Hello, gentlemen, I just had my HOLEP done by Dr. Mitchell Humphreys at Mayo Phoenix, so thought I would post a few observations for the benefit of others who are sitting on the fence deciding whether or not to submit to surgery. I believe Dr. Humphreys spent a year learning the procedure from Dr. Lingeman in Indiana.
First, Dr. Humphreys and his entire staff are consummate professionals. By now, he has performed 600+ surgeries and counting, and stated that only 4/600 have required surgical follow-up. As he stated, they have a "protocol" for all pre- and post-surgical procedures, having had so many experiences with them.
I am 59 years old. I had retention, hesitation, urgency, frequency issues, with several bouts of prostatitis in the past few years. My surgery was on a Friday, and I had the Foley catheter in place until Sunday lunchtime when I was released. My post-op bleeding was a little more than average, but no issues really otherwise. I accepted pain meds Friday and Saturday, but have not needed any pain med whatsoever since. A week later, my urine is mostly clear, with an occasional drop or two at the end of the stream. The stream is unbelievable - race horse quality!! I initiate urination nearly instantly, empty completely every time. I don't even get up a night anymore if I stop drinking fluids by 8 pm or so. I do have occasional minor spasms in my urethra - but I suspect they are caused by Mr. Prostate issuing some post-op complaints. The quality of my life is improved already, just one week out!!
A couple of ideas mostly reiterating what others have said:
1. start taking stool softeners a few days prior to surgery, and pay attention to what you eat. Higher fiber and moderate to light amounts would probably be best. Plan a few meals of your very favorite foods after your release from the hospital - I had lost my appetite, but a after a few choice meals, it has returned with a vengeance.
2. after surgery you are instructed to drink large amounts of water, and by Saturday I was consuming probably 24 oz./hour in effort to help flush the bladder. Be sure to eat adequately to ensure you are taking in electrolytes and sodium sufficiently to avoid hyponatremia - low blood sodium. I had no appetite, and kept drinking water like crazy and had some dizziness and confusion that were probably the imbalance of water to sodium in my system - potentially a dangerous condition. If you are going to drink 4x the normal water, be sure to take in 4x the sodium as well!! (tortilla chips and salsa as regular snacks like the distance bicyclists consume work great!)
3. I think I have found a way to reduce the frequency and intensity of urethral spasms one week after surgery. The spasms occur when I am at the end of a urine stream, emptying my bladder of every drop. If I begin to slow the stream a bit and go ahead and stop urination prior to getting to that point each time, I experience no spasms during the urination, and minimize them afterward. Previously, those spasms would continue for an hour or more after urination, and were pretty uncomfortable. As I understand it, they will resolve on their own in the coming weeks.
4. Don't purchase the full absorbent underwear, get a package of "male incontinence pads." If you wear boxers, it would probably be a good idea to switch to briefs to keep the pads in place until you no longer need them.
5. When it comes time to remove the Foley catheter, ask the nurse if you can do it yourself. Go very slowly, and if it hangs up when you are removing it, twist gently to free the path. Take several seconds to remove the catheter, it's not a race!! My nurse pulled mine out in about 2 seconds, and I almost fell over with the discomfort.
6. Finally, if you are uncomfortable with the Foley catheter while it is still in, try changing your body position in the bed. For me, lying on my back resulted in a constant pressure from the Foley balloon, but if I lied on one side or the other with my knees bent, the pressure was decreased by quite a bit.
7. Follow directions and keep your attitude positive!! I kept repeating to myself "a day or so of misery and the rest of my life in bliss!" Even one week after surgery, I have zero regrets, and am amazed at how much better I feel. I sleep the entire night! I don't have to plan my day around trips to the urinal!
8. Lastly, pay attention to your body when you are healing. Especially that first 48 hours after release from the hospital, get a good book or the TV remote and just lay around. Movement of the prostate from even easy walking tended to keep the (minor) bleeding going, but I could stop my post-hospitalization bleeding every single time by sitting with my weight off of the prostate area. Don't sit in hard chairs with the pressure on your prostate. Sit in soft chairs in which you can lean back and take the pressure completely off of that area.
How are you doing today? Any side effects? I'm thinking about going with Dr. Humphrey as well. I never had surgery so I'm a bit nervous and I read about all those possible side effects.
Why did you choose Mayo Arizona versus Rochester?
I am thinking of going to Mayo for another evaluation. I had one done 6 1/2 years ago and was told that I was a candidate for surgery but they believed that I could also stay on drug therapy safely for longer , if I chose to do that. I stayed on drugs. I now think it is time for another evaluation.
Why did you choose Arizona versus Rochester? Was HoLEP the only option they suggested?