Eight days past HoLEP. Happy to answer questions.

Posted by hoytgier @hoytgier, Sep 30 1:47pm

HoLEP Experience
I am 8 days past a hoLEP procedure and wanted to share my experience and offer to answer any questions. I was nervous prior and found this site helpful.
69 year old male. Tacoma area resident so traveled to Phoenix for the procedure. Large prostate, 200g. Flomax user but ability to urinate was deteriorating and occasionally needed to self-catheter. Ugh. I needed to do something. Otherwise healthy.
Surgery performed by Dr. Briggs and supervised by Dr. Humphries.
Four hours on operating table. Some bleeding beyond normal required an overnight stay (for which I was grateful).
So far I consider the surgery an overwhelming success. Still a little blood in urine and minor discomfort. Almost zero involuntary leakage of urine (and I was living with some prior to surgery). The first 24 hours after are difficult, uncomfortable and a bit painful. But much less so than I anticipated. Passed a moderate amount of blood and some decent sized clots. I was only on pain medication for three days after and it was only Tylenol. Thank god no opioids. My urine flow is strong and the discomfort (feeling like you need to hold back urine while peeing) eases a bit every day.
My care at Mayo has been outstanding. Dr. Briggs is young and very confident and competent. I trusted him from day one. Dr. Humphries is a legend and exudes confidence. I was pleased he was supervising. Nurse Grace in Observation was outstanding. Everyone at Mayo epitomizes caring, competent, professional medical care.
Has not all been perfect but I am very pleased. Fire away if any questions.

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Prostate Size Range Approximate Total Procedure Duration
Small to Medium (<60g – 80g): 25 to 45 minutes
Large (100g – 200g): 1.5 to 2 hours
Massive (>200g): 2.5 to 3+ hours

Big prostates do take longer. Surgeon experience definitely plays a role. So do the shape of the lobes and bleeding. It sounds like you had a younger surgeon performing under the watchful eye of a more experienced surgeon?

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Profile picture for wavelight2020 @wavelight2020

Prostate Size Range Approximate Total Procedure Duration
Small to Medium (<60g – 80g): 25 to 45 minutes
Large (100g – 200g): 1.5 to 2 hours
Massive (>200g): 2.5 to 3+ hours

Big prostates do take longer. Surgeon experience definitely plays a role. So do the shape of the lobes and bleeding. It sounds like you had a younger surgeon performing under the watchful eye of a more experienced surgeon?

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@wavelight2020 Correct on all counts. In my case a very large prostate and above normal bleeding lengthened the procedure and commanded an overnight stay. And, yes, to your question about my doctor. He was outstanding and I recommend him unequivocally.

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Had my Holep almost 5 years ago and could not be happier. I too was 200 grams and it took 3.5 hours.

Skip

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Profile picture for skipz @skipz

Had my Holep almost 5 years ago and could not be happier. I too was 200 grams and it took 3.5 hours.

Skip

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@skipz Thank you for posting; great to hear! Almost two weeks in for me and I also couldn’t be happier at this point. Continued good health to you.

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I'm 18 months post HOLEP (procedure on April Fools Day 2025) and I'm also located in the Puget Sound region. Before my procedure I had a catheter for seven uncomfortable months. And I had a giant prostate. When I asked multiple Urologists what they would do if they were me they both recommended HOLEP. Not easy to find a practitioner around Seattle then, but I did find two, Robert Caras - an active duty Army Urologist that also practices at MultiCare Tacoma and Brian Fong - a Providence/Swedish Urologist practicing in Everett. Saw them both, both agreed that HOLEP was my best option, but they were both booked at least three months out. Dr. Fong had the earliest availability so I chose him.

The procedure went well, in the hospital overnight. I needed diapers for the first four days, then pads for the next three months, with improvement in continence every week. Minimal discomfort after the procedure, nothing that Tylenol couldn't handle and much less discomfort than that awful catheter.

Absolutely no issues after six months. I have nothing but good things to say about my results or Dr. Fong. Make sure you have your questions written down in advance, Dr. Fong doesn't waste any time with chit-chat and he moves quickly,

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Profile picture for stripboat99 @stripboat99

I'm 18 months post HOLEP (procedure on April Fools Day 2025) and I'm also located in the Puget Sound region. Before my procedure I had a catheter for seven uncomfortable months. And I had a giant prostate. When I asked multiple Urologists what they would do if they were me they both recommended HOLEP. Not easy to find a practitioner around Seattle then, but I did find two, Robert Caras - an active duty Army Urologist that also practices at MultiCare Tacoma and Brian Fong - a Providence/Swedish Urologist practicing in Everett. Saw them both, both agreed that HOLEP was my best option, but they were both booked at least three months out. Dr. Fong had the earliest availability so I chose him.

The procedure went well, in the hospital overnight. I needed diapers for the first four days, then pads for the next three months, with improvement in continence every week. Minimal discomfort after the procedure, nothing that Tylenol couldn't handle and much less discomfort than that awful catheter.

Absolutely no issues after six months. I have nothing but good things to say about my results or Dr. Fong. Make sure you have your questions written down in advance, Dr. Fong doesn't waste any time with chit-chat and he moves quickly,

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@stripboat99 Great post. Appreciate you weighing in. Lots of guys like us looking for the best, most current information they can find. Congratulations to you and glad to hear you are living your best life.

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Correct. Apparently AI "Search" became confused with University of Washington, UW, with University of Wisconsin UW.

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Profile picture for dungeness @dungeness

Correct. Apparently AI "Search" became confused with University of Washington, UW, with University of Wisconsin UW.

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@dungeness There is a post above where Dr. Fong up in Mill Creek is highly recommended.

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Another great choice is Dr Austin Slade, Boise ID. Short flight from Seattle. Check out reviews/credentials/where they learned HoLEP/number of cases/etc before making your choice. My experience with Dr Slade was extraordinary

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Profile picture for soor @soor

Another great choice is Dr Austin Slade, Boise ID. Short flight from Seattle. Check out reviews/credentials/where they learned HoLEP/number of cases/etc before making your choice. My experience with Dr Slade was extraordinary

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@soor Thank you for posting. This kind of information is hugely beneficial to people. Continued good health to you.

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