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

To help put our problem in perspective , I will post to you in ounces the size of our prostates before surgery. A normal prostate is 1/3 - 2/3 ounces. Steve you prostate was 2.8 oz. and .98 was removed. Mine {just me} was 3.88 oz and 3.24 oz was removed. That is almost a quarter of a pound of tissue ! Jack, your prostate was 5.75 oz before surgery . You did not state how much was removed. Iwas informed a few weeks after my surgery how much was taken out.That is a lot of tissue to be removed. The difference between Holep and TURP is the blood supply is sealed by the laser in Holep and the turp is left to bleed. These numbers help put our problem in perspective. All the best Gentlemen ! just me

Hi Just Me. I am 15 days past my surgery with Dr. Lingeman. While I am sill wearing a pad [just in case], I don't believe I needed it past the 6th day or so after surgery. The burning stopped around the 10th day although I felt a little bit of burning today. It never was a problem, though, except for the first time I urinated after they took out the catheter. I really have nothing to complain about which is pretty astounding as far as I'm concerned. As I had mentioned, due to a lot of burning after having prior cystoscope exams in Michigan, I was fearing the worst and only experienced very, very minor burning for a few days that really did not bother me. After about 10 days of having dark yellow urine, it is very clear now. I went to the gym yesterday and worked out on the elliptical machine for 45 minutes but stayed away from the weight machines as I didn't want to cause any problem in the surgical area. Perhaps I'm being too conservative about that since I was told I could go back to the weights after a couple weeks. Just Me, I will ask how much of my 163 grams were removed. When do you think it would be very safe to try having sex without incurring pain on ejaculation? Do you know why you experienced bleeding and urinary burning several weeks after surgery? Have others experienced that? Could it be due to scabs forming and falling off the surgical site? I think it might take 6-12 months to see if my bladder will ultimately stop retaining so much fluid [the only reason for my surgery]. Hopefully, I didn't wait too long after having 31-32 years of frequency.
All the best to all. Jack.

Hi Jack, I think you are correct about the scabs falling off and causing burning. As I stated The burning came later.for me . It did not last but a minute, and was at the end of urinating.I wouldnt start to dread it however it wasnt that bad. I made it a practice of collecting a sample of urine in a clear measuring cup to both measure the amount and to look at the clarity of my urine. I found Small thread of blood and tissue for 2-3 months . At my 6 week checkup I had a bladder scan, It was so empty the nurses had a hard time finding my bladder! I was retaining approx 300cc regularly. I experienced acute retention 70 time between the first of July until my surgery Oct 22. I had to self cath myself 2 times daily and when ever necessary. My bladder recovered in spite of the Acute retention. As for Sex, I waited much longer than necessary. I believe it was 6 weeks. There was no pain at all . I even had a normal ejaculation a few times. Dr Lingeman`s nurse Stephanie is very easy to talk to as you know. If you have any Questions about sex , ask her . I do think they advised about 2 -3 weeks post surgery. It sounds as if you are well on the way to a very good recovery. P>S> Dont clean out your Garage! All the best just me

It was 1 year ago yesterday that I had HoLEP at the Mayo Clinic in Phoenix, with Dr. Humphreys. I am so very glad I went that route. I have only praise for the doctors, the procedure, and for the most part, Mayo. Quality of life much better now. Retrograde is the only drawback for me, but it's not all negative. I'm 60 years old.

I had the HoLep procedure done a year ago because of frequent urination, difficulty urinating, weak flow, and urinary retention. I'm 74 and in excellent health. I was back to playing tennis in the 2 weeks the doctor advised I wait, and felt fine. As others have mentioned, I did have clots for several weeks after surgery. Several of them were quite painful but, otherwise, the recuperation was quick. My urine flow is very strong now and I have no urinary retention. I continue to urinate frequently, although not as much at night. I'm fine sexually, although readers should know that after surgery, ejaculation occurs without semen. Satisfaction with organisms is as it was before surgery. My main concern is that I have leakage, although I had some before surgery and was told that I might have it after surgery when I sneeze or when I need to urinate badly. I wear a moderate strength pad from Tena (#3) and have accepted that it will be required probably forever. The doctor did mention the sling procedure but I think I've had enough surgery for awhile.

My surgery was done by Dr. Humphreys at Mayo Clinic Arizona. I'd been seeing him for 4 years prior to surgery and it was obvious, much as I didn't want to have surgery, that it was necessary. Mayo Clinic provides exceptional care. I was out of the hospital the next day, able to urinate without as catheter, and happy to get it over with. Is it an uncomfortable surgery? Yes. Would I have waited or tried more medication? Not really, although like most of us, it would have been nice to think that my BPH would have gone magically away. My advice for anyone having the surgery is to be realistic. In a coin toss between not having it done and perhaps having a compromised kidney as a result, the annoyance of having some leakage seems a small matter compared to kidney problems.

Thanks for reporting in. (You didn't give a first name so we can't even call yiu by that ). In 4 more hours here in Philly it will be 2015 and I'll wish all those on this "support group" a happy and HEALTHY New Year.
Steve

I agree with the Kidney Problems versus the Surgery. I had an Uncle with Kidney trouble . You dont want it! It has been 2/12 years since surgery for me and I still have minor leaks . Why some have leaks and others dont ,I have no idea. If i had to choose between leaks and having to cath , I choose the leaks! just me

Had HoLEP surgery 12/2/14 at Mayo in Rochester, done by Dr. Deborah Lightner and overseen by Dr. Humphreys from the Scottsdale clinic. Hospitalized overnight. I failed the 23rd hour void test so went home for five days with an 18F 3-way Foley catheter. Catheter came out 12/8/14 and I passed the void test. Had blood in urine for about two weeks, then passed a paper-thin fifty-cent piece sized clot on 12/19/14 after noticing significant blood in urine again. Not much pain but scared the hell out of me when my urine stream "slammed shut" while the clot folded up for ejection. Urine was clear again after passing this jewel. No further clots until 1/3/15 thru 1/5/15, when clots of various size and shape were ejected. Minimal pain involved but 1/3/15 clot actually stopped my urine from flowing for about 1 hour. After warm shower, the clots came out, to much relief on my part. No desire to venture into the emergency clinic for a solution. Have booked follow-up appointment with Dr. Lightner for late March when they'll do another uroflow, urinalysis, and culture. Not much leakage experienced after 12/18/14 but when physically stressed can be a problem. I'm still not getting a "signal" from the outer sphincter, so mostly use the clock to "schedule" voids. Ok while sitting/lying down but often have urgent need upon standing. Still working on Kegels.

Thanksfor report LauBla. About those Kegels, you might want to consider having a biofeedback session locally. That was only way I knew I was doing the Kegels right and they worked then, not before. I consider myself really lucky to have my surgeon, Dr. Das, right here in Philly so I, not only didn't need to travel for surgery, but I have the great Jefferson Mediscal Center Urology Dept right here in case I needed to go back for any updates. PLEASE keep us posted! (and thanks for signing in with a screen name. It makes it easier to respond to yiu.

Jack here. I had HOLEP on 12/12/14 with Dr. Lingeman. I had a 163 gram prostate and 133 grams were removed. The only real pain I had was the first urination after they took out the catheter the morning after surgery. The burning on urination lasted roughly 10 days and was not something I considered painful in the least. As I had previously mentioned, when I had prior cystoscope exams over the years [the last in 2004] the burning on urination for a day or so was not pleasant at all. This was not a problem after my HOLEP surgery. I did have a partial urethrotemy. I believe in one of your earlier comments, Justme, you stated that having a urethrotemy will help reduce the chance of having a stricture later. I hope that is the case. While it looked like I may not have needed pads after about 10 days  that was not the case. I went back to the gym to use a cardio machine after two weeks and I went back to using the weight machines after three weeks. I believe this may have caused me to have some very unexpected leakages twice and both while sitting on my bed just before retiring for the night. When I got up from my bed each of the two nights I noticed a fair amount of urine on my bed sheets and was quite surprised as I could not feel the leakage happening. I attributed both incidents as being a result of using heavy machine weights earlier in the day. As a result, I have reduced the amount of pounds I use when weightlifting and haven't had the problem since [the last being about 10 days ago]. Justme, I believe you experienced different episodes due to your occupation and cleaning out your garage. I haven't tried ejaculating yet but hope to within the 2-4 days. As I also had mentioned, I retained 700-800 ml in my bladder after voiding last year so I am curious to see if that has improved. I still believe I am retaining a pretty fair amount but after 32 years of frequency I am not sure the retainage problem will be solved or not. Time will tell. I may notice a slight tinge of blood at the end of urination every three days or so. My urine has been clear pretty much since around 10-14 days after surgeryOverall, I am extremely happy with how well the surgery with Dr. L went as well as the post recovery period. All the best to others.           Jack

Jack here.
I forgot to post a couple other things earlier today. I had my HOLEP on 12/12/14 and while I thought I would be done with pads after a week or 10 days I actually still use them and about a week ago I started using disposable underwear instead of pads only because they help prevent leaks from the side of your underwear. There are days I don't need to wear them or pads but I never know for sure. Also, over the past 2-3 days I had the urge to go and could feel liquid move down my system but nothing came out. This hadn't happened since the surgery until now. It may be that scabs or clots may be causing this. I haven't seen either of these [except for clots for a few days after surgery]. I actually thought yesterday that I may have acute retention but I drank a lot afterwards and things worked fine. On a very positive side, when sleeping I am getting up 1-3 times each night and able to nicely void where I was getting up 7-10 times before the surgery and I had problems voiding when I did. So, again, I'm very pleased so far. Jack.

Hi Jack,
Glad to hear you are doing well. Your bladder should retrain itself in time . Mine did . I no longer get up in the night because of my bladder. After two and a half years my dribbles and minor leaks are starting to be less frequent and less in volume. I am going to try to get by with the less bulky shields over the thicker Guards. Even with the minor inconvenience of dribbles and leaks, Life is so much better than my state pre surgery. I never knew when I was going to completely shut down and cath myself.
You are doing well in the short time since your surgery. I would not worry about an orgasm at this state. I wasited 5-6 weeks before mine. There was no pain at all, and there were no problems were encountered as a result of it.
Glad to hear you went with Dr Lingeman for your surgery. I went back to him for my 6 week and 6 month check up as I live 150 miles from his office. All the best to you .just me

Does anyone know how much the procedure cost at Mayo Clinic in Az? They told me Medicare won't cover it and I would need authorization from Mercy Care and then it would be 15% out of pocket. Thanks.

I don't know about Mayo Clinic but I had it fully covered by Medicare and my supplemental insurance here in Philly with Dr. Das. I didn't even have a deductible.

Which Part Medicare do you have?