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I just had holep this week 12/17. 65 yo, good health prostate 86cc...2 neg biopsies, 2 neg mri in last 5 years. Had a retention in October and was catheterized for 4 days which I didnt want to ever do again. Scheduled the holep with Dr. Dora. Surgery was at 2 pm on wed, I was back in care hotel by 6 pm with catheter. Removed next morning at 8:30 and immediately went to bathroom. Lot of blood but expected. Nurse gave me granny panties to wear as they said would have leakage for up to 4 months. Went back to care hotel, drank 2 liters and returned at 2:30. Scan showed zero urine in bladder so they said I can leave. Today is saturday, 3 days from surgery, 2 from catheter removal. Thursday, drank lot of water, took the meds they gave me for burning when urinating which was bad first day(well 3 on scale of 1-10) and turned urine iodine color. But was able to pee like I have never done before, when they say firehouse its true. Friday, wake up in morning, first pee lot of pinkish blood some more burning but hydrated all day(3 liters water) and keep having strong streams with color still iodine from the meds and some reddish pink. Saturday(today) woke up passed some pink urine to start(ping) but no burning. Stopped the med for burning, took a 2 mile walk, drank about a liter of water on walk. Came home and felt urge to pee, seemed like it was stuck for few seconds then firehose again and noticed 3-4 black scabs which I understand is normal. Color is turning more clear once off the med for burning. Only day 3 but so far I have had zero incontinence and only minor leakage. Few drops when I coughed once really hard and passed gas, but had a very thin pad in and never noticed any liquid at all. No leakage to speak of while walking or any other time which is amazing to me but everyone is different(I did do kegels for 2 weeks prior as suggest so that had to help). Biopsy came back negative and took out 59 of the 86 so prostate size now 29. I can't say enough good things about the Mayo Clinic and Dr Dora and rest of the care team. The day before surgery at pre op, while going thru multiple tests, I have never seen anything as efficient. Blood drawn at 10 am was already posted to my app with results in 40 minutes, EKG results in 40 minutes, I was shocked, why cant every place work like this. So while only day 3, I am beyond happy with the results and again, can't say enough good things about Mayo and Dr Dora who is the goat as far as I am concerned with these types of surgeries.
Replies to "I just had holep this week 12/17. 65 yo, good health prostate 86cc...2 neg biopsies, 2..."
Thanks for the report @alexdav . I'm now seventeen days past my HoLEP procedure and have been reading this website and other user experiences to better understand my recovery. So I thought I'd sign up and report my progress.
One thing I've learned is that there is a wide variance in patient experiences. Some men seem to recover quickly with a strong urine stream, others take longer. Some men leak urine. Others don't. For me, my daytime flow has improved and I am emptying more of my bladder. I do not leak urine. But I still have an initial spurt of bright red blood when I urinate. I thought that would be gone by now. My urologist tells me not to worry, progress is often uneven. But I'm disappointed that I still have blood. I think I know why. I've long suffered from constipation and got accustomed to straining when sitting on the pot. I am taking a daily laxative but I still catch myself straining a bit and, when I do that, I get blood out the penis. So I just started using a combo approach—docusate + MiraLAX. I hope that will help.
My issue was difficulty urinating and sudden urgency, particularly at night. My prostate was 65cc when I had the HoLEP. I had been taking tamsulosin (Flomax) for about ten years when it stopped working so well. So the doctor doubled my dose but that didn't help much. Daytime wasn't a problem. But at night I was getting up six to eight times to urinate. That went on for a year. My sleep quality declined. My mood, alertness, overall health and quality of life declined. I discussed all the alternatives with the urologist: UroLift, Rezum, aquablation, HoLEP. I'm older and don't care that much about retrograde ejaculation, so I went with HoLEP.
Overall I'm satisfied although I feel that HoLEP is oversold a bit. Maybe I just didn't understand, but I thought I'd be back to normal in two weeks with a strong urine flow both day and night. But I still need to be careful about exercise, lifting, straining especially since I'm still getting blood. I spent one day doing nothing, just standing or lying down, to minimize any pressure around the perinium. The next morning, I had no blood when urinating. The following few days I walked and sat normally and also was pushing too hard when defecating, and blood came back. So I guess I'll need to be careful for some time. Otherwise, recovery will take even longer.
One thing I'm happy about, my nocturia has gotten better. I place two small cups on the bathroom counter. One cup has eight coffee beans in it, the other has none. When I get up at night to pee I move a bean from the first to the second to keep track of how often I'm getting up. I'm now averaging three to four bathroom trips. Last night was only two. That's a lot better than eight. I'm sleeping better at night, feel more rested during the day. Since that was my main complaint, I'd say the HoLEP is working as advertised. I wish my recovery was completely over and done with. I want to go back to strength training and home repairs. But I better not until the blood is gone and stays gone.
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Congratulations @alexdav ! I was fortunate and had Dr. Dora’s HOLEP surgery as well…..3 1/2 years ago! Smartest decision I believe I ever made! You’re on your way!