just me, thanks again for your reply.
I did not have a urethrotomy, just the HOLEP.
I have left details with the surgeon's secretary, and she is going to speak to him this afternoon, so I anticipate a phone call later.
The HOLEP has been a very positive experience thus far, and all other parameters are good, so I would not want to negatively influence any potential candidates who may read this. The surgeon I had was excellent.
The small problem is that most of the limited information out there says that you will stop bleeding within 2-5 days. When you appear to be outside of this norm it raises some concerns, and you require reassurance that all will be well within a particular time frame.
I am avoiding any straining or lifting, and have been taking it easy for the past 12 days, so that can't be a factor.
Like you I experience very minor discomfort when urinating, particularly if I do a double void, which has been necessary for the past 15 years. I will have to get out of this habit as it is probably not really necessary now. I still have a slight feeling of retention post voiding, but this is probably more due to the trauma to that area rather than any significant residual urine.
jonal,
I could not agree with you more. Holep has been a very positive experience for me as well. My prostate was very large for my age. 10 years ago my only option would have been complete prostate removal. I am very thankful my surgeon went the extra mile to learn and perfect his skills for the betterment of his patients. I personally thanked him for the positive way he has affected my life. I am so much better off now than I was prior to surgery.
just me
jonal,
I wanted to address your need for reassurance, I called my surgeons nurse twice with questions. There really isn`t a lot of info available . Some of what is out there is outdated. A lot of the sites recommend 4-6 weeks off work . I was only off 2 weeks and I have a strenuous job.
I also have a slight feeling of retention after voiding.I believe my bladder picked up some bad habits over the years and is in need of a good retraining!
just me
just me, I am a little disappointed in that the surgeon has not made contact today. I appreciate he is busy, but just a few words on an e-mail at the very least would have helped.
I noted today, a possible correlation with the bleeding. Due to the fact I am taking it easy I have been spending some time on the computer. I have a hard seat even with a cushion. As this is a little uncomfortable I spent less time on the computer in the morning and I noticed there was less blood in my urine. I then spent a couple of hours on the computer in the evening and my urine was more bloody. This of course may just be a coincidence, but I am going to avoid this seat tomorrow.
In order to manage our urination with prostate enlargement we incorporate coping mechanisms. We have to go through a process of unlearning these mechanisms. Pelvic floor exercises and bladder retraining is a must, to get us back on an even keel, post operatively.
I feel that invasive procedures should always be the last option taken into consideration when all else fails. My husband has been having prostate problems for the last 10 years and was told to go in for the same procedure. Not happy with one doctors prognosis, we went on to another one who suggested we try natural nutritional supplements first. We read up first and came across positive reviews of Super Beta prostate. Decided to give it a shot and it worked great for him. It has no side effects, which was a major plus point and provides all the nutrients your prostate needs to be healthy. Give it shot, only after consulting your doctor first.
james hodge, alternatives to surgery only work up to a point. I too tried herbal and other modes, like beta sitosterol, saw palmetto, permixon, and finally finasteride.
The herbal based ones do help, but do not shrink the growth of the prostate by any degree of significance, so with BPH the prostate will continue to grow relentlessly until it reaches a size that can become significantly troublesome. Only a drug that substantially inhibits dihydrotestosterone will shrink the prostate, don't be fooled otherwise.
My bladder had become significantly muscled to cope with the restriction on the urethra, and you worry that it will eventually lose its tone completely and there will be such back pressure on the kidneys that damage will ensue.
Finasteride will shrink the prostate by 20% to 30% in time, but due to the effect on dht there are side effects to contend with. Some men are affected substantially more than others.
My problems started about 15 years ago and I went through the above range of drugs in that time. I postponed an invasive procedure for as long as I could, but having done my research over the years I watched the development of the HOLEP technique and weighed up the risks of this procedure. There is no way I would have opted for a conventional TURP, but I knew of close relatives who had it done successfully.
If HOLEP in experienced hands had been available to me sooner, I would have taken this step a number of years ago. I am now day 12 post op and am delighted with the change in my urinary dynamics thus far, and by all accounts it will continue to improve.
My only concern is that I am still bleeding and I hope it will stop soon. The literature says that 1in 5 men bleed for 10 to 14 days and I am at day 13.
Would I still recommend HOLEP? absolutely....but choose an experienced surgeon with a good track record and a few hundred HOLEPS under their belt.
Jonal,
How are things going for you? Has your bleeding slowed down? I have been doing the pelvic floor exercises and I have noticed an improvement in stress incontinence. My surgery was 5 weeks ago. I am still dealing with Urge incontinence . my volume is to approx 200 ml up from a consistent 110 ml. I still have some minor bleeding from time to time and some pale rusty colored urine . Today was a very Good Day!
just me
justme, it is now day 19 and my bleeding has been much the same, as has the pain. However, for the first time yesterday and again today I urinated once with no obvious blood. This has been once out of about 8 urinations in the day. At the other times, I am still having the same initial spurt of bright red blood and a few drops at the end of urination. Like you I also have deep rust coloured blood, first thing in the morning. Given the two incidences of no obvious blood I am hopeful that there will be more reductions.
I discontinued the pelvic floor exercises and bladder retraining just in case this was contributing to the bleeding, but I will reinstate them once I have more instances of no bleeding.
I seem to have developed a feeling of distention and fullness and very slight discomfort around the anal area. However, I am pleased with the force of my flow and the increased quantity of urination. Most times now it is around 250 mls. I am still dribbling slightly post urination and although I can have an urge some time after drinking, I don't have urge incontinence. I stopped wearing pads about 4-5 days ago. I am generally only getting up about once at night and this is in conjunction with a higher fluid intake than I normally have.
I believe that once the bleeding stops and I do more vigorous pelvic floor exercises my urination problems will be history.
I am trying not to focus too much on my pending tissue results. They are due towards the end of this week or the beginning of next, depending on the mail etc. I have lived with the potential for prostate cancer for almost 15 years. Although not absolutely foolproof, it would be excellent news to receive a negative result for PCa.
jonal,
I am 43 days post surgery, There is no pain except at the end of urinating. No blood for the last few days. As a whole my urine color is returning to normal. There have been some scabs and small threads of blood .
You are further along with your bladder control, as I am still wearing a pad throughout the day due to stress and urge incontinence. I wear a pad at night as well, but, only as a precaution . The have been no incidents . Sleeping through the night with the exception of 1 trip to the restroom a night is such a welcome relief!
Pelvic Floor exercises are being increased lately, and will be a normal part of the day with the upcoming holidays.
My tissue samples came back negative , in spite of a PSA number as high as 17.
I hope you receive good news as well.
just me
just me, re the stress and urge incontinence, be quite rigorous with the pelvic floor exercises. The reason I say that is because my brother-in-law had a radical prostatectomy because of PCa and he was continent from day 1 or 2. He did his exercises for over a month before the surgery and 6 times a day afterwards, Although not quite so rigorous as him I did the same before the HOLEP and the 2nd day afterwards, and have also been continent from day 1. It may just be a coincidence of course. Like you I am still only having pain right at the end of urination. The last few nights I have been getting up 2-3 times, but I am thankful it does not take me 15-20 minutes as it used to. The frequency of reduced bleeding is increasing, so I am continuing to progress on that front. Your tissue result was heartening. I hope that my one is too.
Having retrograde ejaculation (i.e. no fluid ejaculated) since the GreenLight procedure five weeks ago. Whether you will have retro or not, and how long it lasts, depends on how your surgeon does the procedure. The Greenlight promo brochure states 30% of patients will experience retro ejaculation for up to three months post-op but that usually goes away. Various other web sites about the procedure have that same info. I'm five weeks post op, am experiencing the retro thing accompanied by significant pain in the final parts of the retro ejaculation, and today the surgeon told me that the way he does the procedure the retro thing is 100% guaranteed and worse yet it will be permanent. Direct quote: permanent retro ejaculation is the price you paid to have a better stream.
Don't know why he does it this way but he didn't make it clear before the procedure. Had he done so I would have found a different surgeon. I'm only 57 and my sex life is now over thanks to this procedure.
If you're considering having GreenLight done, think of it as emasculation light. You won't be a fully functional male afterwards.
I think the stats that are given for retrograde ejaculation are somewhat optimistic. If you do a more comprehensive trawl through the internet you will find this. I also think your surgeon should have been more explicit with you. However, unless you intended to father children is retrograde ejaculation that much of a negative? Provided you have the same level of orgasm it is just the fluid end part that is missing. I don't think women would be that bothered. It is important not to get too hung up on it to the extent it does achieve a psychological significance and affect your performance and pleasure. I believe your last two sentences are a bit extreme, and do not bode well for your future peace of mind. I have had laser surgery, but the potential trade off for good urination and healthy kidneys was worth taking. I also had a vasectomy in my 30's. I never felt less of a man because of a loss of some fluid from that direction either. I would advise you ask your doctor when the ejaculation pain should end, and possibly get some medication to tide you over until then. Everyone has their own feelings on the matter, but try and relax and enjoy your sex life. You may be one of the fortunate 20% to 30% where everything is reinstated despite the surgery.
jonal
It`s been 48 days post surgery, and the discomfort at the end of urinating is almost gone. I have been passing tissue with bits of blood , so the prostate is cleaning it`s self out.
In reply to Guest, jonal has given good advice. As the prostate grows , it`s ability to allow urine and semen to pass is greatly diminished. My ejaculations, pre surgery were minimal and there was no force to them at all. My erections were about 70% and I had experienced acute retention 70 times in a 4 month period.
Post surgery i am experiencing retrograde ejaculation with 2 exceptions when I did ejaculate a small amount . For me there is very little difference in quality of orgasm . Healing takes time. Please be patient .
My erections are back to the good old days.
jonal , I have increased my frequency for the exercises at your suggestion. Increasing fluid intake is an excellent idea, one I will pursue when my schedule will allow.
I am hoping for good results for you .
just me
just me, thanks for your comments. We are both making good progress, I feel.
It is day 25 and now only the slightest amount of blood is in evidence at times. I am still experiencing end of urination pain, which can be almost teeth clenching. Fortunately it only persists for about 2 minutes. I still have the peri- anal discomfort which occurs post urination, and can take quite some time to abate. However, I am very pleased in so many ways. My flow is really forceful to the extent that I empty my bladder in seconds. It is like I am back in my 20's. Double and triple voiding post urination is no longer necessary. I also do not need to visit the toilet 4-5 times in quick succession after drinking a mug of tea. Every morning I awake with a strong erection, which makes me feel like a young man again. I have not attempted anything with them yet so can't comment on ejaculation. Pre surgery, the combination of Finasteride and a 90 - 100 gm compressing prostate certainly curtailed quantity. Any improvement would be a bonus, but retrograde ejaculation does not really concern me. I would gladly trade RE for the improvements I am currently experiencing, and they can only get better.
Generally I feel much more energetic and positive. The HOLEP surgery has given me a lift. I know it is not foolproof, but if my tissue results come back negative for PCa, that will give me a further stimulus. I have been living with the sword of Damacles over my head for almost 15 years, not knowing whether all my symptoms were due to a slowly growing cancer.
Keep up the Kegels just me, it will pay dividends. I plan to do them for the rest of my life, and to generally get fitter once my prostate heals.
jonal,
Had 6 week post surgery check up a few days ago. Absolutely no urine retained in the bladder. The pain at the end of urinating is now gone. I am still using 2 pads a day as I have minor dribbling . I am still experiencing Urge incontinence. My Dr assured me this will pass in time.
I was informed there was 92 grams of prostate tissue removed and recovered by Holep surgery.
My PSA test came back 0.3 . Down from a number as high as 17.
I am hoping all the best for you as well.
just me