Just wondering if anyone had blood in his stool after HoLEP. The HoLEP operation is on the prostate which is not connected to the rectal colon. I could not think of any reason why HoLEP should cause bleeding of blood in stool during bowl movement.
It is very surprising to me that HoLEP seems to have improved or resolved my chronic constipation. One possible explanation is HoLEP caused the prostate to shrink so that it is no longer pressing on the rectal colon.
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This my week 6 after holep. Nocturia seems to have reduced to every two hours instead of every hour. Urine stream appears to be stronger than 21cc/sec Peak. According to the literature, it will take 3 months for outcomes to reach maximum.
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Blood in stool turned out was due to hemorrhoid inflammation. Was just given hydrocortisone cream to reduce inflammation. Seems to be very effective.
After 7 weeks, Nocturia is reduced to two times nightly as oppose to 5 times. I also stop drinking water 4 hrs before going to sleep to help to reduce pressure to urine; Other than that no other complications except retrograde evacuation.
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It is great that your nocturia is improving. Most nights I’m only up once. I’m up more often if I drink a lot of water late in the day.
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Brief Update On 11 Month HoLEP Follow-up Visit With Dr N. Miller;
This post is delayed because my life has been rather chaotic recently and I lost my notes from the visit. So I will try to provide something from memory.
One of my big concerns was my PSA, since I do not have a hometown urologist. At my 3 month post op visit I found I was unable to discuss my PSA result with Dr Miller since the lab specimen was not drawn until the time of the doctor visit. So this time I asked to have the specimen drawn the day before so that the result would be available for my doctor visit. This worked out very well and I recommend it. My PSA was 0.72 so it was of no concern.
My other big concern was my seemingly diminished urine flow rate since surgery. I had not only noted a decreased rate when urinating standing but also a significant difference when urinating while sitting. My subjective suspicion was confirmed by a new flow rate test. Unfortunately, I have lost track of the exact numbers. However, I know the my initial flow rate was in the 32 range. This time my rate was down to 13.4. Of Note: I have no incontinence issues; I am able to void without interruption; I feel empty after voiding (and this was also confirmed by ultrasound after the flow test); and I only have to get up once or twice during the night to void. I have been particularly concerned about flow rate status because of the type of surgery that Dr Miller does, where she leaves a little tissue in the area of the urinary sphincter. From the beginning I was concerned that this might cause problems down the road as the tissue enlarged.
What I was told by Dr. Miller: 1) Flow rates decrease during the first three months post-op and then level off. I personally have found that my flow rate has continued to seemingly decrease. 2) The doctor does not consider flow rate an issue until it gets below 10. If it goes below 10 then another cystoscopy is done to see what is going on. 3) Dr Miller claims to have never needed to re-operate due to decreased flow rate. 4) Dr Miller overall seemed to be very satisfied with her surgical results.
So I elected to follow up with Dr Miller in 1 year time since I do not have a hometown urologist and I wish to have both flow rate and PSA monitored by her for the sake of consistency and the fact that I think she is an excellent urologist. If I had to have any further treatment in the future I would once again choose HoLEP by Dr Miller as I have total confidence in her knowledge, skill, and bedside manner.
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We are fortunate that u had time to write ur update. I am also worry about flow rate. For the last severally weeks, I have also noticed that my flow rate had significantly reduced, but don’t have a Qmax measurement to prove it. I plan to bring this up with Dr. Das.
Dr. Das told me that after holep there is 5% chance of scar formation at the bladderneck or in the urethra.
However, I don’t know if the scar will block the urine flow or just reduces it.
Qmax measurement is quote common. If u can find a local urologist, u can get it done sooner.
A Qmax of 10 means urethra is severely obstructed. A Qmax reduction from 32 to 13 could mean something is blocking the urethra.
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Unfortunately the local urologists in my area, and also the local hospital are back in the dark ages. They don't even want to hear about HoLEP or anything else other than what they are familiar with and that makes the most money for the least investment.
Originally I had to find out about HoLEP and do all the research myself. That is when this forum came into the picture and was so helpful.
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I haven't checked in for a while so I thought I'd touch base. I'm now 6 months post HOLEP and am doing great. I still have to go once or twice at night but it's easy. I have no incontinence and my PSA which was over 10 is now 1.5. It was really worth it.
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I am one year out from my surgery. I am continent and can pee like a race horse. In the gym I might pass a drop or two under some conditions. Most often I am up once a night, twice if I have a lot of fluids. I will never be happy with the side effects.
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I had my Holep two years ago. It took me a year or so before I was totally continent. I give public lectures a few times a year lasting one to two hours and for those I still wear a pad, but it's just for reassurance as I've never had a problem during my lectures. I get up on average twice a night but it may not be due to urinary reasons, though when I do wake up I get up and pee. I have no trouble peeing, no pain, no discomfort. Since I am no longer sexually active, retrograde ejaculation doesn't concern me. I am 81 years old and in generally good health. I am happy with the results of the surgery.
This is a good website. It's good to hear from people who have similar situations and to learn how they have done with this surgery.
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