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

Don't be Ron - I'm a "scaredy cat" and that was my first time as an inpatient since I was 7. The catheter will be annoying for a few days but you go home the next day. Unless you have heavy lifting at work you should be back within 6-7 days. Just know that when catheter comes out you'll want to pick up a package of "guards" to go in your underpants for maybe a month in case of urges. I used CVS or Rite Aid brand (53 , I think - for less than $11.) and they are really comfortable. 

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And come back and keep us posted. !

Steve

What is the name of the doctor that you used? I live in West Palm Beach Florida and am having difficulty finding a doctor that is experienced in holep surgery for the prostate.

Hi Mike: I can't remember if it was Jonal or Just Me who used Dr. Lingerman (he'll reply I'm sure). I used Dr. Akhil Das at Jefferson in Philadelphia (who taught Dr. Lingerman the technique and speaks highly of him). One of the two may know someone in Florida. It is an overnight procedure so - if you had to fly somewhere - it wouldn't be long. I was going to post today anyway. Saturday was six months since my surgery and I'm, basically, fully cured. Up once a night and only a rare urge during the day if I drink a LOT - but that's the case with everyone.no matter the age. I do empty. HOLEP is a blessing for me. I fell like a "poster boy" for it. Steve

Hi everyone.

Some time has passed since I last posted on the site.  I thought it was time for me to update my post HOLEP experience and to hear how others are progressing.

It is now 7.5 months since I had the HOLEP surgery.  I will say from the beginning how delighted I remain in the success of this procedure.  I still marvel at the force of my flow every time I pee.  All my other urinary functions are absolutely excellent.  I no longer get up in the night and I can generally retain urine for as long as I want to.  I can bypass toilets without having a precautionary pee when I am out and about, because I no longer feel uncomfortable, and I know I can hold it even until I get home an hour or two later.

I hope all you HOLEP grads are making/have made similar progress.

I remain very interested to know what your respective psa levels are.  As I have said before on this thread, it is important to continue to monitor your psa level.   See here:  http://www.ncbi.nlm.nih.gov/pubmed/19773035  Having undergone HOLEP does not make you immune from PCa.  My psa level 3.5 months post HOLEP was 0.8.  You should receive one every 6 months in the first year post HOLEP, then annually.  My next one is due in August, but it will be at my own instigation.  Once you have had a successful HOLEP many doctors don't want any more involvement.

Let me know your psa level post HOLEP.

Best wishes to all.

Jonal

 

PS I am in the UK and received treatment from a UK specialist who trained in N. Zealand.

 

Hi Steve, I thought I had updated you a few days ago but don't see my reply. So, here is new update. I had HoLEP surgery at Mayo Clinic in Phoenix on 6-12-13. My Dr. was Dr. Humphreys. I have researched and also been told he is one of the best in the country and has performed over 600 HoLEP operations. I only had a catheter in for one night. The Hospital and it's NURSES were excellent...could not have asked for any better care and concern. They all were there to make you as comfortable and calm as possible. I had blood and pain for the first 4-5 days but now only minor irritation, no blood, and no pain pills since day 5. I am extremely happy with the results so far!! I am only getting up once per night (used to be 2-4 times), my stream is forceful like 30 years ago. My only issue, which I have been told will take some time, is I have occasional urges and need to go to bathroom asap! This will calm down according to my DR., as my bladder was very irritated by the operation and years of having to really push to get urine thru my enlarged prostate.
Mike, There is a Mayo clinic in Jacksonville, FL and was told they do Holep operations there. Do not have any Drs. names.
Ron

Hi Ron: That's great news. Maybe I can help with the other issues since I went through same thing (the day urges). Take as many of the following three steps as you can:

First, go to your local CVS or Rite Aid and buy a package of MEN'S Shields. They are small pads that fit easily in your undershorts and you won't feel them. i never really needed them though I wore for about 3 weeks when I left home. But i knew tyhey were there just in case. A package of 53 of them should cost less than $9.99

Ask your doctore for 4 week supply of samples of Myrbetriq (Mirabegron) 25 mg extended release for urges. It's expensive but the samples got me through - if you can't get samples from your urologist, you can pass on this.

Third is to do Kegel exercises twice a day. I couldn't understand how to do them right - despite resrearch and (since I have Medicare) Dr. Das suggested I meet with a Nurse who would use biofeedback to show me how. It worked and I was able to do them. It will stop the urges.

I think the rest of us who have been meeting here can attest that the one think that you need to realize when you have this is that -even though you will sleep beautifully at night (it's when you stand up that you need to urinate) and the blood stops quickly, it will take just under 6 months until those urges go away. But when they do, it's heaven. Go get the pads (yes they will absorb if needed) and check on the sample pills. And give us weekly updates if you can. That's why we are here

Hi Steve, Thanks for all the additional information! I have bought the pads and they do seem to work well. I see my Dr. in a coupe of weeks and will ask about the pills. I also was told about the Kegel exercises and like you do not think I am doing them correctly. I will ask my DR. about doing biofeedback too.

Will stay in touch and Thanks again for all your insight and past experience.

Ron

If you have not had your treatment yet please check out the Prostratic Urolift procedure.  They are doing a clinical research study and they are recuting for canidates right now in several cities.  Look up Jean Brown Research and contact them.  Look at the info on line.  This is an exciting procedure and if you get into the study it's basically free.  I wanted to do it but I do not live in a city that is doing it. 

Hi Mike Kitaeff.

I had surgery with Dr Lingeman in Indianapolis . 

If you are having trouble finding a surgeon in Florida consider a trip to Indy.   A previous contributer  to this site flew in from

California and flew back 2 days later with no problems.  Please dont compromise travel convienence for a less experienced Dr. 

just me

Hi jonal,

Good to hear from you!

I had my 6 month in April and passed with flying colors!  Dr Lingeman said I didnt need a PSA test untill my yearly check in October as my number was so low.  I will post the results to you when I have my next one.

I took the  urinary survey, again, and went from a 26 {severe } to a 2.  There is still a very minor amout of leakage due to stress

incontinence.   

Dr Lingeman declared with a big smile, and handshake," Your Fixed! "

Several of my friends and coworkers are going through the BPH stage .  I have become very vocal about the  positive impact this

surgery has had on my life.  Ive even had some open conversations with some of my female coworkers and friends who came to

me because of their concern for their husbands.

It was a year ago July 2 that I went to the ER . It was my 2nd trip in 6 months  . 

I am very thankful to my Urologist for referring me to Dr Lingeman.

just me

 

Dave,

Look into Prostatic Urolift procedure. They are doing some clinical research studier at Jean Brown Research. The procedure looks safe and effective with a lot less recovery. But you might heve to travel to one of the places they are doing it.

Hi Just Me:
I second your opinion--I am 5 months post HoLep with Dr. Lingeman.
No pads ever; no incontinence, no leakage, some bleeding initially and through out the healing stage (scabs through the urine), but overall an excellent result.
I feel like I am just starting to appreciate the benefits.
Bill in CA
Yes, flew back one day after release and had no problem on the airline.

Wow amazing news- Thanks

Can anyone tell me what the RE feels like. I am scheduled for the HoLEP but I am really concerned about the RE. Is is less enjoyable? Does it take long to get used to?

Hi  Bill in Ca,

   Good to hear from you as well.  I cant say enough about the GREAT care In Indianapolis. 

It amazes me you had no issues with  incontinence at all.  I still have very minor leaks with stress incontinence.  I am not yet retired and I have a streneous job. 

 Kegals are still a part of my exercise routine.

I have no regrets at all about my surgery .  So thankful my Urologist reccomended Dr Lingeman .

Just me