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

I am wondering if somebody who had HOLEP more than 1 year ago still reads the forum. If you do let us know. We all want to know what to expect long-run

Thanks

SiS
I generally go on 4-hour hikes. I have a feeling you have more IC than I did because I'd never fill up a Heavy Duty pull-on in that time period. On days I went for 6-hours I'd bring a couple of extra pads and insert 1 as needed into the pull-on next to my junk so that got filled up first, and brought a zip-loc for the pad(s) if it(hey) got saturated. Not ideal conditions but after 5-months I don't bring (wear) anything at all anymore regardless of the distance. My wife and I are going to Cancun tomorrow and there'll be plenty of walking but I'll only bring a couple of Depends (CVS equivalent) for night-time activity. Your surgeon probably told you that the prostate capsule will close (cave) in over time as surrounding organs adapt to less resistance from the prostate. I can already feel that happening. Not sure how, it just feels like it.

Looking to do 183-miles on the Pacific Crest Trail in late August preceded by a 104-mile hike from Logan Pass in Glacier NP to Waterton, Alberta and back. Retirement is great. Now if I could only get my wife to retire . . .

Have a Happy
JD

One month since my surgery I am doing ok, exept still having IC. Strangeliy I don't have any urges and can sit quite comfortably for hours, but as soon I start woking it starts leaking. Feels like my sfincter doesn't close completely. It usually starts in afternoon and more I walk worse it gets. When I go to bathroom after walk there is almost nothing left. I am wondering if somebody had similar expirience. I was warned by the doctor of strong urges, but it is not like that. I ma doing Kegels three or four times a day, is it enough?

 

Hi Sleepless (and others). FIRST let me wish those who celebrate Christmas, a Merry Christmas (and a belated Happy Hanukkah to those who are Jewish). And to all a Happy New Year. It's now one year plus two days since my surgery! (and yes, I'm still subscribed!).
Sleepless, I found kegels helped in moring and night. Did you do a biofeedback to make sure you are doing them correct. MORE importantly, it is ONLY one month since your surgery. You can get concerned about IC after 3-4 months but it's still too early to have them stop.
Hang in there! What's a few months when you'll have YEARS of healthy life ahead of you!
Steve

Thanks Steven. Happy holidays to you too. It's great to have you on the forum. Conversations with you and others helped me a lot in making decisions about the treatment, and I hope my experiences will be useful to others.
I am doing kegels three times a day, morning, lunch and evening, about 10 repetitions. I am seeing my urologist in two days and will ask him about biofeedback. You are probably right, it's too early to panic about IC. I was warned that my bladder became too thick after many years of obstruction and may act out. But my IC is caused not by overactive bladder but rather inability of sphincter to hold urine. I am wondering if it was damaged in the process. Hopefully time and kegels will help. Anyway I have no regrets, at least not yet. Given my conditions before the surgery there weren't much choice.
I am able to go to work and elsewhere wearing pads and change them 3-4 times a day.

Hi Sleepless,

I am still on here. I had my Surgery a year ago in October. Everything is doing very well.

I still have minor stress incontinence . I am still working a pretty streneous job. I go through 1 pad in a 24 hr period. No leaking at night or when resting.  While Deer hunting this year I had to go outside.  Just for the fun of it I tried to see how far away I could  urinate . With a nice arch, I could reach 10 ft!  I dont pee on my boots any more!

Just me again

Hi Just me!

You made my day! I just got up off the floor after falling off my chair laughing, when I read your last sentence.

 

Hang in there and happy new year.

 

Steve

I hoped to lose the pads sooner, but shooting 10 ft makes it worth. How was your aim?

I am coming up on 1 year post HoLep with Dr. Lingeman at Indiana University--never used a pad--ever--

I pee very well and wake up usually once per night (sometimes sleep through the night).

There is RE; but, that comes with the territory. 

I am quite pleased with the result and am grateful to Dr. Lingeman & Staff--he is excellent.

I recommend Dr. Lingeman at every approporiate opportunity.  Bill in CA

Hi sleepless,
My aim was pretty good in spite of having a Urethraotomy. My urethra needed to be enlarged to accomodate the resectescope and prevent againts strictures. These type of tissues do not bond back to themselves well,so I have a larger diameter Urethra than I did pre surgery. I have a lot better aim now compared to pre surgery ! The presurgery dribbles were not very accurate.

Hi Steve,
Glad you got a good laugh out of that! It is true! I strained to push it out just to see how far it would go. I am so thankful ,to be where I am now, compared to presurgery. I have shared my story with many of my pee challenged friends , encouraging them to look into the holep procedure.. Even with my minor IC It was more than worth it.
Happy New Year,
Just me

I seem to still be getting just digests here but changed my notifications setting again. I did want to jump in here and wish all my HoLep buddies a happy (and, more importantly, HEALTHY. 2014. For those still within the 6 month window of se=urgery, hang in there. FULL relief is coming and you have your whole life ahead of you.! BTW, I remember last year (hey that was YESTERDAY ) someone was planning to use Dr. Das at Jefferson in Philly. But they never returned. Am I the only one here who used him? Just curious.

Happy New Year guys. We made it.

I had follow-up appointment with my local urologist last Friday. My PSA dropped to almost nothing, there are no signs of infection, and retention is normal. My urologist told that if he did the surgery (open prostatectomy) I wouldn't have IC by now, but I am not so sure. According to my research IC is as common after open surgery as after holep.

I am doing kegels and IC seems getting better, but not as fast as I would like. 

For those who considering holep and wonder about sex: my schedule is pretty much the same. RE is a little disappointment, but something I can live with. It seems orgasm became less intense. I attribute it to removal of most prostate tissues. During the act penis pushes against prostate increasing the sensation. Now when my prostate is basically an empty shell it doesn't work as well as before. I hope that with time when internal organs readjust it becomes better. But it is not too bad even now. Anyway surgery should be the last resort. I live on Flomax for many years until it became unberable. 

Hi JustMe
Was you urethrotomy done before, after or during holep?

The diameter of my urethra could not be dialated enough to accomadate the resectescope. . . The diameter of those are about 25/64 of an inch. It was done in order to insert the resectescope. It was also a precaution to lessen the possibility of strictures. The meatus, or opening is about an eighth of an inch longer now. This tissue does not bond to itself well. It is permanent. It does not bother me in any way.
I dont believe the comment your Dr made about not having IC after an open prostectomy. I have a friend at work who had one due to PC and he is totally incontinent.
I will also encourage you about RE. After my Holep, my erections improved, my first orgasms were ok,but in time, they improved as well.
My prostate was 110 grams and 92 grams were removed.. I did not have a forceful ejaculation for quite some time prior to surgery. .It has been 1 yr and 2 months since surgery. I still have very minor leakage..
6 weeks after surgery we took a trip to see family. I traveled quite well and had no urge to go until I got out of the car. Immediately on standing i had an uncontrollable urge to go .Thank goodness for pads! I got much better in time.
hope this helps
just me