My experience with HoLEP has been very positive. I had it done by Dr. Amy Krambeck at Northwestern Memorial Hospital in Chicago. She has done over 3000 HoLEPs. My research told me that is what you want--someone who has done a lot of them. To answer your questions:
I was not in hospital overnight--it was day surgery at the hospital. I got out after a few hours in recovery. The catheter was removed in the recovery room that same day. There was almost no pain in recovery. I had only a little incontinence to begin with, and now almost none. My urination is much better after many years of struggling to urinate. When I urinate now I usually have a strong stream and seem to empty much better than before. I had no problem with getting out and about after the surgery. Actually was walking around Chicago the day after the surgery--probably too much activity that soon, but went just fine. Regarding sex, no problem getting an erection. Regarding ejaculation, I do ejaculate, but it is retrograde ejaculation--no sperm/seminal fluid comes out of my penis. I believe that is because the connection is cut when you have the HoLEP. So you do ejaculate but it goes into your bladder, I think. However, you do experience an orgasm just as before with great pleasure. I believe retrograde ejaculation results from every HoLEP.
A few addition thoughts: I needed a HoLEP due to medical necessity since at that point, in 8/21 I could not urinate at all and so it was covered by insurance. That was because I essentially went into acute renal failure due to urine retention. I only found this out as I was sick and went in for testing. I have ready that this often happens as very little symptoms of kidney failure, sometimes. Had my wife not insisted I go to the doctor, who knows how much damage my kidneys would have suffered. The urine backed up into my kidneys. I had urinating issues for years due to a very large prostrate--130 mgs at the time of the HoLEP--but no one ever warned or monitored whether I was retaining urine or the possible consequences for my kidneys. So important that you ask about this to avoid this issue. I wish I had been having bladder scans during those years which would have perhaps avoided my crisis but no one ever ordered one or warned me of this danger. I now have stage 3b chronic kidney disease due to the original problem in 8/21. I am okay but my kidneys will never be the same.
These are just my personal experiences, others may have had more complications from the HoLEP. There is a lot of info on the web about this, so do your research. All I know is from what I found there and then my own results of the procedure. Best of luck!
Thank you so much for the time and effort you invested to answer my questions, I am so very grateful! Your reply is informative and helps me prepare for what’s ahead. Have a great day friend!