holep surgery recovery

Posted by rwinpa @rwinpa, Jul 4, 2025

I had holep surgery in march of 2025. Three months later and I still leak constantly during the day. Night time in bed I can sleep all night and wake up pretty much dry, but on my feet, especially with activity I leak almost constantly, 6-7 depends guards a day. Very frustrating. Three month follow up the Dr. did not have much to say. Started myrbetrique and said keep doing kegels. Called a place to start pelvic floor PT. Very trying time. Can't really go anywhere or do anything. My prostate size was in the 90's and I am a 67 year old in good health.

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soor | @soor | Jul 14 9:34am

Many of the high volume, highly experienced HoLEP surgeons are discharging their patients the same day without a catheter. If you pass your voiding test and meet all their other criteria you go home without one!

duntama | @duntama | Jul 14 12:04pm

Had TURP 5 weeks ago. Burning and perineal pressure have continued unabated. Dr gave me tramadol, didn’t work and caused panic attacks. Now he wants me to try bee venom suppository. First he said 6 weeks to heal, now he says maybe 3 months.

heath2026 | @heath2026 | Jul 14 5:01pm

In reply to @robert5167 "Did you have a catheter when you were discharged after Holep ?@heath2026" + (show)

@robert5167 Holep was on afternoon of June 19. Catheter was removed at 6am 21 Jun. I went home by 10 am. The catheter was on after Holep for the purpose of continuously flushing the treated area - the color went from light pink to almost colorless 24 hours after Holep. By the time I left hospital, the voiding without catheter was 100% clear. I checked the various procedures and rejected those that require me to go home with a catheter! I am on day 26. In that time day 2-18 saw 100% clear urine. Days 19-24 saw some color (expected "scabbing of prostate internal surface as it heals), then clear on day 25. Then some color over night day 26 but has since totally cleared again on wkaing up day 26. Two more days and I will be allowed to return to running. There has been a 4 week ban of exercise activity. There is absolutely no pain, not even in the slightest, from Holep. Amazing.

robert5167 | @robert5167 | Jul 14 5:48pm

In reply to @heath2026 "@robert5167 Holep was on afternoon of June 19. Catheter was removed at 6am 21 Jun. I..." + (show)

@heath2026
I have difficulty starting and retention. Doctor is advising Holep over other procedures.
Never been catheterized, have you had incontinence and how bad ?

heath2026 | @heath2026 | Jul 14 10:21pm

If you do not have a long history of being stuck on catheter, you will have no problems recovering from Holep. In my case I had Holep at 2:30PM on June 19. When I woke up, it was about 4:15pm, and I was attached to catheter. This was left on over night, to flush the bladder with saline solution. NO PAIN. I took 2 panadols ONLY because I was given and asked to take it soon after I woke up. I didn't need to take it and refused any more when they kept asking me if I wanted more Panadols. There is absolute no pain and no discomfort! By 10am Sat, I was still stuck with the bag (catheter) but no longer stuck to the machine that circulated the saline solution. I had a shower with that "bag" with me. At 5:30am on Sunday, they removed the catheter, ask me to wee, which I successfully did. I was discharged at 10am and by that time, my urine was 100% clear. It is day 26 for me of a 28 day ban on exercise such as running. So far very UNEVENTFUL (which is good). Holep is very advanced now and makes the old giold standard TURP look "barbaric" and outdated. I had Greenlight in 2012 but like most other procedures, the prostate will regrow back over the years. Holep was still new in 2012 hence I didn'thave it, Now Holep makes Green light outdated.

Greenlight - laser is used to burn off a channel for the urine to flow through. During the 4 weeks of recovery, bits and pieces of prostate tissues that had been lasered (burnt) die off, detach, and sometimes cause a momentary blockage - chunks of dead prostate tissue being ejected from bladder. When the prostate grows back over the years, it looks chaotic - like a cave of nodules that can bleed easily during running!

During HOLEP, the internal prostate tissue is cleanly "peeled out", leaving the outer prostate capsule. So no tissue is left to regrow back in the next 10 years! Also what is peeled out, is totally removed from the bladder during procedure. That tissue is sent to the lab to test for cancer etc (part of Holep). So the great part of Holep is you do not spend the next 4 weeks passing out lumps of dead prostate tissue that can "clog up your plumbing". This is the huge difference between old procedures such as greenlight and Holep. So far, only ONCE, on day 10, did I see a tiny "speck" passed out in the urine! Why? Because the tissue hollowed out of the prostate capsule was all removed during the Holep procedure. That is the best part of Holep!

alfonse | @alfonse | Aug 8 8:20am

In reply to @rwinpa "@chop I would say there has been some improvement, but not enough. Having a test next..." + (show)

@rwinpa I would recommend looking into seeing Dr Mitchell Humphreys at Mayo Clinic in phoenix. They are actually doing a EMSELLA chair study for post HoLEP incontinence. Also Dr Humphreys has done about 7,000 HoLEP Surgeries. I had to wait two months to get it done by him. I’m 3 weeks out and do have incontinence. Mostly stress incontinence. But it is now getting better and better by the day. I went from using 5-6 pads a day and now 2-3 pads. Hopefully I get to zero pads!