Recovery expectations 6 weeks after HoLEP prostate surgery.

I had HOLEP 3 Dec 2024 and still have leakage. I don’t do pelvic floor exercises every day like I did for the first 7 months. I am still using 1 to 2 liners daily. My prostate was 100 grams and the urologist removed 60% of it. I don’t have a forceful stream, but I do empty my bladder. It has been a long journey for me that has yet to end. I started doing pelvic floor exercises again yesterday to hopefully stop more of the leakage.

Does anyone have experience with a Cunningham clamp. My Dr. suggested this for the incontinence that does not want to go away so far. It literally clamps on your penis to stop the leakage of urine. It looks more like a torture device but if it helps to be able to do more things without changing guards every two hours I might try it. I did Physical therapy and was told I have good strength and control over my kegel muscles and yet the leakage continues five months after surgery. Going anywhere or doing anything for any length of time is a struggle.

@diverjer Everyone is going to be different. I wasn't having any luck with Flowmax. I had the HoLEP 5 days ago and I am already feeling great. I'm taking it easy at the gym but, my flow is great and I have no pain. I am usually very sensitive to pain. I have a slight pink tinge to my urine and I am waking up to urinate a couple of times. It is less than when I was on the tamsulosin and terazosin. I also have great flow and it feels like my bladder is emptying. I haven't healed 100% yet but, I recommend it.

Glad things are going well. HOLEP is no longer an option for me. They now say I have prostate cancer with cribriform (which they say means aggressive) masses and are doing further testing like PSMA Pet Scan Friday. Seems to take them forever to do anything, they say you have cancer and take a month to do more testing. But it is a national recognize cancer treatment center that I have to drive 150 miles RT to get to. From biopsy's, I just as soon stop all testing and take the prostate out.

@medinfo1 l am having very similar out come at just over 4 weeks flow slowed and urgency has gotten to be a real problem.
Not sure I am emptying. Hoping it gets better.

@8152580549
I had similar issues after two months and was questioning my decision to have the HoLEP procedure. I am 68 and didn't have major issues before surgery but the urologist convinced me by making the point that the older I got or the longer I waited, the longer the healing process would be.
I am now 4 months out and finally feel better than before the surgery. He did warn me that recovery was a long time and it would probably be 2 to 3 months before I saw improvement and a year before I was totally healed. What really helped me was doing physical therapy. I signed up for 4 weekly sessions. The urgency issue was really frustrating for me but now that has almost completely gone.
Hang in there! It gets better!

@twmcneil58 Thank you for your comment. I had HoLEP about a month ago. Side effects have been worse than advertised. At 3 weeks, I began struggling with spontaneous incontinence, very frequent daytime peeing, and pain before and after urination. My doc started me on mirabegron and recommended changes in diet (no caffeine, alcohol, carbonation, etc.). Has anyone reading this seen improvements from diet changes and/or mirabegron? Will definitely try the PT route. Thx again for your comment.

@8152580549 just to give you some perspective- Dr Dora said to just give it time that set backs do happen. I continued to do my core exercises and in time everything healed. Everything has been working as expected ever since.

I am just at the one year post Holep surgery mark. I am 100% back to what a normal younger man experiences with urination. I am 74 and my prostate was 134 grams. My incontinence lasted for 7 months after the procedure. My PT was invaluable in getting me over the hump, and I highly recommend their help. They are a critical resource. Hang in there, it does get better in time. Holep gave me back my life.

Thank you for your comment. I am reluctantly increasing the timeline for my hoped-for recovery from HoLEP, but at least I still have some hope! Thx again.