69 year old, very fit, healthy.
Most recent PSA of 9.1 PSA has been >7 for 15 years.
Two biopsies and two MRI's; No cancer detected.
Problems emptying my bladder easily. Waking as many as 6 times a night to pee.

I had the HOLeP procedure on late September 2024 under general anesthesia in Charlotte, NC. Catheter removed the next day. Bladder filled prior to removal. Voided 260ml. Went home and drank two full glasses of water, thinking that all was well but ended up almost peeing myself an hour later. But that was my fault. I should have gone a bit slower instead of overloading my bladder.

Pathology showed NO cancer cells in prostate tissue removed during procedure.

Minor incontinence (occasional random leaking of a few drops) during the daytime, used pads for two week, then used small shields for a few more weeks. No nighttime incontinence.

Urine stream very good. No pain. No blood clots or scabs (later). Doc said that's normal but they prepare everyone for the worst case.

Waking 3-4 times per night to pee during the first month, but I think it was just allowing my bladder to learn to hold urine. Prior to procedure, I was able to pee but only a dribble and then it took sitting and waiting as long as 20 minutes to finally dribble enough to go back to bed. Measurements at doc prior to procedure showed retention of 260ml post void!

After procedure, I am definitely able to completely empty my bladder when I peed. I have found that I do need to push the final bit of urine out before I finish, to avoid post void dripping. I've been doing Kegels but probably not as aggressively as I should have been.

Urgency and frequency are diminishing as time passes. Overall, I am very very satisfied!

My only challenge is that I leak when sexually aroused, which is a problem. Orgasms are as strong as before procedure but completely dry (and this really depends upon how much prostate tissue is removed during the procedure. My prostate was 112cc; surgeon removed 85cc of tissue.) Using an elastic ring around base of penis when aroused prevents leakage, but I am hopeful this will resolve eventually. If not, I will seek a referral to a pelvic floor physical therapist (I have discussed this will doc).

Give yourself time to heal, relearn how to hold your urine and manage your new normal. Complications are actually rare statistically. Again, I am very very pleased to have had the HOLeP. So thankful that we have a very kind, experienced and competent surgeon here that has performed 700+ of these procedures.