Eight days past HoLEP. Happy to answer questions.

Thanks for this report. I will be facing this procedure a little later this year, and am reading everything I can find. So this is really helpful. Congrats on your recovery, and good luck with the weeks ahead. In particular, it would be appreciated if you could follow up with reports on your experience with incontinence, if any.

@beren I suffered some minor incontinence in the two years leading up to the procedure. Not much but maybe two to three times per day one small drop of urine would slip out before I could “catch” it. Usually when driving. Never got to be embarrassing but it was uncomfortable.
Incontinence was my major concern going into the procedure (my wife’s too she told me later as she said I would be unbearable if I suffered for the long term). My doctor told me I would most likely have some. But he said it would be temporary (months at the most, not forever). To me that was the key. I can deal with temporary, I just didn’t see myself as wanting/needing to wear diapers the rest of my active life. My doctor explained that my prostate was doing a lot of the work that my bladder used to do (holding back urine) and my bladder would need to relearn its function. Made sense.
My most pleasant surprise since my surgery is that I have had almost zero incontinence. The first few days I had a tiny bit of bloody pee leakage but really very little. The last few days I’ve had almost zero. I don’t wear anything special around the house. I went to get my car serviced yesterday (first big outing since surgery) and did wear a liner in my underwear but had zero leakage. There are some tough stories about guys with serious leakage. So far I seem to be one of the fortunate ones. I will post again if anything changes.

Thanks for addressing this issue specifically and in such detail. Very happy for you! I have a few years on you, but am glad to have your experience to make me optimistic about my upcoming holep. Good luck on the rest of your road to recovery.

4 hours in the OR? Is it THAT complicated? What requires the 4 hours?

@bajjerfan Driven almost totally by prostate size. Given the size of mine it was not a surprise.

@beren Still have 1% incontinence 15 weeks post Holep. But it is 99% fine. I stopped wearing Depends during the day from day 33. Thereafter I only wore it at night, and each depends would last 3 nights wear because there was really no incontinence during sleep. In the last 4 weeks, I stopped wearing depends during sleep. There is still leakage 1% of the time especially on finishing urinating. Totally manageable.

Other than that recovery from Holep has been totally plain sailing!

@hoytgier Past 15 weeks post Holep. Stopped wearing Depends during the day, from day 33. Up until week 4 weeks ago, wore Depends only during sleep but that was really unnecessary because there was no incontinence during sleep, and each Depend lasted 3 nights of wear.

I returned to running from day 28. Did not need to wear depends! O urgency to wee or leak during that first run and still the same in week 15.

There was absolutely NO PAIN right from the moment I woke up from anesthetic after Holep. In short, recovery from Holep has been plain sailing.

@bajjerfan FOUR HOURS sound too long for Holep! Must be typo.

@heath2026 No, that time is accurate. I was scheduled for 3 hours and twenty minutes. Took a little longer than expected. I had a 200 gram prostate. If you research you will note that HoLEP scales linearly, meaning the bigger the prostate the longer it takes.

@heath2026
I guess I'll find out next summer. Got prostate reduction with dutasteride, but not enough. Currently not enlarged enough to need TURP. I will need intervention, but not on asap basis.