holep surgery recovery

My HoLEP was 2 July 25 and I have similar issues. My pain hits when my bladder empties, I do a Kegel and it stops but my bladder is still overactive. My bowl movements cause a pain in the tip of my penis like a razor blade, I try not to push and let my body do the work and that helps. I take extra Magnesium to help soften my stool. The rectum and prostate are innervated by the same nerve so that explains the pain relationship and I'm hopeful with more time this will diminish. I also have pain when I rock forward after sitting. It seems the base of my penis is tender and can be very uncomfortable at times. I hope this improves. Overall goal of a great urine stream has been met and exceeded. I'm so much better, not perfect, but good. Let's check back at 6 months?
BTW, I monitor the Aquablation posts to compare results to mine. There are so many more posts, tons of serious complications with bleeding, readmissions etc. I think the post op course is tougher with Aqua than HoLEP. It seems like most are happy after they heal but it's not a 100% guarantee that you will have normal ejaculations.

Have you turn the corner yet?

@chop
I would say there has been some improvement, but not enough. Having a test next month to get more information about the condition of my bladder. PT helped some. Still doing kegels as directed. trying another medication. Did a cystoscopy a couple of months ago and was told the sphincter is weak and everything looked fine. Looking into alternative treatments. Also thinking about another opinion from a place like Mayo. Talked to another doctor but his specialty is artificial sphincter surgery and that is what he wanted to perform. Not sure I am ready for that. Wish I could be more positive but it just isnt there.

@rwinpa thanks for the update I’m only 6 weeks post HoLEP but my symptoms are exactly the same I’m even 67 my prostate was 106. Didn’t dream it would be like this I hope you get control soon.

Here is my story. I had holep procedure on March 18th so I am only 9 days out from the surgery. I am 75 years old and generally in decent shape and overall health. I am 6'2'' and weigh 215 pounds and have always been athletic. I played football and other sports back in my day and continued to play other non-contact sports until just a few years ago. I later switched to bicycle riding and light weight lifting, which I did until this recent surgery. I was diagnosed with BPH about 15 years ago and was prescribed finasteride and tamsulosin. I continued to take those meds until just recently when I had the holep procedure. My BPH was very manageable with those meds. I would wake up every night about 3am to use the bathroom and after that I was ok until around 6:30am when I would get up for the day.
However, I was unable to fully void my bladder and my urologist told me that condition would get progressively worse and would lead to more serious problems later unless I did something about it. He also told me I could stop taking those meds if I had the holep procedure. The thought of taking fewer meds was very appealing to me. I made the decision to have the procedure based on those two facts.
I realize it has only been 9 days since the surgery and is probably much too soon to know but I am wondering if I made a big mistake in doing this. I was able to manage the BPH before the surgery and still maintain an active lifestyle but holep has put an end to that (temporarily I hope). I don't have pain but the incontinence is driving me crazy. The surgeon told me to expect some "leakage," but this has been more like a flood. I am a prisoner in my own home and I can't go anywhere. I have been using incontinence pull-up underwear but as soon as I put on a new pair I leak again and need to change once more. I can't resume my normal active lifestyle and I did not expect that. I know it is early in my recovery, but I really need some encouragement that the incontinence will at least show some improvement soon and eventually go away. I am very discouraged right now and I need some help. I am getting no help or encouragement from the doctor's office. All they did was prescribed some physical therapy (pelvic floor exercises) but my first appointment is still 5 weeks away. Can somebody offer some encouragement? I really need it. Thanks.

So sorry to hear this, I had HoLEP of the exact same day with Dr. Slade in Boise ID. Here is my google review:
At age 74 now, I suffered with symptoms of enlarged prostrate for over 25 years. I had a UroLift years ago, which helped for only several years. I took meds for many years, but BPH symptoms worsened. Then recently I had a very large bladder stone which led to pain and periodic bleeding. My Wisconsin urologist suggested a TURP but after very extensive research I concluded the best treatment would be a HoLEP performed by Dr. Slade. I submitted an e-mail request to Dr. Slade, and he called me the next day. He agreed to see me and do my surgery within a few weeks. We traveled from NE Wisconsin to Idaho. He was in network with my insurance and the whole process was flawless and nearly painless. My symptoms began to improve immediately. I went from being up 7-13 times a night to sleeping through night or maybe up 1-2 times. I would highly recommend this procedure with the experienced Dr. Slade and his very professional team. For me they were an answer to my prayers!
You may wish to reach out to him. I was struggling with some leakage (urgency) before the surgery, so he used Botox in the bladder as part of the surgery. Now it is 95% better, rarely an issue now. To anyone reading this... an experience surgeon really does mater, Dr. Slade will soon hit 1000!

@sittingdeer couldn’t agree more on surgeon experience. I rushed into Holep with a less experienced surgeon and am still leaking 10 months later. Do not let an inexperienced surgeon practice on you. They are much more likely to do damage that cannot be reversed. I’m still stunned by the arrogance it takes to use patients to practice without mentoring.

@sittingdeer
I guess everyone recovers from the surgery differently. I now get up only 1 time a night (around 1:30 - 2:00am) and then I sleep through the rest of the night until about 6am. This is a good thing, but daytime is another matter. Once I am up and walking around I constantly leak. I assume this is because when I am lying down my bladder is in a position in which urine does not leak out as easily as when standing or walking. I'll just have to wait longer and see how it goes.
Thanks for sharing your experience with Dr. Slade. I am not going to mention my surgeon's name but when I first spoke to him he told me he had done this procedure more than 1000 times over the past few years with a success rate of over 99%. I guess I should have asked him to clearly define success rate. That sounded like plenty of experience to me.
Oh well. I'll just try to stay calm and carry on the best I can. Thanks.

@leo3 I had Green Light laser surgery 11 yrs ago for my BPH. It wouldn’t have changed my mind, but no one said it would last only 10 yrs, the symptoms returned and I’m in need of another surgery . This time it was recommended and I opted for Holep as I’ll never need to go through another BPH surgery. The surgeon is at Yale New Haven Hospital Urology and he’s the gold standard there, as well as the entire east coast. I’m planning the surgery during the summer and hope it’s a better experience than I had with Green Light. It took me 2 months to pee without a catheter. 🙏

@aflik The green light laser surgery caused you to have the exact opposite side effect that I had with holep. You couldn't pee normally for 2 months after. I pee uncontrollably ever since holep surgery. Both situations are bad. I assume after the 2 months you were able to get back to living relatively normal. Yes, it's true holep offers the longest lasting results and that is one of the reasons I opted for holep. The other reason was I take a blood thinner (warfarin) and holep results in less bleeding than the other procedures. Sounds like you have the best available surgeon. Good luck with the procedure and your recovery.