steve