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

Dear ceder88,
I'm scheduled for surgery In Dec. with Dr. Lingeman.
However I'm very concerned over the chance, (10% short term and 2% long term) of ending up with urinary incontinence.
How did you go ahead with HoLEP with this as a possibility?
It makes me feel like canceling.
Thanks,
Fiddler

I am a 64 year old man and had a 150 gm prostate . I went through all kinds of medications for ages with little or no results . At the advice of my Urologist, Professor Roger Kirby , I eventually had my HoLEP on 24th October 2012 at the London Clinic , U.K. , performed by Mr. Ben Chalacombe , consultant at the Prostate Center , London.

For the benefit of all my fellow BPH sufferers, I want to make it clear that at the end of the day a surgery is a surgery . It is not a walk in the park. Yes all went quite well , and yes I did have the catheter removed next day, and yes I did go home a day later (2 nights in hospital) , it remains important to state somewhere in these lines to expect different levels of pain and burning urination and blood in the urine for the first 2-3 weeks .

I am now (16 days later) just beginning to reap the results . Much improved erections (no sex yet) , and much improved flow . What more can I ask for ?

My advice is don’t drag your feet . Consider HoLEP .

Dear Fiddler, 

   I Had Holep surgery performed by Dr Lingeman about 3 weeks ago. 

I must say the Dr and his staff , and the staff at Methodist  Hospital were wonderful!

The first 2 days I was completely incontinent but I have been improving rapidly.

I have complete control now through the day and night under resting conditions.  

I returned to work after 2 weeks off.  I am still experiencing stress incontinence due to the constant bending, twisting and lifting

that is involved  with my job , but It is improving.  I had a very large prostate before the surgery and I know it will take some time

to get back to normal. 

  I am so pleased with the outcome of my surgery. 

  I would encourage you not to cancel and go ahead with your appointment.  If you have Dr Lingeman as a Dr , You will not find a

better one.

just me

 

 

Thanks so much for your reply. Just a few more questions. Does the day of your surgery and the following day in the hospital qualify as the two days you were completely incontinent? Or were they the day the catheter was removed and you remained in the hospital, plus the day after when you were released? I'm scheduled for surgery 8:30AM. I'll there that day and the following day in the hospital. I'll fly back home the 3rd day in the afternoon. I'll be in the air 2/1/2 hours. I'm concerned about travel under the constant anxiety over being incontinent under these travel conditions. On your flight back were you still incontinent? Finally, how large was your prostate? Mine is 70-100. I appreciate your sharing your experience. Thank you. Fiddler

Dear Just Me, Thanks so much for your reply. Just a few more questions. Does the day of your surgery and the following day in the hospital qualify as the two days you were completely incontinent? Or were they the day the catheter was removed and you remained in the hospital, plus the day after when you were released? I'm scheduled for surgery 8:30AM. I'll there that day and the following day in the hospital. I'll fly back home the 3rd day in the afternoon. I'll be in the air 2/1/2 hours. I'm concerned about travel under the constant anxiety over being incontinent under these travel conditions. On your flight back were you still incontinent? Finally, how large was your prostate? Mine is 70-100. I appreciate your sharing your experience. Thank you. Fiddler

Dear Just Me, Thanks so much for your reply. Just a few more questions. Does the day of your surgery and the following day in the hospital qualify as the two days you were completely incontinent? Or were they the day the catheter was removed and you remained in the hospital, plus the day after when you were released? I'm scheduled for surgery 8:30AM. I'll there that day and the following day in the hospital. I'll fly back home the 3rd day in the afternoon. I'll be in the air 2/1/2 hours. I'm concerned about travel under the constant anxiety over being incontinent under these travel conditions. On your flight back were you still incontinent? Finally, how large was your prostate? Mine is 70-100. I appreciate your sharing your experience. Thank you. Fiddler

Dear Fiddler,

       My surgery was at 4:00 in the afternoon.  I was in my room by 8:30  ,  4 1/2  hrs later.  I had a real meal an hour after recovery.   My catheter came out at 4 am .  There  was no pain when it was removed .  There was no pain to speak of as a result of surgery! If you have Krystal as your nurse , You have a GOOD  one .  The nursing staff was GREAT!  My Prostate was 110 grams,and I am 58 yrs old.  I was released to go home when I urinated the second time.  I was in the hospital about 23 hrs. 

   The catheter was removed at 4 am . 2 !/2 hours later I urinated.   The Flow was amazing!  I am a grown man  and I almost cried for joy !  I had experienced acute retention 70 times since July 2  and was self cathing twice a day per Drs. orders, plus cathing when I was experiencing acute retention.   That is all behind me now!

   The hospital supplied several absorbent pads that were very effective .  The pads were made to be easily replaced without removing any clothing , a plus in a small airplane restroom.  I had a 3 hour ride  in a car and  it took care of me very well.  You should have no problem , just make sure you have some extra pads available  in case you need them.   

  I am currently using a male guard Pad and a Depends  as a safety , but the depends  has not been wet yet , and I am very active at my job. 

  I encourage you in keeping your appointment .  

  I am glad to be of help to you. 

  just me

Dear Ceder88, A member asked you "Why did you choose Dr. Lingeman instead of the Dr. Amy Krambeck at the Mayo Clinic ?" to perform your holep surgery. And I never saw your reply. Could you respond? Thank you.

Dear fiddler,

  I saw this post this morning and thought I would respond to it. 

I am sure you will do well with either Dr Lingeman or Dr Krambeck.

Dr Lingeman brought this surgery to the US from New Zealand . He is the most experienced surgeon of Holep in North America.

He is not only an excellent surgeon , but a world renowned teacher as well.

Dr Krambeck was a Student of Dr Lingeman.   I am confident you will get very good results from either one  of these excellent

doctors.

just me

 

 

 

Hamzamale,

I am having continuous ongoing bleeding problems 11 days post HOLEP.  I note from your last post that you mention bleeding for 2-3 weeks.  could you please elaborate on your experience?

My expectation was for bleeding to stop within 4-5 days, and most of the experiential feedback and information on the web seems to support this.  I am therefore a little concerned that my bleeding is continuous, ongoing and showing no sign of lessening.

Dear Hamzamale,

I'm scheduled to have Holep soon and I'm seeing my urologist tomorrow.

I'll ask his opinion about your your experience and see what he says.

May I ask where you went for your surgery?

Thanks,

Fiddler

Hi,

I am Jonal, but I think your question was addressed to me.

I had my HOLEP done in the UK.

If you have chosen an experienced surgeon, then I can fully recommend it.  It is only day 11 and I am already pleased with the result.  I have good frequency and am only getting up once at night.  My flow is good and no incontinence.  My only problem is continued bleeding, and it is not reducing.  Hopefully it will stop soon.  I would have liked to have other personal experiences concerning longer bleeding time for reassurance.

Good luck with your surgery.

 

Jonal,

  I had my surgery a month ago.  My bleeding had stopped  with the exception of the rusty brown urine. I did experience some pretty heavy bleeding about 5 days ago after rearranging some objects in my garage.  It did stop after 30 minutes. If you are experiencing continuous  bleeding this long , I would contact your Dr.

just me

just me, Thanks for your post. Was it HOLEP you had? How many days did you bleed continuously for, after the surgery? Every time I urinate, there is a spurt of bright red blood at the beginning. My urine with the blood is the colour of a quite red rose wine. I have also just started experiencing small clots. I don't know if this is a good or bad thing. Does it indicate a response to increased bleeding or my system trying to stem the flow? My problem is that the hospital where I had the surgery is almost 500 miles away and the doctors locally are not familiar with HOLEP. I sent the surgeon an e-mail on Saturday and hopefully he will respond on Monday.

jonal,

 Yes I had a Holep as well.  I experienced the same situation .  I had urethratomy ,an interior incision of the urethra. This made the urethra larger in diameter to allow insertion of the resectescope  and was a safeguard against strictures .  Did you have a urethratomy?   The initial spurt of blood is what was in the urethra from this incision and flushed out by the urine. This took some time to heal. At the beginning of every void I would pass some blood. I contacted the surgeons  Nurse by telephone  and she assured me that it was normal.  She  also informed me it can take 3 months for the interior of the prostate to  heal. It is normal to pass small clots , rusty colored urine ,scabs ,and blood. I passed a considerable amount of blood a month after surgery after some heavy lifting and I passed some small clots today.

I am also experiencing some minor discomfort  each time I urinate. The nurse informed me the nerves from the raw surface of the prostate radiate up to the bladder and at times through the urethra to the tip of the penis. I had a concern the incision was not healing properly.  Fortunately that is not the case. 

If you still have concerns I would contact the surgeons office and express your concerns to them.  

I hope this helps.

just me