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

Thanks for clarifying Feedguy1. Good news for you. Just be patient on all fronts. Your symptoms are much less severe than what I experienced and mine have improved over time (more slowly than I would like but it is what it is) as I know yours will too. Continued best wishes!

Just found out I have UTI, Pseudamonas, that the urologist suspects was introduced into my system during the surgery. Will have to take antibiotics (once the right one is found that kills this organism). Has anyone else had similar complications?

I had my first follow up with Dr. Krambeck. My PSA  .042 and I passed my urine flow test with flying colors. Furthermore I totally emptied my bladder.  I am down to mini pads aka shields. I still use a standard pad when I go to the gym, for obvious reasons. I have been doing Kegles regularly.  Since my bladder neck sphincter was incised the Kegles are to strengthen the outer sphincter.  For reference my surgery was JAN. 31,2018. My prostrate was 214 grams and they removed 110 grams. 

This is the first time that Dr. Krambeck made time for me to have a real discussion. I had complained about the lack of interaction, she explained that there were only three doctors at IU Methodist that performed HoLEP so they need to be efficient. That is interesting since IU Methodist is advertising HoLEP on the net.

Has anyone found a remedy for retrograde ejaculation?

Hi Buster. As far as I know, there is no remedy for RE due to the removal of the internal urethral sphincter. It is just a permanent side effect of HoLEP we all live with. As a 62 year old (far past the time I want children :), it's one I'm willing to live with since the upside of the surgery far out-weighs the side effect in my estimation. Orgasms are still pleasant enough.

Blayneb, This is Don.1.
Well yesterday I spent my first day and night without a pad. I had my surgery the 23 Dec. 2017 so I’m 5 months in. Today will be day 2 so I’ll see how it goes. I cut grass, washed my car and all was ok.
I’m 77 yrs old and peeing like a 6 yr old.
Will report back and let you know how it goes.

That's great Don1! Really happy for you. I will be 6 months out on June 7th. I still dribble a little, though I have seen a big improvement in the last week. I still must wear a shield, but I'm down usually to 1 a day. Slow progress, but progress nonetheless. I am still optimistic I will have total continence at some point, just not as fast as I would like. I continue kegels daily, and am hoping in another month or so I may get there. In the meantime, I too pee like a fire hose so I am very thankful. All the best!

That’s exciting!!! I just started using shields. I am going to help a friend pick up hay this afternoon. I hope this will not be too much activity.

My surgery was Jan. 31 so I am 3 and a half months out. I look forward to no paper in my underwear.

Buster

Most men who post on this site have had the Holep recently or are thinking of having it done in the future. I thought it might be interesting to hear from someone like me who had his Holep 17 months ago. I was then 79 years old and had been having ever more frequent bouts of inability to pee, which many of you know is very painful and requires ER insertion of a catheter. I went to Indiana U hospital where Dr. Lingemann performed my operation. I was sent home the next day and wore pads daily for about six months. But no more problems peeing and after a week or two, no pain at all. Now, occasionally I will have an involuntary urinary squirt. I don't use pads anymore except when I will be in a situation where I could not easily use a restroom. For example, I am a public speaker and several times a year speak to groups for an hour and a half or so. I always wear a pad in those situations, I think because psychologically it makes me more comfortable. I must say the pad has never been needed in those situations, but I still will continue to use one then because, as I say, it puts my mind at ease.
I am very happy I had the Holep.

Thanks for this Learner! Unfortunately many of the guys who have had HoLEP, posted frequently in the days early in their surgical journey but rarely do they come back and post longer term out like you have. It is very encouraging for us to hear that you've had a good experience and especially that long term your continence is going very well. Really helps me to stay optimistic, being close to 6 months out as I am and still experiencing mild incontinence. Really appreciate it. Don't stay a stranger! :)

Thanks for the report! I certainly understand the need for security. My wife and I took a 2 and 1/2 day road trip two weeks after my surgery. I’d used paper underwear and a pad. It was really overkill but I had a high degree of confidence.

I just ran tractor for a buddy. One small squirt after the job was done. I feel great since I am only using a mini-pad (shield).

Three weeks post HoLEP

Since I had been lurking on this web site for over a year before having the HoLEP procedure, I thought it only fair to share my experiences in the hope that it will help other considering this procedure. My prostrate was enlarged, and was causing me to get up 6 – 8 times at night - apparently I was not completely empting my bladder. I had a weak stream and also had, on occasion, leakage.

Dr. Amy Kremback did my procedure on The 15th of May 2018 at IU Medical Center, Methodist Hospital in Indianapolis. I live about 2 hours away from Indianapolis, so my wife and I drove down the night before. After the operation, we drove back to our motel and I spend the remaining day, in our room. I was not in a lot of pain, but was uncomfortable at times, primarily because of the catheter. The next morning, I was in Dr. Krembaeck’s office for the removal of the catheter. I was told that once the catheter was removed, and I urinated, I could go home. The procedure was: remove the catheter bag, but leave the catheter tube in place. A bag of saline solution was connected to the catheter tube and by way of gravity, 200 cc was put back in my bladder. The catheter tube was then removed. I was told, I needed to return 200 cc of fluid in a container jug before I would be dismissed. If I could not do that, the catheter would be reinserted. Luckily, I was able to return the fluid and after some additional instructions, I was able to go home.

The first week: I did have blood in the urine. I was told was normal but should clear up in a week or so, but could persist for up to a month. I also had painful burning not only while starting and urinating, but also for about 5 minutes after finishing. At night, I had a few seconds of delay in starting to urinate, and the burning was a bit more intense. I presumed this was normal and other than these issues, I was not having any problems. I was also leaking, but this was expected and really not much of a problem. Following instructions and did not lift anything over 10 pounds and pretty much took things easy during this first week. I felt fine.

The second week: I saw much less blood in my urine and at times did not see any discoloration. The burning, while still present, was subsiding. Still some incontinence, but I used a light pad and it did not bother me at all.

The third week: I have resumed normal activities, except for riding my bike. I play pickleball, golf and work out at the fitness center. I am not seeing any blood and only on occasion do have any burning. I do still wear a light pad and occasionally leak when passing gas, laughing hard and sneezing. I am doing the exercises to strengthen my pelvic muscles so I presume in a few months I will not have this problem. Wearing a light pad is not a big deal for me. It does not affect my quality of life. I have not notice any effect on my sex drive or performance. So, after three weeks, I am very happy with the results. I am sleeping much better and getting up once or twice at night to urinate. My stream is much stronger.

(sorry of I posted this in the wrong section or in duplicate).

Great to see you've had such a successful outcome so quickly Shotgun. May I ask how large your prostate was? Mine was over 150 grams (over 5 times normal) and was quite long which proved a challenge for the equipment, and hence at 6 months out, I still experience slight incontinence and still wear shields.

Hello Shotgun233,

I also had Dr. Krambeck. Did she explain all of the side effects to you?

I am 73 and had a prostate of 214 grams. My surgery was on 1/31/18. She removed about 110 grams. My surgery took an hour including morcellation. I had to stay overnight in the hospital with that humongous catheter, wow. I left the hospital the day after surgery. My home is an hour and a half from the hospital. My first 2 weeks were similar to your experience. The main difference is that my wife and I left for an 1100 mile road trip two weeks after surgery. At the first of March I returned to the gym. I had been out of the gym for 4 months due to urinary retention, 2 other surgeries and the prostate surgery. I am now wearing a shield and I hope to be continent soon.

How old are you? What are the stats on your surgery?

Thanks

i am 5 weeks post Holep surgery. Dr. Joel Funk in Tucson, AZ did it and as of Feb 2018, he had done over 700. Had great experience and Banner Health Hospital in Tucson was excellent. Prostate was 116 grams + he removed 99. Stayed 1 night in hospital and catheter was removed 13 hours after surgery. Prior to surgery I was voiding less than 3ml/sec with PVR of 65. 5 weeks after, I am at 12ml/sec with PVR of 18. Never needed any pain meds or meds for burning. Prior to Holep, was up 3-4 times/night; now I am at 1. Prior to Holep I was voiding 15 times per day; now I'm down to 6-7 including the nighttime void. After week 2, I was able to wear shield for occasional drips + hope/expect that can be eliminated in few weeks. Overall, great experience. BTW, I am 73 so with Holep, i should not need to worry about BPH again.IMO, if you are in southwest USA, you won't go wrong with Dr Funk.