Age 63, 55 gram, large median lobe, high bladder neck, 26 grams removed.
Daily Coumadin (anticoagulant) - for Mechanical Heart Valve
Urolift in 2021. Complete failure. Median lobe issue, not part of the procedure.
I was, at the time, and 2 years later, under the impression that I did not have a median lobe issue.
2nd Uro confirmed large median lobe and high bladder neck Aug 2023.
February 8th, 2024: HoLEP Performed.
February 9th
Catheter removed. Returned, 5 hours later with kidney pain and 950 ml urinary retention. Catheter was inserted and remained in place thru the weekend.
The catheter clogged 3 times throughout the weekend. Each time it was unclogged, 100's of clots came out.
February 12th:
Urine was clear, no blood
Catheter was removed. Returned 5 hours later.
In order to start a stream I was required to bare down hard. I was able to empty my bladder with 20 ml remaining.
I told the doctor about how hard I had to bare down. He was not in favor of a 3rd catheter stating it was most likely swelling, not blood clots causing the difficulty in urinating. He said give it some time.
February 16th:
Required to bare down to start, but nowhere near as hard as I did on the 12th.
I have a small amount of blood at the point where my bladder is almost empty.
I do not empty in one void.
I am required to do kegels in order to get the remaining urine pumped out, so to speak.
February 18th:
Able to urinate without pushing. There is an obvious start delay at this time, but its progress in the right direction.
I do not have full stream yet. Swelling appears to be subsiding.
On another note; I have a strong desire to itch the perineum, which is another sign of healing / scabbing.
February 19th:
Additional notes; when blood is present in the urine, I get overactive bladder symptoms, the feeling that I need to urinate when I don't.
I have been walking for the last 4 days on a treadmill, 20 min increments, on a pretty good incline, enough to break a sweat.
Immediately following the walk, I place an ice pack on my perineum to reduce any inflammation I may have caused from the walk.
February 20th:
This morning, I start passing very large blood clots.
The good; swelling has reduced enough enabling me to pass the clots. I would not have been able to pass the clots 5 days ago.
So far, the rest of the day has been free of any clots.
February 25th:
Very small amount of blood at the end of a urine stream following the 1st bowel movement of the day.
No blood for subsequent bowel movements.
I get up 4-5 times a night to go to the bathroom. I believe this is due to the fact I'm drinking water up to the time I go to bed.
I have a lingering spasm/ feeling in my urethra to go to the bathroom after I empty my bladder. Subsides after 20 minutes.
February 26th:
Starting to see tiny scabs. No pink colored urine, so far.
February 27th:
More pink than usual at the end of a stream
Perineum feels swollen. Uncomfortable sitting in a car seat. Couch is ok.
February 28th:
One scab, no pink. Perineum doesn't feel swollen.
Continued urethral spasms for about 20min following an empty bladder.
February 29th: 3 weeks Post-Op
No pink as long as I don't push hard while having a bowl movement
No scabs
Continued urethral spasms - not lasting as long or as intense
March 1st - 5th:
No Pink
Continued urethral spasms - not lasting as long or as intense
Nocturia - Continuing to get up 4- 5 times per night to urinate
March 6th 11:30 a.m:
Delayed urination until Bladder was full. I do not get the pp dance, urgency to go feeling anymore . Just the pressure.
The stream is strong on the first void. Void stops, then requires pushing on the subsequent voids in order to empty the bladder fully.
March 7th 9:00 p.m.
1st experience with retrograde ejaculation.
Forceful ejaculation; burning, throbbing, and cramping from my scrotum back to my rectum.
I could feel the semen shooting back into my bladder.
No blood following the experience.
March 10th 2:00 p.m.
2nd Experience with retrograde ejaculation.
Confirmed retrograde (dry), although it didn't feel like it. No pain, no blood
Orgasm Intensity is about 70-75% of pre-op
Occasional urethra spasms
Occasional Perineum Cramps on left or right side, not at the same time. Occurs mainly on the right side.
Starting a Urine stream is quick and easy. Additional rounds of pushing required in order to empty completely.
March 15th
3rd sexual experience ejaculated about a teaspoon of Semen
Noticing slightly red urine drops only following a bowl movement.
Only notice the red when urine drops landed on the toilet seat.
Urine continues to spray to the right side (makes a mess), similar to poor flowing sprayer nosal,
instead of flowing like an open ended hose.
Occasionally, empty the bladder on the 1st void.
Most of the time, additional rounds of pushing is required to completely empty.
March 20
Urine flow spray is starting to reduce
Urethra spasm have reduced in frequency and intensity
- Spasms are felt anywhere from the base of the scrotum to the tip of the penis
March 21 -- 6 Weeks Post - Op
- Dry ejaculation continues
- Post-op Nocturia... 3 - 6 times per night with 5 being the average - Fluids stopped at 5 pm.
- Pre-op Nocturia..... 3 - 30 times per night. 15 - 120 minutes to void to the point I could resume sleep. 8-10 being the average - Fluids stopped at 3 pm.
- Urethral spasms continue with occasional perineum cramps (assuming overactive bladder)
- resumed very light gym exercise routine.
- 1st void doesn't empty the bladder completely, but I get most of it out.
Thoughts:
The surgery exposed how extreme my urine retention had become over the past 3.5 years.
A prime example would be Feb 9th. A full bladder was normal to me.
I didn't recognize that I had an emergency room issue (950 ml).
I felt pain in my back (kidney), but thought it was gas from the anesthesia.
I have recently tried to let my bladder fill to my Pre-Op levels in an attempt to reduce my over active bladder (nocturia) issues, but I can't get there. It becomes way to uncomfortable for me to hold it that long.
I can easily push on my bladder and not feel like I need to go. Completely, opposite of my pre-op days.
Hopefully, at 12 weeks most of my residual issues will resolve themselves. I intend to update at that time.
March 22
Stopped fluids around 5:00 p.m. Snack, around 7:30pm, of 10 chips containing 70 grams of Sodium.
Up three times instead of my usual 5, to go to the bathroom. Full each time.
A short delay requiring a small push to start the stream.
The stream sprays, not solid flowing.
In order to completely empty following the 1st void,
I am required to push on subsequent voids.
March 23
Retrograde:
Partial - more than 50% antegrade, did a hard kegel during orgasm. Close to pre-op intensity.
A couple of globs with some trace blood came out when urinating.
Nocturia
Repeated March 22 experiment with more salt
Stopped fluids around 5:00 p.m. Snack, around 7:30pm, of 10 chips containing 70 grams of Sodium. plus salted hard boiled egg
Up 2 times instead of my usual 5, to go to the bathroom. Full each time.
A short delay requiring a small push to start the stream.
The stream sprays, not solid flowing.
In order to completely empty following the 1st void,
I am required to push on subsequent voids.
March 27
Nocturia
Rough night, stopped fluids and food at 3:30pm. NO snack or salt before bed
Urinating like a horse every 30 min.or sooner. This went on for 2-3 hours.
After falling asleep, I was up an additional 3 times.
For me, salt definitely reduces my night time bathroom trips.
March 27
Nocturia
Rough night, stopped fluids and food at 3:30pm. NO snack or salt before bed
Urinating like a horse every 30 min.or sooner. This went on for 2-3 hours.
After falling asleep, I was up an additional 3 times.
For me, salt definitely reduces my night time bathroom trips.
March 28 & 29
Nocturia
In my failed search for a low dosage salt table, around 100mg, I ran across Cell Salt tablets.
They are small and melt under your tongue.
The tablet contains 12 different Cell Salts in 1 tablet.
4pm: Stopped fluids and food
10pm: Placed 2 cell salts tablets under my tongue and went to bed
Up 2 times each night instead of my usual 5.
The cell salts appear to contain enough salt to reduce my night time bathroom trips.
March 28 & 29
Nocturia
In my failed search for a low dosage salt table, around 100mg, I ran across Cell Salt tablets.
They are small and melt under your tongue.
The tablet contains 12 different Cell Salts in 1 tablet.
4pm: Stopped fluids and food
10pm: Placed 2 cell salts tablets under my tongue and went to bed
Up 2 times each night instead of my usual 5.
The cell salts appear to contain enough salt to reduce my night time bathroom trips.
April 4 - 8 weeks post-op
No visible signs of blood since March 31
Urine flow sprays if my bladder is not full and streams when very full.
Stopped, Cell Salts, April 1st. They increased the time to start a stream to around 30 seconds on my night time bathroom trips.
The cell salts contained antihistamines and pain relievers.
I believe the pain reliever helped reduce the trips to the bathroom and the antihistamine caused the delay in starting a stream.
Taking ibuprofen before bed is a common practice to reduce your bathroom trips, but it’s hard on your liver.
Incorporating more red meat, instead of chicken, for the taurine and B vitamins.
Results:
- 4 hamburgers in one day, up 2 times that night
- 1 hamburger the next day, up 3 times on that night.
Short bouts of depression, around the 7 week post-op time frame, thru April 3.
I can definitely tell that my body is going thru some chemistry changes.
The depression may be my body reverting from a sympathetic (3 yrs of fight or flight) mode to a parasympathetic (rest and digest) mode.
April 4 - 8 weeks post-op
No visible signs of blood since March 31
Urine flow sprays if my bladder is not full and streams when very full.
Stopped, Cell Salts, April 1st. They increased the time to start a stream to around 30 seconds on my night time bathroom trips.
The cell salts contained antihistamines and pain relievers.
I believe the pain reliever helped reduce the trips to the bathroom and the antihistamine caused the delay in starting a stream.
Taking ibuprofen before bed is a common practice to reduce your bathroom trips, but it’s hard on your liver.
Incorporating more red meat, instead of chicken, for the taurine and B vitamins.
Results:
- 4 hamburgers in one day, up 2 times that night
- 1 hamburger the next day, up 3 times on that night.
Short bouts of depression, around the 7 week post-op time frame, thru April 3.
I can definitely tell that my body is going thru some chemistry changes.
The depression may be my body reverting from a sympathetic (3 yrs of fight or flight) mode to a parasympathetic (rest and digest) mode.
May 2nd - 12 weeks post op.
From what I have read, most of my healing should be completed by now.
Where am I in the process?
Sex and Retrograde:
Ejaculation intensity is about 98% of pre-op. I'm only leaving off 2% because I still feel like there's something missing.
I'm making a big assumption that there is some nerve endings towards the end of your penis which gives you that completion or satisfaction feeling after ejaculation.
Since I do not feel the semen coming out, I miss that feeling.
It's not a visual thing it's purely sensual.
At times I could swear it's coming out the correct way, but it's not. I've actually had my wife check herself a couple times, nothing there.
My semen appears to be contained within the urethra or prostate. I’m assuming this due the globs of semen I urinate out after sex.
I've never had cloudy urine.
Flow:
If I'm full, within 5 seconds, I relax and it just comes out in a full stream.
If I'm not full, 15-20 seconds, I relax, feeling the urine coming down, slowly, but when it comes out it sprays until a full stream is achieved.
Pushing to start a stream is very common for me unless I'm very full.
Spaying is new to me; I did not spray prior to my surgery. It seems to have gotten a little bit better since I 1st mentioned spraying,
I have found that certain foods (salty) or supplements will cause a delay in starting a flow (15-20 sec), regardless of how full I am.
Burning:
I still feel, couple times a day, some burning at the end of my penis.
Nothing intense, but notable.
Some odds and ends:
Recently, in the perineum area, I feel like I pulled a muscle. Not sure how, not exactly sure when.
That lasted for a couple of days. And it literally felt like a pulled muscle on the right side of my perineum south of my rectum.
Stun gun shocks:
I used to get these on the right side of my perineum all the time. 3 weeks ago they shifted to my left side. However I have not felt any for the last week or so.
It literally feels like somebody briefly turned on a stun gun. The shock radiates from my rectum to the end of my penis. Very much a surprise when it happens.
Nocturia:
This one will not leave me alone. I get up on average between 2 and 4 times a night.
I still have bouts of anxiety when I'm trying to sleep, so on occasion I'll take Xanax, if my supplement stack doesn't work.
The Xanax allows me to sleep through the night without bathroom breaks.
The stack lets me sleep between two and four hours on average between bathroom breaks.
If I don't take the stack or xanax, sometimes, I can get two to three times between bathroom breaks.
Everything is dependent up on my anxiety level at bedtime.
Habits:
Going to the bathroom, pre-op, multiple times before I leave the house is still a standard procedure for me, when it shouldn't be.
Regrets:
I have no regrets
The frog in boiling water metaphor is the best way I can describe my pre-op condition.
My condition declined over the years until I was about to reach the boiling point, but didn't recognize it. I automatically adapted to my new normal.
A few weeks post-op, I started looking back and recognized the extreme severity of my condition, mentally and physically.
Physically, it was bad, no substantial complaints on my current status.
Mentally, it was worse. This is something which will take me awhile to overcome. Occasional depression, anxiety is the main issue.
Depression is simply chemical, changes in body chemistry, since I no longer am on edge all the time, my body chemistry goes in the opposite direction some times.
Anxiety, I'm down to 3 times a week, mainly when I'm trying to sleep.
Pre-op days I would basically play beat the clock.
Could I get to sleep before I had to go to the bathroom? This was critical at the time because it took me anywhere from 20min - 2hrs to empty my bladder.
By that time I was wide awake again.
This is the source of anxiety which is lingering today.
End of week (9 days as of today) post HoLEP procedure. May 2 (day of surgery) to May 11. Age 61, 105cc prostate, general anesthetic with propofol and rocuronium and gas inductions. I live alone and have taken care of all of my own needs. American in Barcelona, Spain.
Not as much incontinence as I expected. I can stop the stream at will and resume.
If I am full, some tiny dribble-squirts in my light underwear pad. Nothing dramatic enough to immediately swap out for a new one.
The first day post procedure while still in the hospital, I was left alone after catheter removal to pee.
I was taken aback that I was literally getting an erection. This ability has not stopped.
First week at home:
Bed rest.
Consuming high fiber foods, taking Augmentin 500/125 for 7 days. I finished as of Thursday May 9.
Urine started out as dark cranberry-color, but throughout the week later in the day appears normal in color.
At times there is a little stinging at the tip of my penis, but I found that pushing my lower abdomen out to force a stronger stream- I'm talking garden hose- settled the sting. The sting goes away completely by midday.
Nocturia
Note: I keep a large 8 liter water bottle near my bed to pee in while I am in bed so I can get back to sleep. I can also examine it upon morning for color. I see scabs and little clots at the bottom, the color is like a rosé wine, but this is due to dilution from nocturia multiple. Today's scab that was sloughed off was approximately 3 cm in length.
There has been urge frequency, but I prefer not to hold it in since I want to eliminate the antibiotic and any clots / scabs that may be there. If I am out, and experience the urge, I am able to hold it until the urge settles and I pee comfortable at home.
This week I did a test for erectile function. Too soon for this, but I felt compulsive and really need to be patient.
While stroking I discovered that a pre-semen fluid was coming out of my penis. I don't understand why, unless 1) the surgeon did a "partial enucleation," leaving enough gland behind, or, 2) it is traces of semen emerging through the urethra. My follow-up and cytology discussion with the surgeon is June 3.
Orgasm was achieved, yet it wasn't as fulfilling as when semen flows outward. The nerves in the urethra aren't registering the sensation of ejaculation and this could be that "thing" that is "missing." Instead of semen, it was a few shots of urine, not as comfortable since my urine PH is likely more acidic due to the antibiotic. Not the same. Neither would I care to ejaculate urine with a partner. I'm hoping this ceases at some point.
Presence of frank to light blood at the beginning of the day is present at the beginning of the stream, but quickly runs clear- normal in color. This could originate from the bladder and descend to the prostate capsule or an accumulation solely in the capsule.
I am resuming bed rest with occasional excursions to the market for supplies. No bearing of heavy weight, or extreme bodily movement. I have cabin fever, I am pale from lack of sunlight, but it will be a little time after taking Augmentin that I will be having any prolonged exposure to UV light.
I am very pleased with this outcome so far, the rate and pace of healing, all seem within textbook norm for the most positive outcomes and I would recommend this to any man facing surgery. I would have had the P.A.E. if it was offered here in Barcelona, Spain, under the socialized healthcare scheme; I had to demand HoLEP because I wanted to avoid blood transfusion risks. With a 105cc-sized prostate at age 61, under the extreme stress and elevated cortisol, I would eventually have it all removed for the factor of regrowth.
May 2nd - 12 weeks post op.
From what I have read, most of my healing should be completed by now.
Where am I in the process?
Sex and Retrograde:
Ejaculation intensity is about 98% of pre-op. I'm only leaving off 2% because I still feel like there's something missing.
I'm making a big assumption that there is some nerve endings towards the end of your penis which gives you that completion or satisfaction feeling after ejaculation.
Since I do not feel the semen coming out, I miss that feeling.
It's not a visual thing it's purely sensual.
At times I could swear it's coming out the correct way, but it's not. I've actually had my wife check herself a couple times, nothing there.
My semen appears to be contained within the urethra or prostate. I’m assuming this due the globs of semen I urinate out after sex.
I've never had cloudy urine.
Flow:
If I'm full, within 5 seconds, I relax and it just comes out in a full stream.
If I'm not full, 15-20 seconds, I relax, feeling the urine coming down, slowly, but when it comes out it sprays until a full stream is achieved.
Pushing to start a stream is very common for me unless I'm very full.
Spaying is new to me; I did not spray prior to my surgery. It seems to have gotten a little bit better since I 1st mentioned spraying,
I have found that certain foods (salty) or supplements will cause a delay in starting a flow (15-20 sec), regardless of how full I am.
Burning:
I still feel, couple times a day, some burning at the end of my penis.
Nothing intense, but notable.
Some odds and ends:
Recently, in the perineum area, I feel like I pulled a muscle. Not sure how, not exactly sure when.
That lasted for a couple of days. And it literally felt like a pulled muscle on the right side of my perineum south of my rectum.
Stun gun shocks:
I used to get these on the right side of my perineum all the time. 3 weeks ago they shifted to my left side. However I have not felt any for the last week or so.
It literally feels like somebody briefly turned on a stun gun. The shock radiates from my rectum to the end of my penis. Very much a surprise when it happens.
Nocturia:
This one will not leave me alone. I get up on average between 2 and 4 times a night.
I still have bouts of anxiety when I'm trying to sleep, so on occasion I'll take Xanax, if my supplement stack doesn't work.
The Xanax allows me to sleep through the night without bathroom breaks.
The stack lets me sleep between two and four hours on average between bathroom breaks.
If I don't take the stack or xanax, sometimes, I can get two to three times between bathroom breaks.
Everything is dependent up on my anxiety level at bedtime.
Habits:
Going to the bathroom, pre-op, multiple times before I leave the house is still a standard procedure for me, when it shouldn't be.
Regrets:
I have no regrets
The frog in boiling water metaphor is the best way I can describe my pre-op condition.
My condition declined over the years until I was about to reach the boiling point, but didn't recognize it. I automatically adapted to my new normal.
A few weeks post-op, I started looking back and recognized the extreme severity of my condition, mentally and physically.
Physically, it was bad, no substantial complaints on my current status.
Mentally, it was worse. This is something which will take me awhile to overcome. Occasional depression, anxiety is the main issue.
Depression is simply chemical, changes in body chemistry, since I no longer am on edge all the time, my body chemistry goes in the opposite direction some times.
Anxiety, I'm down to 3 times a week, mainly when I'm trying to sleep.
Pre-op days I would basically play beat the clock.
Could I get to sleep before I had to go to the bathroom? This was critical at the time because it took me anywhere from 20min - 2hrs to empty my bladder.
By that time I was wide awake again.
This is the source of anxiety which is lingering today.
Hey there. I know what you mean about the part that's "missing." I have the same interpretation about the sensual aspect of the urethra sensing the semen flow. In my case it's urine with an off-kilter PH from antibiotics.
Since my first ejaculation, too early I admit, I too have felt that ache in the perineum with a dull intermittent shock which is not that remarkable, (fits your description well).
Since the two years of wearing an indwelling catheter, I became a little neurotic, anxious and fearful of which the suppression of these led to depression. My outlook was hopeless, I couldn't see any positive outcome from this or the surgery. Future-thinking, poor outlook and prolonged fighting of a chronic UTI was also affecting my emotional state. I did not know that I had been protecting myself by unconsciously pushing people away. It wasn't until after the surgery, in retrospect and introspect that this had been a running background noise that I had become accustomed to out of self preservation. My, what a change. I feel diametrically the opposite. Light, like a helium balloon and opening up to new ideas and decisions.
If this healing keeps up, I am ready to begin a new chapter of my life.
Thank you for your time and effort at logging your experience, it is valuable.
End of week (9 days as of today) post HoLEP procedure. May 2 (day of surgery) to May 11. Age 61, 105cc prostate, general anesthetic with propofol and rocuronium and gas inductions. I live alone and have taken care of all of my own needs. American in Barcelona, Spain.
Not as much incontinence as I expected. I can stop the stream at will and resume.
If I am full, some tiny dribble-squirts in my light underwear pad. Nothing dramatic enough to immediately swap out for a new one.
The first day post procedure while still in the hospital, I was left alone after catheter removal to pee.
I was taken aback that I was literally getting an erection. This ability has not stopped.
First week at home:
Bed rest.
Consuming high fiber foods, taking Augmentin 500/125 for 7 days. I finished as of Thursday May 9.
Urine started out as dark cranberry-color, but throughout the week later in the day appears normal in color.
At times there is a little stinging at the tip of my penis, but I found that pushing my lower abdomen out to force a stronger stream- I'm talking garden hose- settled the sting. The sting goes away completely by midday.
Nocturia
Note: I keep a large 8 liter water bottle near my bed to pee in while I am in bed so I can get back to sleep. I can also examine it upon morning for color. I see scabs and little clots at the bottom, the color is like a rosé wine, but this is due to dilution from nocturia multiple. Today's scab that was sloughed off was approximately 3 cm in length.
There has been urge frequency, but I prefer not to hold it in since I want to eliminate the antibiotic and any clots / scabs that may be there. If I am out, and experience the urge, I am able to hold it until the urge settles and I pee comfortable at home.
This week I did a test for erectile function. Too soon for this, but I felt compulsive and really need to be patient.
While stroking I discovered that a pre-semen fluid was coming out of my penis. I don't understand why, unless 1) the surgeon did a "partial enucleation," leaving enough gland behind, or, 2) it is traces of semen emerging through the urethra. My follow-up and cytology discussion with the surgeon is June 3.
Orgasm was achieved, yet it wasn't as fulfilling as when semen flows outward. The nerves in the urethra aren't registering the sensation of ejaculation and this could be that "thing" that is "missing." Instead of semen, it was a few shots of urine, not as comfortable since my urine PH is likely more acidic due to the antibiotic. Not the same. Neither would I care to ejaculate urine with a partner. I'm hoping this ceases at some point.
Presence of frank to light blood at the beginning of the day is present at the beginning of the stream, but quickly runs clear- normal in color. This could originate from the bladder and descend to the prostate capsule or an accumulation solely in the capsule.
I am resuming bed rest with occasional excursions to the market for supplies. No bearing of heavy weight, or extreme bodily movement. I have cabin fever, I am pale from lack of sunlight, but it will be a little time after taking Augmentin that I will be having any prolonged exposure to UV light.
I am very pleased with this outcome so far, the rate and pace of healing, all seem within textbook norm for the most positive outcomes and I would recommend this to any man facing surgery. I would have had the P.A.E. if it was offered here in Barcelona, Spain, under the socialized healthcare scheme; I had to demand HoLEP because I wanted to avoid blood transfusion risks. With a 105cc-sized prostate at age 61, under the extreme stress and elevated cortisol, I would eventually have it all removed for the factor of regrowth.
I had semen coming out just thinking about sex. I didn't have to touch it
at all. This happened pretty early on after the procedure I think it was
like, 3 weeks. At one point I could actually get a teaspoon of semen out.
That's not the case now, however the organs are much better.
Like I said in my earlier post I have no regrets. I'm still amazed that I
can go to the bathroom without the extreme stress I had pre-op.
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Small Prostate HoLEP - Log
Age 63, 55 gram, large median lobe, high bladder neck, 26 grams removed.
Daily Coumadin (anticoagulant) - for Mechanical Heart Valve
Urolift in 2021. Complete failure. Median lobe issue, not part of the procedure.
I was, at the time, and 2 years later, under the impression that I did not have a median lobe issue.
2nd Uro confirmed large median lobe and high bladder neck Aug 2023.
February 8th, 2024: HoLEP Performed.
February 9th
Catheter removed. Returned, 5 hours later with kidney pain and 950 ml urinary retention. Catheter was inserted and remained in place thru the weekend.
The catheter clogged 3 times throughout the weekend. Each time it was unclogged, 100's of clots came out.
February 12th:
Urine was clear, no blood
Catheter was removed. Returned 5 hours later.
In order to start a stream I was required to bare down hard. I was able to empty my bladder with 20 ml remaining.
I told the doctor about how hard I had to bare down. He was not in favor of a 3rd catheter stating it was most likely swelling, not blood clots causing the difficulty in urinating. He said give it some time.
February 16th:
Required to bare down to start, but nowhere near as hard as I did on the 12th.
I have a small amount of blood at the point where my bladder is almost empty.
I do not empty in one void.
I am required to do kegels in order to get the remaining urine pumped out, so to speak.
February 18th:
Able to urinate without pushing. There is an obvious start delay at this time, but its progress in the right direction.
I do not have full stream yet. Swelling appears to be subsiding.
On another note; I have a strong desire to itch the perineum, which is another sign of healing / scabbing.
February 19th:
Additional notes; when blood is present in the urine, I get overactive bladder symptoms, the feeling that I need to urinate when I don't.
I have been walking for the last 4 days on a treadmill, 20 min increments, on a pretty good incline, enough to break a sweat.
Immediately following the walk, I place an ice pack on my perineum to reduce any inflammation I may have caused from the walk.
February 20th:
This morning, I start passing very large blood clots.
The good; swelling has reduced enough enabling me to pass the clots. I would not have been able to pass the clots 5 days ago.
So far, the rest of the day has been free of any clots.
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5 ReactionsFebruary 25th:
Very small amount of blood at the end of a urine stream following the 1st bowel movement of the day.
No blood for subsequent bowel movements.
I get up 4-5 times a night to go to the bathroom. I believe this is due to the fact I'm drinking water up to the time I go to bed.
I have a lingering spasm/ feeling in my urethra to go to the bathroom after I empty my bladder. Subsides after 20 minutes.
February 26th:
Starting to see tiny scabs. No pink colored urine, so far.
February 27th:
More pink than usual at the end of a stream
Perineum feels swollen. Uncomfortable sitting in a car seat. Couch is ok.
February 28th:
One scab, no pink. Perineum doesn't feel swollen.
Continued urethral spasms for about 20min following an empty bladder.
February 29th: 3 weeks Post-Op
No pink as long as I don't push hard while having a bowl movement
No scabs
Continued urethral spasms - not lasting as long or as intense
March 1st - 5th:
No Pink
Continued urethral spasms - not lasting as long or as intense
Nocturia - Continuing to get up 4- 5 times per night to urinate
March 6th 11:30 a.m:
Delayed urination until Bladder was full. I do not get the pp dance, urgency to go feeling anymore . Just the pressure.
The stream is strong on the first void. Void stops, then requires pushing on the subsequent voids in order to empty the bladder fully.
March 7th 9:00 p.m.
1st experience with retrograde ejaculation.
Forceful ejaculation; burning, throbbing, and cramping from my scrotum back to my rectum.
I could feel the semen shooting back into my bladder.
No blood following the experience.
March 10th 2:00 p.m.
2nd Experience with retrograde ejaculation.
Confirmed retrograde (dry), although it didn't feel like it. No pain, no blood
Orgasm Intensity is about 70-75% of pre-op
Occasional urethra spasms
Occasional Perineum Cramps on left or right side, not at the same time. Occurs mainly on the right side.
Starting a Urine stream is quick and easy. Additional rounds of pushing required in order to empty completely.
March 15th
3rd sexual experience ejaculated about a teaspoon of Semen
Noticing slightly red urine drops only following a bowl movement.
Only notice the red when urine drops landed on the toilet seat.
Urine continues to spray to the right side (makes a mess), similar to poor flowing sprayer nosal,
instead of flowing like an open ended hose.
Occasionally, empty the bladder on the 1st void.
Most of the time, additional rounds of pushing is required to completely empty.
March 20
Urine flow spray is starting to reduce
Urethra spasm have reduced in frequency and intensity
- Spasms are felt anywhere from the base of the scrotum to the tip of the penis
March 21 -- 6 Weeks Post - Op
- Dry ejaculation continues
- Post-op Nocturia... 3 - 6 times per night with 5 being the average - Fluids stopped at 5 pm.
- Pre-op Nocturia..... 3 - 30 times per night. 15 - 120 minutes to void to the point I could resume sleep. 8-10 being the average - Fluids stopped at 3 pm.
- Urethral spasms continue with occasional perineum cramps (assuming overactive bladder)
- resumed very light gym exercise routine.
- 1st void doesn't empty the bladder completely, but I get most of it out.
Thoughts:
The surgery exposed how extreme my urine retention had become over the past 3.5 years.
A prime example would be Feb 9th. A full bladder was normal to me.
I didn't recognize that I had an emergency room issue (950 ml).
I felt pain in my back (kidney), but thought it was gas from the anesthesia.
I have recently tried to let my bladder fill to my Pre-Op levels in an attempt to reduce my over active bladder (nocturia) issues, but I can't get there. It becomes way to uncomfortable for me to hold it that long.
I can easily push on my bladder and not feel like I need to go. Completely, opposite of my pre-op days.
Hopefully, at 12 weeks most of my residual issues will resolve themselves. I intend to update at that time.
March 22
Stopped fluids around 5:00 p.m. Snack, around 7:30pm, of 10 chips containing 70 grams of Sodium.
Up three times instead of my usual 5, to go to the bathroom. Full each time.
A short delay requiring a small push to start the stream.
The stream sprays, not solid flowing.
In order to completely empty following the 1st void,
I am required to push on subsequent voids.
March 23
Retrograde:
Partial - more than 50% antegrade, did a hard kegel during orgasm. Close to pre-op intensity.
A couple of globs with some trace blood came out when urinating.
Nocturia
Repeated March 22 experiment with more salt
Stopped fluids around 5:00 p.m. Snack, around 7:30pm, of 10 chips containing 70 grams of Sodium. plus salted hard boiled egg
Up 2 times instead of my usual 5, to go to the bathroom. Full each time.
A short delay requiring a small push to start the stream.
The stream sprays, not solid flowing.
In order to completely empty following the 1st void,
I am required to push on subsequent voids.
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6 ReactionsMarch 27
Nocturia
Rough night, stopped fluids and food at 3:30pm. NO snack or salt before bed
Urinating like a horse every 30 min.or sooner. This went on for 2-3 hours.
After falling asleep, I was up an additional 3 times.
For me, salt definitely reduces my night time bathroom trips.
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6 ReactionsMarch 28 & 29
Nocturia
In my failed search for a low dosage salt table, around 100mg, I ran across Cell Salt tablets.
They are small and melt under your tongue.
The tablet contains 12 different Cell Salts in 1 tablet.
4pm: Stopped fluids and food
10pm: Placed 2 cell salts tablets under my tongue and went to bed
Up 2 times each night instead of my usual 5.
The cell salts appear to contain enough salt to reduce my night time bathroom trips.
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5 ReactionsAmazing breakdown. A credit to the blog.
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1 ReactionApril 4 - 8 weeks post-op
No visible signs of blood since March 31
Urine flow sprays if my bladder is not full and streams when very full.
Stopped, Cell Salts, April 1st. They increased the time to start a stream to around 30 seconds on my night time bathroom trips.
The cell salts contained antihistamines and pain relievers.
I believe the pain reliever helped reduce the trips to the bathroom and the antihistamine caused the delay in starting a stream.
Taking ibuprofen before bed is a common practice to reduce your bathroom trips, but it’s hard on your liver.
Incorporating more red meat, instead of chicken, for the taurine and B vitamins.
Results:
- 4 hamburgers in one day, up 2 times that night
- 1 hamburger the next day, up 3 times on that night.
Short bouts of depression, around the 7 week post-op time frame, thru April 3.
I can definitely tell that my body is going thru some chemistry changes.
The depression may be my body reverting from a sympathetic (3 yrs of fight or flight) mode to a parasympathetic (rest and digest) mode.
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2 ReactionsMay 2nd - 12 weeks post op.
From what I have read, most of my healing should be completed by now.
Where am I in the process?
Sex and Retrograde:
Ejaculation intensity is about 98% of pre-op. I'm only leaving off 2% because I still feel like there's something missing.
I'm making a big assumption that there is some nerve endings towards the end of your penis which gives you that completion or satisfaction feeling after ejaculation.
Since I do not feel the semen coming out, I miss that feeling.
It's not a visual thing it's purely sensual.
At times I could swear it's coming out the correct way, but it's not. I've actually had my wife check herself a couple times, nothing there.
My semen appears to be contained within the urethra or prostate. I’m assuming this due the globs of semen I urinate out after sex.
I've never had cloudy urine.
Flow:
If I'm full, within 5 seconds, I relax and it just comes out in a full stream.
If I'm not full, 15-20 seconds, I relax, feeling the urine coming down, slowly, but when it comes out it sprays until a full stream is achieved.
Pushing to start a stream is very common for me unless I'm very full.
Spaying is new to me; I did not spray prior to my surgery. It seems to have gotten a little bit better since I 1st mentioned spraying,
I have found that certain foods (salty) or supplements will cause a delay in starting a flow (15-20 sec), regardless of how full I am.
Burning:
I still feel, couple times a day, some burning at the end of my penis.
Nothing intense, but notable.
Some odds and ends:
Recently, in the perineum area, I feel like I pulled a muscle. Not sure how, not exactly sure when.
That lasted for a couple of days. And it literally felt like a pulled muscle on the right side of my perineum south of my rectum.
Stun gun shocks:
I used to get these on the right side of my perineum all the time. 3 weeks ago they shifted to my left side. However I have not felt any for the last week or so.
It literally feels like somebody briefly turned on a stun gun. The shock radiates from my rectum to the end of my penis. Very much a surprise when it happens.
Nocturia:
This one will not leave me alone. I get up on average between 2 and 4 times a night.
I still have bouts of anxiety when I'm trying to sleep, so on occasion I'll take Xanax, if my supplement stack doesn't work.
The Xanax allows me to sleep through the night without bathroom breaks.
The stack lets me sleep between two and four hours on average between bathroom breaks.
If I don't take the stack or xanax, sometimes, I can get two to three times between bathroom breaks.
Everything is dependent up on my anxiety level at bedtime.
Habits:
Going to the bathroom, pre-op, multiple times before I leave the house is still a standard procedure for me, when it shouldn't be.
Regrets:
I have no regrets
The frog in boiling water metaphor is the best way I can describe my pre-op condition.
My condition declined over the years until I was about to reach the boiling point, but didn't recognize it. I automatically adapted to my new normal.
A few weeks post-op, I started looking back and recognized the extreme severity of my condition, mentally and physically.
Physically, it was bad, no substantial complaints on my current status.
Mentally, it was worse. This is something which will take me awhile to overcome. Occasional depression, anxiety is the main issue.
Depression is simply chemical, changes in body chemistry, since I no longer am on edge all the time, my body chemistry goes in the opposite direction some times.
Anxiety, I'm down to 3 times a week, mainly when I'm trying to sleep.
Pre-op days I would basically play beat the clock.
Could I get to sleep before I had to go to the bathroom? This was critical at the time because it took me anywhere from 20min - 2hrs to empty my bladder.
By that time I was wide awake again.
This is the source of anxiety which is lingering today.
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5 ReactionsEnd of week (9 days as of today) post HoLEP procedure. May 2 (day of surgery) to May 11. Age 61, 105cc prostate, general anesthetic with propofol and rocuronium and gas inductions. I live alone and have taken care of all of my own needs. American in Barcelona, Spain.
Not as much incontinence as I expected. I can stop the stream at will and resume.
If I am full, some tiny dribble-squirts in my light underwear pad. Nothing dramatic enough to immediately swap out for a new one.
The first day post procedure while still in the hospital, I was left alone after catheter removal to pee.
I was taken aback that I was literally getting an erection. This ability has not stopped.
First week at home:
Bed rest.
Consuming high fiber foods, taking Augmentin 500/125 for 7 days. I finished as of Thursday May 9.
Urine started out as dark cranberry-color, but throughout the week later in the day appears normal in color.
At times there is a little stinging at the tip of my penis, but I found that pushing my lower abdomen out to force a stronger stream- I'm talking garden hose- settled the sting. The sting goes away completely by midday.
Nocturia
Note: I keep a large 8 liter water bottle near my bed to pee in while I am in bed so I can get back to sleep. I can also examine it upon morning for color. I see scabs and little clots at the bottom, the color is like a rosé wine, but this is due to dilution from nocturia multiple. Today's scab that was sloughed off was approximately 3 cm in length.
There has been urge frequency, but I prefer not to hold it in since I want to eliminate the antibiotic and any clots / scabs that may be there. If I am out, and experience the urge, I am able to hold it until the urge settles and I pee comfortable at home.
This week I did a test for erectile function. Too soon for this, but I felt compulsive and really need to be patient.
While stroking I discovered that a pre-semen fluid was coming out of my penis. I don't understand why, unless 1) the surgeon did a "partial enucleation," leaving enough gland behind, or, 2) it is traces of semen emerging through the urethra. My follow-up and cytology discussion with the surgeon is June 3.
Orgasm was achieved, yet it wasn't as fulfilling as when semen flows outward. The nerves in the urethra aren't registering the sensation of ejaculation and this could be that "thing" that is "missing." Instead of semen, it was a few shots of urine, not as comfortable since my urine PH is likely more acidic due to the antibiotic. Not the same. Neither would I care to ejaculate urine with a partner. I'm hoping this ceases at some point.
Presence of frank to light blood at the beginning of the day is present at the beginning of the stream, but quickly runs clear- normal in color. This could originate from the bladder and descend to the prostate capsule or an accumulation solely in the capsule.
I am resuming bed rest with occasional excursions to the market for supplies. No bearing of heavy weight, or extreme bodily movement. I have cabin fever, I am pale from lack of sunlight, but it will be a little time after taking Augmentin that I will be having any prolonged exposure to UV light.
I am very pleased with this outcome so far, the rate and pace of healing, all seem within textbook norm for the most positive outcomes and I would recommend this to any man facing surgery. I would have had the P.A.E. if it was offered here in Barcelona, Spain, under the socialized healthcare scheme; I had to demand HoLEP because I wanted to avoid blood transfusion risks. With a 105cc-sized prostate at age 61, under the extreme stress and elevated cortisol, I would eventually have it all removed for the factor of regrowth.
So far, so good.
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1 ReactionHey there. I know what you mean about the part that's "missing." I have the same interpretation about the sensual aspect of the urethra sensing the semen flow. In my case it's urine with an off-kilter PH from antibiotics.
Since my first ejaculation, too early I admit, I too have felt that ache in the perineum with a dull intermittent shock which is not that remarkable, (fits your description well).
Since the two years of wearing an indwelling catheter, I became a little neurotic, anxious and fearful of which the suppression of these led to depression. My outlook was hopeless, I couldn't see any positive outcome from this or the surgery. Future-thinking, poor outlook and prolonged fighting of a chronic UTI was also affecting my emotional state. I did not know that I had been protecting myself by unconsciously pushing people away. It wasn't until after the surgery, in retrospect and introspect that this had been a running background noise that I had become accustomed to out of self preservation. My, what a change. I feel diametrically the opposite. Light, like a helium balloon and opening up to new ideas and decisions.
If this healing keeps up, I am ready to begin a new chapter of my life.
Thank you for your time and effort at logging your experience, it is valuable.
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1 ReactionI had semen coming out just thinking about sex. I didn't have to touch it
at all. This happened pretty early on after the procedure I think it was
like, 3 weeks. At one point I could actually get a teaspoon of semen out.
That's not the case now, however the organs are much better.
Like I said in my earlier post I have no regrets. I'm still amazed that I
can go to the bathroom without the extreme stress I had pre-op.
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1 Reaction