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

Before I answer your question, may I suggest that you either log in before posting *Steadyhealth doesn't send spam) or - if signing in as a guest sign with some kind of name (your first?). That way we can tell who we are responding to. Were both the posts this morning from you? (We can't tell).

In answer to your question, go back about 10 posts where I go into more detail but - basically - you meet with a nurse and she hooks you up to a machine (totally painless) which measures the strength of your contraction when you do the Kegel exercises. You can see it on the screen and practice getting it right. Once you know that you have the concept (trust me, Youtubes didn't help me) you will do them better. It took me two session - covered by Medicare! - and I was fine.

One of our group here (in Delaware) has his HoLep tomorrow. I'm sure vwe all wish him well.

Have you gone back to read earlier posts? There aren't that many and most of us here have posted results.. I know some are older than me (I'm 70) and some younger. But, there are so many positives about HoLep that I recommend it. This issue for many is where they can have it done close enough to home. Quite a few surgeons are recommended here - all competent. I was luck that I only had to travel 15 blocks (1/2 mile) from home to get mine done in Philly.

Spend some time looking at the posts here and I think you'll find answer for yiur father.
Steve

I'm in a hospital room after Holep surgery done by Dr. Das at Thomas Jefferson hospital. I'm taking no pain medication and the nurses are impressed with the lack of blood  in the bladder irrigating fluid. 

Everything has gone exceptioniall well.

I'll post tomorrow about the dischard and catheter removal.

Don

Wow Don - we never had a report from the scene! That's greAt news! Please give Dr. D a high five for me! Great report!

I'm now home and recovering nicely.  Because of SteveinPhiladelphia I found Dr. Das.  I spoke with Dr.Das about Jefferson hospital's website not using the term HOELP, they don't have it as a procedure, they identify it as TURP but with a laser.  He's going to try to get the web page updated after I described my searching trying to find a HOLEP urologist nearby.  The next sentence is to help people who like me want a urologist in the Philadelphia area.  Dr. Akhil Das performed the HOLEP prostate procedure on me at Thomas Jefferson hospital and all went very well.  Dr. Das remembers Steve when I told him about my difficult time finding a urologist in the area who does HOLEP.

Here's my update, I had the procedure on Monday around 2pm.  It is now Wednesday afternnon and I'm just resting without any discomfort except when urinating.  Here's some tips,  Since I had no sedation it was difficult sleeping, (Jefferson is a busy hospital).  I'd now take ear plugs and something to cover my eyes so I'd sleep better.  They also used compression pads on calves to prevent blood clots, these also kept me from sleeping.  I asked them to be removed at the 4:30am visit.

  I had no pain so I didn't take any of the pain medicine after the surgery.  I now wish I had taken something about an hour before the catheter was removed because urinating was painful.  I needed to urinate 3 times with reasonable results prior to being discharged.  Which I did easily.  Because we needed to be back home by noon I made sure to drink water starting around 6 so I'd be very hydrated, I was told some people take 4 hours before they complete all 3 urinatitions.  They removed the catheter at 8:45 am and they charged my bladder with with some of the irrigating solution before removing it so I could urinate at that time.  Since the catheter had held the prostate and urethra open that 1st flow is amassingly strong.

   In hindsight it might be better to not worry so much about getting the catheter out sooner rather than later because while it is in place the prostate is healing.

   Since HOLEP is only performed by Dr. Das the nurses don't see a lot of HOLEP patients and were pleased with the clearness of the bladder irrigating fluid.  FYI, this fluid is not in contact with the prostate. 

    After urinating at home a few times I had to fill the pain med prescription.  Now there is just little discomfort urinating.  I'll post again in a few days.

Hope this helps others.

Don

   

Thanks for report Don. You obviously know medicine more than me. I didn't know the tech terms. Not sure if you read my original post-surgery posts but I had mine done on Friday before Christmas (which was the next Tuesday)and so cathether stayed in through Wednesday. I fell on Monday from dizziness and went to Jeff's ER and spent Christmas eve and Day as an inpatient. Catheter came out Wednesday.

I assume you bought some pads to wear for a while and you should start the Kegels soon to. You can get a biofeedback session at Jeff with Darlene - she's great - and that may help. I did me.
Yes we are lucky to have Dr. Das here in Philly. No one over at Penn or Temple ever heard of HoLep!

It has now been one week since Dr. Das performed the HOLEP surgery at Jefferson in Philadelphia and I'm coming along nicely. 

    I had to ask for a pad which surprised the nurse but she found one which I didn't need to use on the ride home.  I haven't had a leakage problem but I did wear a genric adult pad at night.  I have total control of my bladder.  There has been a bit of blood in my urine until a few days ago.

    The post operative instructions are that I don't go back to work until I see him again which will be 2 weeks after the surgery.  I see Dr. Das on Tuesday the 28th.  I'll post again then.

don

Great report Don. As they say.. "Just keep on Keepin' on".

Glad to hear Don is recovering well.

Week 11 post-op for me.  In the past week all burning at the end of urination is gone.  Keeping up with Kegels and incontinence continues to improve.  For guys that need to wear pads - I switched from wearing boxer briefs to briefs.  For me the mid-rise style works best at keeping the pad positioned and secure.

Big50

Hi Big 50. I never needed briefs. I bought the pads at CVS and they fit comfortably in my briefs (I'm not a Boxer shorts guy ). Basivally never needed them but I knew they were there JUST IN CASE.

Sorry for the confusion.  I was refering to brief style underwear to best secure the pads.  I too did not need the pull-up diapers.

Big50

I guess we keep calling them pads when the manufactures call them "guards". Depends is the most advertised but I found the CVS ones perfect (I think they come in packages of 44)

Final update of my HOlEP surgery by Dr. Akhil Das at Jefferson Hospital in Philadelphia.  I met with him this morning and everything is working great!  Normal urine retention in the bladder and good flow rate.  Today is April 29th and I had the surgery on the 13th.  Go to earlier posts for some detailed information about my experience.

  I recomend any of you living in the Philadelphia area contact Dr. Das about HOLEP. He has agreed to be my urologist going forward.

Good Luck everyone.

Do

Great news Don. Boy you healed up quick. Dr. Das in my regular Urologist now so maybe we'll meet one day on a common office visit.

Steve

Jack here.
I had the surgery in Indianapolis on Dec. 12, 2014 and things were great for the first three months. Then I came down with a UTI around March 5 and was successfully treated for it but my urinary frequency was still a little more than it should have been even though the infection was gone and just in the past two days I have had to go roughly every 20 minutes and it is mostly dribbling rather than a regular flow. I had a urine culture done today to see if I currently have a UTI. Also, I have had to go back to pads and diapers as of a couple weeks ago. So, I am having a cystoscope exam with my local urologist next Tuesday, I believe. The concern is that I may have a stricture or bladder neck contracture. I did have to have a partial urethrotemy with my HOLEP. I am feeling discouraged as I write this as I believe strictures can be difficult to deal with successfully and I'm not too sure about the success in treating bladder neck contractures. Does anyone have any information to share about either of these two conditions are what else could possibly be going on?
Thanks very much.
Jack