I am really excited that you had such good results with Dr. Miller! Of course, I was a bit apprehensive about giving such a strong recommendation of her, but it seems that your experience was very similar to mine. Congratulations!!!
The six week follow up is a short visit (probably an hour --- maybe two at the most). It involves a flow study, a residual check, an interview, and labs. I strongly suggest that you request to get the labs done Before the visit so that you can discuss the results with Dr Miller when you see her.
For others --- yes - you are right - Dr Miller leaves a bit of prostate tissue around the sphincter which assists with the incontinence issue. I hope she is doing a study of the process that will result in it's widespread use by other doctors.
Again --- congratulations and take care while you recover.
You have been such a great help, in making me go with Dr. Miller at Vanderbilt.
I am very happy with my results. My pathology result was also good , no signs of cancer, in the pieces which was sucked out. I guess that does not rule out cancer in the outer parts of the prostate, where cancer usually starts.
Did Dr Miller do a DRE on you at your 6 week follow up? Or is that not important to do after the HoLEP surgery? Did Dr. Miller take the Psa test on you before the surgery or only at 6 week follow up?
Yes I wish I could go a day before to take the tests, but it is not possible for me to do. I had two people looking after my dog when I was gone, I just dont want to ask them again to look after my dog.
Sunshine:
No DRE at six week check.
No PSA pre-op by Dr Miller. She accepted others that had been done previously.
PSA done at six week check is done to establish a new baseline. She said: Thereafter any doubling of the PSA is considered cancer until proven that it is not.
I suggest you try to get your labs done at Vanderbilt before your appointment that day, after you arrive (same day). Ask them if that is possible. The turn around time should be pretty quick and it would be very nice to be able to discuss the results with Dr Miller when you see her.
Again, congratulations. I am so happy that you had a very good experience.
I thank this site and those that contribute for helping to make it possible.
A guess Dr.Miller didn't want to do the DRE. so short time after the HoLEP to not aggravate the prostate. If the PSA is the new standard for finding out about if having prostate cancer, there maybee is no need to go to the Urologist, but only buy the PSA test kit on the web. You mentioned in an earlier post that you had used PSA test kits before and it was quite accurate.
I am going fly in earlier that day of my 6-week appointment . My appointment with Dr. Miller is 3 PM, I should be able to be at the clinic at 12Pm, I hope that will give me time to take the tests before seeing Dr. Miller.
So how are you with your healing? Are you getting back to normal activites?
I am doing very good, walk about 2-3 miles a day with my little dog.
After I did my six week checkup I also did a PSA test with a kit (ZRT) ordered over the web and it correlated perfectly with the PSA done by Dr Miller. That probably would work fine for you unless the value went over 4 --- in which case you probably should see a doctor. Reason: The kits do not provide PSA ratios which are necessary for values over 4.
I am back to normal. No problems. I have resumed all normal activities -- some of which are rather physically strenuous. My urination easy and strong. But honestly, I feel that sex is not what it once was. I have no problems in the performance department but the pleasurable ejaculation sensations are not what they once were. That said --- my wife came right out and said that she appreciates the fact that there is less of a mess afterward. I guess I should be happy that at least I can still do a good job satisfying her.
I just had Holep Surgery last Friday 3/23/18. It is now 7 days after surgery. I have this feeling that I have to urinate all of the time even though there is little urine stored in bladder and little urine expelled. So, I urinate every 30 to 60 minutes. I do not wait until my bladder tells me it is full as I am trying to drink lots of water and drain things. I had some urgency at times.
How much water should I be drinking as I enter the second week?
Does anybody know what causes this feeling that your bladder is full and have to urinate all of the time after Holep? One surgeon said that it is caused by the bladder sphincter muscles and surrounding tissues that have been damaged or irritated during surgery. So, it is that irritation that causes the false sense of needing to urinate.
Also, at the end of urination, I feel pain and bleed a little. Once again, I was told that this is the irritation or the bladder sphincter muscles.
Have any of you guys experienced these things after Holep and what causes them? How long do they last? When can I expect to feel better as I get little sleep with this uncomfortable feeling?
Thanks, Ray
I had bleeding a week or two after surgery but no pain. I have been told I have a high pain tolerance.
As for the urgency I don’t think I can help.
LOL, with less mess as your wife said, but you are losing the sensation with the ejaculation. I had retrograde ejaculation before the surgery, because of finasteride and tamsulosin. So in my case it would not be be different.
I will order that test kit on the web, to see if it correlates with the PSA test at my six week follow up.
I am glad you are back to normal, beside the negative feeling about sex.
I am feeling great, I am so thankfull I can pee like normal again, and still no blood or incontinence after the surgery.
Take care Philip.
The day after my surgery when I left the hospital I could only urinate very little. That night I was up every hour or 2 hours having to urinate. The next day was almost that bad. I was just about ready to go back to the hospital and have them insert another cathiter when I went to the bathroom and peed and out came a large blood clot and after that during the next few days little smaller ones. I saw blood every time but I take blood thinners.
I’m into my 3rd month now and everything is going good. I’m wearing pads still but don’t know how long that will continue so I just take it day by day.
When you go back for your check up tell the doctor what you are going through.
Drink as much water as you can take because it helps to clean you out. I hhsve not experenced the exact that you have only similar ones
Good luck with your recovery and I hope I helped.
Don.1
Ray, I'm sorry you're having urination problems. I have several thoughts: first, you're only 7 days out of surgery. It's not uncommon to have incontinence problems for up to several months after Holep surgery. So there's hope that time will improve your situation. Also, are you doing kegels? They are recommended for us who've had Holep to strengthen the sphincter muscles. It sounds as though they might help you. If you're not famiiar with them, search kegels for men (they're also used by women who have leakage problems). Most post-Holep men have some bleeding on urination for one or a few weeks, sometimes with pain on urination. Usually these disappear over time. If they don't, you should talk to your doctor to see if there's some problem you need to address. By the way where and with whom did you have the procedure?
Hope that helps,
Learner
Hi Ray. I had Holep 3.5 months ago with Dr Das in Philadelphia. I was told to NOT over drink and just drink a normal amount, no more or less. I am still seeing some bleeding (usually only with strained bowel movements) and sometimes at the end of urination still, but my local urologist (who I saw Wednesday) told me this is normal and nothing to be concerned about. I had a "massive" (in his words) prostate (150 grams) and with the amount of tissue removed it simple takes time, but all will heal. I still have stress and urge incontinence which has steadily improved over time, but is still there which I manage with light duty shields (change 2 or 3 times a day max) and he also said this is normal and that kegels are A MUST and that I should do them as many times a day as I can, standing, sitting, whenever, wherever and that they will really help things improve. From there on it is just patience. Good luck to you and I'll be glad to answer anything else if you wish.