Has anyone experienced incontinence after HOLEP surgery?

@elcorbs Oh My, so sorry. I hope you get answers and that it finally clears up. My UR was smart not to recommend the HoLEP, but again, any procedure has risks. We all should do our best to speak at length with our surgeons to decide on the right method. Good Luck.

@danilo1m Thank you. I did speak with my Urologist about the risks and did a lot of reading myself. One of my kidneys was not operating fully because of the urine backed up before the surgery. When I emptied I always had 400 plus ml remaining in my bladder. I only did this surgery to try and save my kidneys. I now have incontinence that won’t go away, constant UTI’s and to add to that ED. I was fine till the surgery, now it doesn’t work anymore. I consider myself to be quite young at nearly 74 and I am in good shape. I am learning to live with these issues and remain happy but disappointed in the final outcome of the surgery.

I had HOLEP done in October ‘24. I still experience stress incontinence but can normally get through a day on 1-2 pads, depending on my activities. I’m undergoing Pelvic Floor Therapy which seems to help both from the standpoint of exercises and getting another perspective on dealing with stress incontinence.

8 months out with persistent leakage. Quality of life is far worse than pre op. I’ve done everything that was suggested by the practice or that my research indicated. Surgeon seems to feel the outcome was successful but I obviously disagree. Wearing wet pads and depends 24/7 is miserable. Surgeon simply reminds me of the risk and that it takes time. Provided a referral for artificial sphincter after I reach a year but I’m reluctant to pursue that. I would recommend caution and diligence in vetting surgeons and not dismissing the warning of the 2% incontinence risk.

I had HOLEP in Dec 2024 and it was a failure. I had recurring UTI’s for 14 months, always wore depends or underwear liners. It never got better. It took me 10 minutes to empty my bladder. On March 3, 2026 my doctor did a real quick TURP procedure. Since that time my life has gotten better. I don’t wear liners when I go to bed and I can pee like a teenager. Not sure what he and another urologist saw that corrected the HOLEP, but it worked. I hope to be fully back to normal in the next few weeks. No more depends or liners.

@elcorbs Nine months out and still with reduced but still life altering leakage. Been plateaued for past 4 months. Diligent Kegels and other exercises. Bottom line is I rushed into it with a less experienced surgeon and am now looking at a year of misery and possible AUS. I can’t emphasize enough doing due diligence on surgeons. Don’t let an inexperienced surgeon use you for practice. Regret it every day.

I am 12 months past Holep and still leaking. I am 67, healthy, proper weight, bph had a 85-90 prostate. No incontinence prior to surgery. I had two doctors post surgery told me the holep caused incontinence. The surgeon was not interested in seeing me after my 6 month follow up. He referred me to an artificial urinary sphincter doctor. I still do kegels, etc. Penn State Hershey PA. did the surgery. I complained to the patient advocate and the hospital did nothing. I was also told the Holep instruments are large and they stress the sphincter quite a lot. Something I was not told prior to surgery. I went to Johns Hopkins also, that surgeon also said the surgery caused my incontinence. I have found on the internet information that claims Holep surgery incontinence can run as high as 40% of cases. Some resolve, some do not. If I could have a do over I would choose another remedy, one that is less intrusive and saves the sphincter from stress. Having an unsuccesful procedure that can be done again is far better than the point of no return from Holep. I am beginning to think this Holep thing is more like a commercial money maker for someone. All the advertising pre surgery was misleading. Holep has destroyed my quality of life.

@elcorbs
Glad to hear you are making progress!
I would be really interested to hear how the TURP corrected your issues. I had a holep and was always told it would remove, and did remove all of the tissue within the prostate. The surgeon (who does not do Turp) told me holep was more effective than turp because holep removes everything, whereas turp is "just" a resection, and might have to be redone. Of course a surgeon specializing in TURP would tell me TURP is better than holep! Some salesmanship going on IMO.
I had some leakage and urgency for the first days, maybe week, but not serious. Flow is really not much different from before, that is to say quite adequate, not a problem. However I have not experienced the "flow that lets you pee again like a teenager" that a couple of TURP recipients have told me about.

@southwest After 14 months of incontinence and standing over the urinal/toilet for 5 minutes to empty (which never occurred) along with 11 UTI’s, I was totally frustrated. Like I said previously, the second opinion I received confirmed the failed HOLEP and my surgeon completed a TURP procedure to correct the area of my prostate that was pooling the urine and not allowing me to flow freely. My next appointment with the surgeon is June and I will see if I am completely emptying my bladder with the void test. I can tell you right now, I am emptying. I haven’t had this feeling for probably 30 years or more. I will also know if I am not emptying once I get off the antibiotics and see if I get another UTI. I only had 2 UTI’s over my lifetime prior to the HOLEP and had 11 UTI’s over the last 14 months. I never gave up on doing kegels. I was only wearing guards in my underwear and only use 1 all day. Now after the TURP I can sleep at night without the guards and only wear during the day for stress leakage!