just me, that is an excellent result, particularly a PSA of 0.3 at 6 weeks and no urine retention! In this part of the world they do not initiate a post op PSA until 3 months, because they believe that the prostate has to fully heal and settle down. I will not get any uro-dynamic testing until the 3 months have elapsed, so I don't know what my bladder retention is like yet.
92 grams is a lot of tissue. I had 50 grams removed. It is now 32 days and I still have not had my tissue results back. The hospital literature states that results should be available in 2-3 weeks, so I may chase them up.
My urination is very good on all fronts. I have completely stopped bleeding, but still have the same level of pain at the end of urination. Can you remember when your pain ended? I suspect the pain I am experiencing is possibly referred from a bladder neck spasm at the end of urination. Apparently this is quite common with the HOLEP procedure.
Thanks for your comments. I wish you continued good progress also.
Jonal, to help prevent urge incontinence after HOLEP, can you please tell me the specific
pelvic floor exercises that you practiced before and after surgery?
Many thanks,
Fiddler
Fiddler,
Did you decide to proceed with the surgery? If you did ,Which Dr did you go with?
just me
Fiddler, I simply do the conventional pelvic floor exercises. I am not that precise in my timing, unlike my brother-in-law who sets an alarm on his mobile to remind him 6 times a day, and is very precise in his repetitions etc.
With the repetitions, I just mix them up whilst watching television or lying in bed, and even when standing. I do 20 rapid clenches with 4-5 repetitions, then clench and hold for as long as possible times 5. I do this about 4 to 5 times per day. Sometimes I am preoccupied with other things, so do the best I can on the day. If there was a piece of music on the radio or tv I would sometimes do them to the beat. This made it different and less boring.
It is important to restore muscle tone in that area, just do it your way, and in a situation that is not too boring. Don't be too hidebound by precision. Your tone will improve.
Just Google male pelvic floor exercises and take it from there.
just me, did you need to take anti-bio-tics to cure the post voiding pain? I ask because my doctor wants me to take them, even though my urine does not appear infected.
I am not one for taking anti-bio-tics without good reason.
jonal'
Ive tried to respond to this question 3 times but for some reason it wont post.
There were no antibiotics post surgery. I did take Macrobid prior to surgery,my last dose was the day before surgery.
I did get a script for an antibiotic from my family Dr 2 weeks before my surgery as a precaution against an inner ear infection.
Surgery appointments are hard to come by and I did not want to miss mine for and earache! One can assume your Dr wants you to
try the antibiotics as a precaution,which is not a bad idea. I do agree with you on the meds I dont like to take them unless
necessary. I believe over use can render them ineffective.
I seem to recall there was no post void pain for the first week after surgery, it developed later. It went away about day 50.
You are about 2 weeks behind me . You should be getting there soon. I never took any pain meds either. The only pain killers I had
was the Morphine given to me by the surgical team after surgery. I have a high tolerance for pain, which I attribute to eating Hot
Chili peppers regularly!
Im still wearing a pad as I am experiencing minor dribbling ,and urge incontinence. I have been working on trying to hold it and
have made a LITTLE progress. I have increased my reps for te pelvic floor exercises . My Dr said I need to look at progress week to
week not day to day. You are way ahead of me in this
department. It will take me some time I believe because of the size of my prostate, and the amount removed. Even at that I am
so pleased at the dramatic difference this surgery has made in my life.
all the best to you .
just me
just me, thanks for your reply. I also did not have the same type of pain initially. It is not that I cannot cope with the pain, I too have not taken anything for this, it is whether I should take an anti-biotic. Anti-biotics destroy the natural flora in your gut and Ciprofloaxicin has a significant list of possible side effects, which I would rather avoid if I can.
A recent urine test showed no infection, but there was an increase in pus cells and red blood cells, which are indicative of inflammation, but this is only to be expected.
As you say I am two weeks behind you at day 36, so hopefully the pain will go around day 50 or sooner.
Keep with the pelvic floors, I am sure it will pay dividends. The removal of 90 grams of tissue is probably a significant element in your slightly slower urination progress.
I don't know if it is the pelvic floors or the HOLEP, or a combination, but I am not dribbling at all now. I dribbled quite a bit before the surgery. So this is another plus.
Like you I am grateful for the already significant improvements in my urination dynamics.
I also received a nice Xmas present yesterday. I was informed by the surgeon that the tissue that was removed was completely benign. I know that most PCa is present at the margins of the prostate and this area would not have been enucleated, but nevertheless it is still a tremendous boost. As BPH generates the same symptoms as PCa, I have never had peace of mind over the past years. Now I feel more relaxed.
Once I have my PSA results at the 3 months post op point I will have a new baseline with which to track. If it is as good as yours I will be over the moon. You had a tremendous result. PSA reduction is on average about 80% to 85%. This usually correlates with the percentage of tissue removed.
Wishing you continued progress.
jonal ,
I celebrate with you on your good news! It is a well timed Christmas present! You have been on my mind .
When it comes to all these meds , one has to balance the benefits with the risks, a situation I am currently debating in my own
mind. Both of us just came through that decision concerning our surgery. I have eaten yogurt in the past after using antibiotics
and found it helps the gut return to its normal function.
Have a Merry Christmas !
just me
I would like to thank all who posted their info here on HOLEP and other threads here related to HOLEP. It has been very valuable to my husband's decision to have HOLEP done which he did on 12/17/12 exactly a week ago with Dr. Nicole Miller at Vanderbilt Hospital. She was an excellent surgeon and spent plenty of time on his pre-op visit and did a lot of testing, scoping, and evaluating him as a good candidate for this surgery.
We felt vulnerable being from out of state, but her assistant, Jennifer, is easy to access and very helpful. The operation was at noon on the 17th and the catheter was removed the following morning, and he was discharged with no pain, no blood and no leaking! The tissue testing came back in one day as benign. Dr. Miller said she took out 75cc of prostate and left 15cc. The day of the operation he had a little pink in his urine bag, and for the first day or two there was an initial drop of blood at the start of the urine and a slight burning when he peed which only lasted a couple seconds and Doc said was from the irritation of the catheter. He was put on antibiotics for a week. Never needed the pain meds.
One week in and there is still no leaking, no blood at all, no pain, and the only problem is he has to pee every 2-3 hours even at night because apparently the bladder is still in shock, but he has good flow with no stopping and starting problems. He is drinking A LOT of water. The only time he felt mild prostate discomfort was when he sat too long in the car on the drive home, but it went away quickly and as others have shared here, sitting on hard surfaces or for long periods is not good at first.
Will update as time goes by.
Good luck to you all!
lafcadio,
No leaking, blood or pain post op is an excellent result for your husband. 15cc remaining of a 90cc/gm prostate is a good enucleation. The surgeons usually leave about 20%. In your husband's case it is a little below that at 18.75%.
I never had the 2-3 hour frequency, but had bleeding for just over 3 weeks. I still have post voiding pain at 40 days which lasts for 2 minutes. However, I never took any anti-biotics or pain meds.
It is interesting that there are different post op experiences with HOLEP.
just me
Thanks for your good wishes. A Merry Xmas to you also.
I previously composed and sent a longer reply, but it seems to have gone into a black hole.
I am still experiencing the same pain. I have resisted ant-biotics until now, but may re-appraise this if there is no change in the next few days.
All other parameters are really good. I hope yours are too.
jonal,
Thank you for your response and encouragement.
Within in the last 2 weeks I`ve taken 2 road trips With a few minor problems . Something I would not have attempted pre
surgery.
One was a 450 mile trip to see my in-laws who I have not seen in 2 1/2 years. We left directly from the Dr office which was 1/4 of
the total distance. It was very refreshing to see the reaction on the Drs face when my wife and I told her the positive effect The
Drs involved with my surgery had on the quality of my life. All too often, Drs dont receive the thanks due them for their hard labor.
I for one am very
thankful for them, and I have decided to express my Gratitude to them . To my surprise , most of them have stated , they dont
hear it very often.
I find it interesting that many of the top Holep surgeons are women Drs. I am currently under the care of a Woman Dr in
fellowship at a Major medical university . I am very impressed with her.
As I have been working my pelvic floor exercises I have noticed a notable difference in my ability to work the portion controlling
the anal muscles as opposed to the bladder muscles. One of the websites recommended trying to flex the anal portion first , then
the Bladder,followed by releasing the bladder then the anus. In attempting this I am now quite aware of the lack of control Ive
lost with my bladder as a result of my BPH. I`ve got some work to do.
just me
lafcadio,
These are impressive results for sure! Your husbands prostate was 90 grams? May I inquire as to his age?
I am nearly 59 years
and had a 110 gram prostate pre surgery. I was referred to as the young man with the BIG prostate. 92 Grams were removed
and recovered. While bringing another Dr up to date concerning my surgery , I stated how large it was and he appeared very
surprised.
Please keep us posted on your husbands progress . We all have something to share and plenty to learn.
just me
Hello. I am in Canada and the procedure is apparently shunned here. I too am resear4ching but would appreciate some of your discoveries. I will be paying out of pocket. How are you now that you have done it over a year ago? Is Dr. Santos in the US or Spain? Will you please share some information? Thanks
Dear all , Season’s greetings .
I’ve been reading all your comments and experiences with HoLEP , and would like to share with you my own experience as well . I am 64 years old and had a 150 gm prostate . I had my surgery on 24th October – just over two months ago at the London Clinic , London UK, and had posted my initial experience two weeks after my procedure on this site .
Two months post operation I recall the old saying “we don’t know what we’ve been missing until it arrives” .
The 3 main objectives of the procedure : sleep, voiding and erections have all been improving slowly but steadily ;
- Sleep : While I still get up once and sometimes twice to go to the loo, when I go back to bed , I get into a deep sleep. I attribute this to no longer having that irritating feeling of pressure between my legs and around the prostate area.
- Voiding : Complete voiding every time . No more double voiding .
- Erections : I judge my improvement to be around 10-15 % , although no sex yet as will explain below , it is quite promising .
Although the old post ops bleeding is now long gone , I still pee a thin rust colour initial burst first thing in the morning. The rest of the day is a good colour urine , often followed by a drop of rose colour at the end of the wee.
My other major concern at the moment is a faint itching (not nice) sensation starting from the anus stretching all the way to the penis . I saw my GP about it who arranged a urine sensitivity test , which revealed an infection. I went on a 5 day course of antibiotics and did another sensitivity test which came back negative.
However I still have that itchy sensation , albeit slightly less than before taking the antibiotics , my GP considers this to be in line with my HoLEP procedure , especially that my prostate was rather large , ie there is a large inside surface area still in the process of heeling .
The remaining point is incontinence ; For me this is the last of my worries . I have no dribbling or leakage throughout the day or night but I still wear diapers . I suppose I still wear them for fear of urge incontinence as I had a couple of unfortunate incidences when I just had to let go when luckily I was on my way home on both occasions.
So there . This just about sums it all up till now.
Your comments will be appreciated.
Happy new year .
Hamzamale