Experiences with Holmium Laser Enucleation of the Prostate, HoLEP, Laser Surgery

Glad most posters here haven't had any issues, or very minor ones! I have come to accept that I am in the 15% of HoLEP patients that will have Incontinence following surgery. Hopefully it is transient and will gradually go away within the next 3-4 months. That is what Dr. Das is saying, as well as many posts here have indicated. I guess I just wasn't really prepared to be in the 15% and experience what I am experiencing, which is total incontinence with no control. That is my fault...... but I think something everyone considering this surgery needs to think about. I would rather be self-cathing 5 times a day (like I was pre- HoLEP) then constantly leaking and worrying about managing that, especially since I travel a lot with customers. As long as the IC improves with time I think I will be fine (and thrilled with the end result) but it is very frustrating now. Thanks all.... I will get through this!

So sorry to hear this klink. Really hoping you'll get thru this sooner rather than later. I m sure dealing with this is daunting. I wonder if in your situation, the fact that you had to self cath so much prior to surgery contributed to the IC you are experiencing today since you weren't voiding normally (as much as any BPH sufferer can) for a while? Just a thought as to why this may be happening to you (muscles we use during urination weren't getting exercised much due to the self cathing). In any event, keep doing those kegels, and know that we're all behind you here, pulling for you, and hoping for the best!

I'm 58 years old and have been on Flomax then Jalyen for over 10 years and I'd finally had enough of the drugs and the limited relief they provided. I Had HOLEP on 11/27/17 by Dr.Nicole Miller at Vanderbilt. Spent one night in the hospital with catheter in and was released the next morning after catheter removal and urinating a few times on my own. I was back at work on the 29th but I have a desk job. No leakage or control problems from the start so I guess I'm very fortunate in that respect. I'm still a little ways from feeling 100%. A little more tired that normal and I've had a few slight headaches. I think it's more from the anesthetic than the procedure but probably a little of both. The first few days I was urinating a lot but It's more normal now and the stream is like I'm in my 20s again. I only had to get up once last night. Still too early to comment on erections or retrograde ejaculations as they say not attempt sex for at least 2 weeks. My takeaway so far is that I wish I had had HOLEP years ago.

I just posted this today to the general site. Dr. Miller is the best.

I'm 58 years old and have been on Flomax then Jalyen for over 10 years and I'd finally had enough of the drugs and the limited relief they provided. I Had HOLEP on 11/27/17 by Dr.Nicole Miller at Vanderbilt. Spent one night in the hospital with catheter in and was released the next morning after catheter removal and urinating a few times on my own. I was back at work on the 29th but I have a desk job. No leakage or control problems from the start so I guess I'm very fortunate in that respect. I'm still a little ways from feeling 100%. A little more tired that normal and I've had a few slight headaches. I think it's more from the anesthetic than the procedure but probably a little of both. The first few days I was urinating a lot but It's more normal now and the stream is like I'm in my 20s again. I only had to get up once last night. Still too early to comment on erections or retrograde ejaculations as they say not attempt sex for at least 2 weeks. My takeaway so far is that I wish I had had HOLEP years ago.

Yes the experience was as good as expected. The facility is undergoing a lot of construction/renovations and was extremely busy when I went for my initial appointment and for the surgery too. Both Dr.Miller’s staff and the hospital staff were very efficient, caring and comunicative. Overall it was a good experience and I give then high marks. Vanderbilt was a closer option for me thanIndiana or Mayo and the fact that Dr. Miller has done so many HOLEPs was a big factor. She has a great bedside manner and really made me wife and me feel at ease.

Hi
After 12 weeks had holium laser surgery and now i have pain in bladder after ejaculation and urgency
Please tell me why

WILL IT GET BETTER, I WONT HAVE PAIN AFTER EJACULATION ON MY BLADDER AND FREQUENCY FOR DAYS AFTER

I am now three weeks post HoLep and still experiencing incontinence. Good news is I am now experiencing some urges to urinate on my own and and I am encouraged by that. I am getting the urges when sleeping especially and am able to just make it to the bathroom and pass on my own. To some degree this is happening at times during the day as well. Yay!
Just did some travelling and the IC is really burdensome, having enough pads with me to make it through the day and flying hasn't been pleasant. I hit the 21 day post surgery marker Monday, and have passed some chips both on Monday and thru today. A little burning at the end of urination. Doing the kegels and thankful for the small forward progress, and hoping it continues!
I am home today and it is much easier to manage all of this. Travelling with customers is not an ideal way to handle this but that is what my job requires. I am drinking endless amounts of water today in the hopes of getting my bladder to re-learn how to operate, and am seeing some movement in that direction.
Thanks to all for your support guys, and I will continue to update as those before me have. And Blayneb, good luck next week with Dr. Das!

Thank klink! Glad you're seeing some incremental improvement. Really hoping it continues. Got the call today for my Monday surgery and as with you, will be reporting at 6 AM. Thanks to you I know just what to expect. Got my pads and stool softeners and doing many kegels, and am just hoping Dr Das will not run into the possible complication with the length of my prostate (that may require an incision - fingers crossed)! Continued good wishes to you and I will update all next week.

I had a dull ache occasionally prior to my HOLEP. Nothing remotely similar since then, though.

Good luck with your surgery.

Here I sit in my hotel room in Philly, roughly 29 hours after having HoLEP performed by Dr Das at Jefferson Hospital. I won't go into a long description on the surgical experience since Klink did that earlier superbly, and his pretty much mirrors mine. I will instead discuss my situation and my post-op experience.  Dr Das had warned me that due to the apparent length of my prostate that he may have to make an incision as in a prostatectomy since it may be too long for his instruments. Luckily this turned out not to be the case. Dr Das informed me that he removed as much prostate tissue down to the capsule he could reach which turned out to be about 140 grams of my 200 gram prostate.(70%). He said the procedures went very well, they had some difficulty getting all the tissue into the bladder for the morcelator, but in the end succeeded. He also said my bladder is in good shape and all in all he expects a good result.

I spent the evening and night having my bladder flushed and bags changed hourly (and almost no sleep) but this morning I still passed several large chunks and was not able to leave with a catheter until about 2 pm after Dr Das's team was satisfied with the color of my urine and lack of further chunks (after Suzanne from his staff manually irrigated me earlier in the day). I was given RXes for Colace and Sienna for constipation (I have only gone once this morning, very sparse and hard even though I started taking my own stool softeners on Sunday). Also taking Bactrim to ward off any infection from the catheter. I am set to go back Thursday to have the cath removed and Dr Das wants me to stay until Friday catheter free just to be sure everything is OK before I make the trip back to DC. For now (5:30 pm EDT) my urine looks fairly clear in the cath making me optimistic things will be ready for Thursday, I will hope to be peeing freely and not have a lot of incontinence since I have done kegels for years, but this will be the next hurdle I will report back, probably Thursday evening.

And btw the entire staff at Jefferson were all top-notch, caring and very personable, especially Sen, Diana and Joe my nurses and Dr Das's team of MDs.

My good holiday wishes to everyone here! Anyone have any questions please fell free to ask.