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Post HOLEP weak stream
Has anyone experienced a very weak stream almost 7 weeks after HOLEP. Seemed like it was getting progressively weaker than all of a sudden it was just pencil thin stream for two days. Now, just a very weak stream with dribbling at the end.I was on oxybutynin for 17 days prior to this but stopped as soon as this started to happen called surgeons office got nurse practitioner. She pushed it off, just bladder irritation over the phone. i’m going to call back. Try to get an appointment with the surgeon which is always almost impossible or see my regular urologist when he comes back from vacation next week.
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I am 5 months from having a HOLEP. I have a bladder neck contraction caused by scar tissue from the surgery. It will and has caused a slower stream. I will need to have a second surgery to repair the bladder neck. Your urologist will need to schedule a cystoscopy to check what maybe causing the issue. Good luck.
I had HOLEP on June 19 this year. So I have just finished exactly 6 weeks rehab, today July 31. y recovery has been text book so far.There has absolutely no pain since I woke up from anasthetic on June 19. Catheter was removed at 40th hour post Holep, and urine has been 100% clear. For the first 4 weeks I used 2 x Level 3 Depends daily, Since then, it has been 1 x "Level 1" Depend each day, with the last 3 days this week, where I did not have to use Depend. The improvement is very gradual. Some days it might get "worse" but the trend is continual improvement towards full bladder control.
As for urine stream, it has been "Niagara Falls" gush by day 2 as soon as catheter was removed. Were you taking medication over a long period, to ease the "plumbing problem" before you had Holep? You must contact the urologist ASAP to find out why your urinary stream is getting weaker. It makes no sense. BE PERSISTENT. Keep ringing back to demand an answer. Do not suffer in silence. Demand a CYSTOCOPY immediately to find out what is going on INSIDE your prostate.
Another question re your medical history before you had Holep. Obviously you had to put up with this "male plumbing problem" for a while before you finally had Holep?
(1) Were you on long term prostate reduction medication?
(2) Have you had to wear a catheter for prolonged periods, due to blockage, before you finally had Holep?
If so, those two "treatments" can complicate your post Holep recovery simply because your muscles were forced to work differently to force urine through an enlarged prostate blockage. Now that Holep has totally removed the prostate blockage, but the muscles have been so used to have to work double time to force urination. It is still doing that (even without the blockage) hence causing an over active bladder. It will take time for the those muscles to re-adjust, relax, and stop being so over active.
I was told to lay off the coffee for a few weeks after Holep. Caffeine is a stimulant for urination. I went back to drinking coffee daily once I finished my 4 weeks. But I drink just a cup daily; not a heavy drinker.
@donkeegan
Have you had it for five months or did you just start to develop it? I’ve already missed enough work. I don’t think I can’t miss anymore. Is it something that can be put off until a person has the time? Had bladder scan and urine test they were both OK. Now I’m going for a uroflow in two days. My surgeon won’t be back to work till next week so I would have to wait for a cystoscopy anyway. Good luck to you.
@heath2026
First week my stream was like I was 20 again. I think I did too much too soon. Then it dialed back just a touch but still good. I was happy. Four week follow up told the surgeon about my bladder spasm squirts. He put me on low dose of oxybutynin. I was on it for 17 days stream didn’t feel quite the same finish was slower but it helped the spasms. One day like a flip of an of a switch everything changed super weak stream, but still emptying thankfully. waiting for the surgeon to come back from vacation going for a uroflow test in the meantime. I’m sure I’ll end up with a cystoscopy. It’s the only way to really tell. Glad everything worked out for you. My brothers went off without a hitch not even a leak. And he’s six years older than me lol
"bladder spasm squirts" .... just when you thought it was safe, they return! I have stopped wearing Depends during the day, since 10 days ago. If bladder spasm squirts happen, too bad! I only wear it at night, and 1 depend last 2 nights! I was average 2 daily (Depend Level 3) up until day 36. Today is day 48 post Holep.
Had my follow up appointment yesterday. The urologist told me I am his "text book" patient and he is using my example when he is training his students (I assume fellow doctors are learning how to use Holep). He mentioned that the bladder squirts will take time to fade away completely, at different rates for different people. I can see the trend of improvement in my case. Although it wasn't bad in the first 2 weeks (can't be that bad if I needed only 2 Depends daily, it has significantly improved by day 48. My scariest moment was on day 6 when I had a total block for an hour! I thought I would have to rush to ER but fortunately the "plumbing" was back to normal after an hour. Did you have the same urologist as your brother?
No, I wish I did, but he lives in Northern Vermont. I live in Massachusetts. If I could turn back the clock, I would’ve never taken the oxybutynin. The spasm squirts were just a nuisance compared to what’s going on now.I hope it didn’t do something to my bladder. I’ll find out a little bit more tomorrow. I am on week eight after week two I was using just maybe one pad a day sometimes two just to keep it clean. never had any soakers. now, for some reason when I get the leaks, I have to change right away. Glad to hear things went well for you.
@rkid
Had a cystoscopy after 4 months of fairly sever pelvic floor pain that they tried treating with antibiotics. While doing the cystoscopy the found the bladder neck contraction. It's rare but could be one of the causes of your issue. Best to see doctor and hopefully he will do a cystoscopy to help get to the bottom of the issue. Good luck.
@donkeegan
My pelvic floor has been achy right along. When I first got in touch with them last week, it was really sore and it’s still sore when I sit on it for a while. I read that’s one of the side effects of the obstruction. Did they happen to say to you or did you ask how long the recovery is going to be for that compared to the HOLEP. I work in a very busy kitchen lot of lifting especially with deliveries.
They put me on a prescription that took away the pelvic floor pain. Which was great. Uribel 118-10-40.8-36 mg capsule. Now I will have a second cystoscopy in a month to check progress of contraction. Scheduled for surgery early October. Your doctor should be able to diagnose the exact issue. Bladder neck contractures are usually caused by the HOLEP procedure but are rare. Also went through months of PT to help with pelvis floor pain and incontinace. Good luck.