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

I had holep survey on August 16th, 2017 at IU Methodist performed by Dr. Amy Krambeck. It is now 3 weeks post surgery and I am experiencing quite a bit of pelvic pain. It comes and goes but can be very painful. Has anyone experienced this?

Dear guest,
There were periods of time I would experience pain, especially at the end of urinating. But it was never long enough to warrant taking anything by way of pain relief. Ibuprofen, Tylenol, aspirin etc. The only pain med I ever took was the Morphine administered by IV in the recovery room.
I have a high level of pain tolerance as I eat very hot peppers regularly. It is a fact they boost ones tolerance for pain.
If you are concerned, contact the nurse . Dr Lingeman's nurse was named Stephanie. I'm not sure she is still there. She was very helpful in answering all the questions I asked.
Knowing Dr Lingeman , he has a very high level of care. Your Dr Amy Krambeck was trained in Holep by Dr Lingeman. I'm quite sure she is very capable and will provide assistance to any question concerning the pain you describe. Give then a call if it persists.

just me

Another vote for Dr. Bandi at Georgetown. I saw Dr. Lingeman in Indiana but stuck with my local doctor for convenience. Prostate measured 140cc. He removed 110 grams, no cancer, was urinating day 1 (had a catheter for 3 months). Highly recommended procedure and physician!!

I am seriously considering HoLEP. I am 58 years old and live in Suburban Philadeplhia. I have gradually had increased urinary frequency in recent years. I had episodes of kidney stones about 5 years ago and tried Flomax then without much success, so I stopped taking it. All was well until about 6 weeks ago, when I had periods of greatly increased urination and some pain. I visited the local Urologist that had handled my kidney stones previously, and he noted I was retaining urine but thought I was suffering from a UTI. He prescribed a 30 day regimen of antibiotics, with a PSA Test to follow after the regimen was complete.

Well I travel a lot for work and several weeks later found myself half way across the country, with extreme pain every thirty minutes or so with a need to void, but I couldn’t pass any urine. Ended up in the ER. The ER there diagnosed Acute Urinary Retention and inserted a foley for several days and prescribed Flomax for 30 days. I followed up with a Urologist there that performed a voiding test. I was unable to void so they taught me how to self-cath which I have been doing ever since, typically 5 x a day (YUK!) The Urologist there conducted a digital exam and said my prostate was enlarged, and to follow up with a Urolgist once I got back home. I had the PSA test when I returned home but while I was still cathing and on Flomax, so it was inaccurate.

I followed up at a large Urology practice closer to Philly last week. I did not want to go back to the Urologist I had seen locally as I dislike his practice (minimum hour wait after appt. time every time, etc.), so I researched and went and saw a well respected urologist in Media, PA.. He and his staff were great. He conducted a Urodynamic test which showed the bladder was functioning fine, and he suspected the prostate was blocking flow. The next day he performed a cystoscopy, and indicated that the prostate was very enlarged and blocking flow.

He indicated that with the size of my prostate and symptoms, that medication most likely would not be successful. In office procedures had a low chance of success as well. He recommended a TURP procedure, and in fact I am waiting for a phone call from their office to schedule that procedure.

After many hours on the computer this weekend , I found this site and learned of HoLep and the wonderful experiences all of you have shared here! I can't thank you all enough for sharing your experiences. Based on many comments here (especially Steve and Don) , I made an appointment with Dr. Das at Jefferson for as soon as he could see me (about 2. 5 weeks from now). I also followed up with an email to him to explain my case and ask some questions. To my AMAZEMENT, I received a phone call from Dr. Das about two hours later (yes still can't believe that), and had a fantastic conversation about my case. If he is as caring and professional in person as he was on the phone, I will be going to him for a HoLEP instead of TURP as planned. Impressed beyond belief with his personal response and looking forward to meeting with him in October.

Again my thanks to all that have posted here. Its an unbelievable resource that I just happened to stumble upon! And I think I can say this forum will change my life for the better, HoLEP instead of TURP!

My experience before surgery was similar to yours: several incidents of painful urinary retention requiring a Foley catheter at the ER and diagnosis of an enlarged prostate. Except I am much older than you: I was 79 when I decided to have surgery. I had it with Dr. Lingemann in Indiana and am very happy with the results. From everything I have read about TURP, Holep is the way to go. I stayed in the hospital one night only (typical for Holep) then went home. Recovery is pretty quick. No more bleeding after a week or two and no pain on urination. I think most men who've had Holep report similar results.
I haven't heard of Dr. Das. If you don't know, you should inquire how many Holeps he has done, what kind of results his patients had, and ask with whom he trained.

Thanks for the reply! I am extremely comfortable with Dr. Das he has done over 2000 of these surgeries and trained in New Zealand with Dr. Peter Gilling, who according to Dr. Das trained he and Dr Lingeman just before those two brought the procedure to the US. I think he flies under the radar compared to Dr. Lingeman but very confident in his reputation. Glad for your success and reply!

Dr Dora Chandler in Tampa and Dr Masel in Hollywood

I had Holep surgery in mid August with Dr Das at Jefferson hospital in Philadelphia. Dr Das and the nursing staff at the hospital were wonderful.

I'm 69 and I found out 4 months ago I was retaining 900 ml of urine after peeing as much as I could. I did not have any other symptoms other than a large prostate and periodic urgency to pee. My local Doc then had me catherize myself 4 times a day to relieve the pressure on my kidneys. My prostate was about 80 grams with a median lobe sticking into the bladder. I went to Dr Das based on info I saw here on this blog. He was was very competent and helpful. I also needed to have a surgery in three months to cut out the end of my colon because of a polyp that could not be removed via a colonoscopy. Dr Das suggested I have them both done at once and coordinated with another surgeon at Jefferson to have it done. The result is both surgeries were successful with no complications. I had to keep the catheter in for a week after surgery because Dr Das was not sure if I would be able to empty my bladder and I needed to heal if I was going to still have to self catherize. After the catheter was taken out I could empty my bladder and pee like I was thirty. I had no leakage even the day the catheter was taken out. An added benefit is my erections are quicker and harder, but the semen doesn't come out.

I forgot to mention. My surgery was in the afternoon and I was out of the hospital by 11am the next morning.

You have had a hard road . Good Drs. Are a blessing from above. Hopes for continental improvement.
just me

Hi, I am considering Dr Bandi since I live in N VA but already have an appointment with Dr Das in Philly in a few weeks. Seems like your experience with Dr Bandi was very good? Anything else you can tell me? Are you still doing well? My feeling is that perhaps Dr Das has more experience with HOLEP but maybe I am worrying needlessly. Thanks for any insight!

Hello all, 2 weeks post op. Removed 45 grams of tissue, no cancer. I am about 75% of normal. No real pain after the surgery.( Dr. Amy Guise, Froedert & Medical College of Wisconsin, Wauwatosa (Milwaukee) Wisconsin) I have almost no blood in my urine unless been sitting on a hard surface or overdoing any activity. What blood I do have is only in the last few drops of Urine. My stream is strong, the urge is even stronger! I haven't gotten complete control of stopping any leakage yet. I still leak sometimes with bending or raising my leg to dry myself after a shower or putting on my trousers. I, like some others, have a "irritation" after urinating at the tip of my penis which includes the anal muscles. I wear a pad to control leakage. I get up only once during the night which I could probably control if I cut down on my water intake later in the evening. One of the biggest problems I have is that I don't seem to be able to "Feel" my leaking. So if I step out of the shower and bend down, I leak without feeling it. I have started the "kegal" muscle exercises a couple of days ago so maybe that will help a little further down the road.
I have followed this forum since before surgery and just thought I would throw out my experience.

First of all thanks to all who posted to this forum. What a wealth of knowledge/experiences/info regarding HoLEP.
I had my HoLEP procedure done on Oct 5, 2017 by Dr. Marawan El Tayeb at Baylor Scott & White Hospital, Temple, Texas. I'm glad I opted for spinal anesthesia with a very short recovery time. Had the procedure at 8:00am and was eating lunch at 11:30am. Numbness on my lower extremities lasted until 4pm. Tolerated the whole procedure without any pain. Took out 45+ grams of prostate and biopsy was negative. Catheter was removed the next day at 6am and discharged the same day after voiding x2. Bloody urine was expected and cleared a little after 3 days. Now, only have a small amount of blood at the beginning of the urine. May I reiterate that I have no pain whatsoever; did not take any pain medication.Just a little irritation at the tip of the penis during urination which was gone in seconds. This is most probably from the bigger instrument used during the procedure. Leakage is non-existent but I still wear thin pad for precaution.
I would encourage to have this procedure done for those who are still contemplating. For my personal experience, it is the immediate relief from years of inconveniences/discomfort that I'm most happy about. I stopped taking Tamsulosin and Finesteride. I now have a strong flow during urination and without hesitancy. Only get up once a night versus 3 to 4 times prior to surgery. I expect only more improvements from here on forward.

I had sex after 4 weeks from holium laser surgery. 6 times can I cause damage or get prostatitis. Or damage prostate