Connect
HoLEP procedure experiences?
Background: 62 yo in good health, no meds or other conditions other than 3,3 Gleason and 4.8 PSA. Had my first visit to Mayo (Jacksonville) and was blown away by their efficiency, courtesy, and knowledge. Had blood test, MRI, and Uriflow exams. I am currently on active surveillance with an enlarged prostate causing retention and flow issues, risking damage to my bladder which shows some distention. I have a tele-health appointment this week to discuss having a HoLEP procedure (Holmium Laser Enucleation of the Prostate) and would love to hear from you if you have had this done in regard to your experience, what to expect, what to ask the surgeon, etc. Thank you!
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
1bikerchuck - you have already had radiation?
I was diagnosed with Prostate cancer in summer of 2023 and decided to go with radiation therapy rather than surgery. I complete 18 sessions in December 2023. The radiation got rid of the cancer. In Jan. of this year 2025 I had some blood in my urine went to a urologist and he prescribed and antibiotic for an UI. I spent the month of Feb. in fl. and started to urinate blood and clots. I went to the Sarasota Memorial ER in Venice, Fl. After being admitted they inserted a catheter and scheduled for surgery the next day. they cleaned away the blood, clots and took out some of the prostate to send to the lab so a partial Turp. The bleeding has stopped but I still have an enlarged prostate. It is 123 or twice the size of a 73 year old prostate. I'm evaluating the Holep procedure the newer gold standard for size reduction vs. turp the 40-year-old gold standard used by most urologists. I would love to receive input to help me make this decision. My concern is incontinence as a result of either approach or procedure.
-
Like -
Helpful -
Hug
1 ReactionWelcome, @jmurp6762. I moved your question about incontinence and the HoLEP procedure to this existing discussion:
- HoLEP procedure experiences? https://connect.mayoclinic.org/discussion/holep-procedure-experiences/
I did this so you can read past posts and connect with other members more easily.
-
Like -
Helpful -
Hug
2 ReactionsI’m 59 from the USA and had the HoLEP procedure (100g’s) on July 1, 2025.
It is now 8/04/2025. I hesitated but I have to say… this was the best decision I’ve ever made. I can Urinate like I’m 20 again. I was getting morning erections 4 days after surgery and they continue. I can also ejaculate normally. This is a miracle procedure. If you are hesitant in getting this procedure, …don’t. You will not regret it. Do what they tell you after surgery and you will have your life back again. Totally worth it!
-
Like -
Helpful -
Hug
4 ReactionsI’m 59 from the USA and had the HoLEP procedure (100g’s) done here in South Korea July 1, 2025.
The cost was less than 2 grand. It is now 8/04/2025. I hesitated but I have to say… this was the best decision I’ve ever made. I can Urinate like I’m 20 again. I was getting morning erections 4 days after surgery and they continue. I can also ejaculate normally. This is a miracle procedure. If you are hesitant in getting this procedure, …don’t. You will not regret it. Do what they tell you after surgery and you will have your life back again. Totally worth it!
Wow, Will911! That’s amazing and encouraging! I had my procedure done two years ago this fall, and like you, I told my wife I can pee like I’m a teenager again. Lol. Plus, I can “hold it” when I need to and that’s was getting almost impossible before because my bladder wasn’t emptying very much at all. You are having better results than me in the sex arena though as I have “dry” ejaculation. That is encouraging news for others, though! 👍🏼
I'm posting this here as it seems to be the most extensive HOLEP discussion, though I've posted about earlier experiences in other threads. Short background: I'm 61 and have had a mild burning sensation urinating my entire life. Like: since consciousness. Repeated scans and xrays of bladder, kidneys, etc, revealed nothing. I had HOLEP in March 2024 to relieve BHP after about 6 years on Flomax that was gradually ceasing to work. The surgery was a success, though my doctor said he found something he'd never seen before - hundreds of prostate stones, a thing I didn't know existed. Was it possible that's what had been causing me pain my whole life? Maybe. No pain now whatsoever and my flow is so great I want to show it off like a party trick sometimes (don't worry - if you invite me to a party, I won't actually do that).
I wanted to update this: my surgeon guaranteed me I'd have dry ejaculation afterward - removing the anatomical feature that releases semen was essential for the surgery's success - and he was correct. I didn't really care about this as long as the feeling was the same. He assured me it would be, and he was incorrect. For the first six months, orgasms were odd - sometimes disappointing, sometimes 98% as intense as before, but never as pleasurable. But also, for the first time in my life, sometimes when approaching orgasm, it was like my body just gave up and all sensation drained out, and I lost my erection. I mentioned this to my surgeon, and he just shrugged like he'd never heard it before, but I've noticed other posts on this topic confirming what I'd experienced.
I mentioned this to my new urologist, and he immediately said (I'm paraphrasing here - I didn't catch all the anatomical nuances) Yeah, there is evidence that the actual release of semen comes with its own specific, quick hit of oxytocin or dopamine, so when you remove the seminal ducts, that's gone. I appreciated the candor. I don't tend to give up, and I'd say that by really focusing and trying to train my brain, I've reclaimed that last 2% over the last few months, but it's still...different. Like the feeling is more in my body than before, and sometimes it's even more intense than before. Like: way more intense. The ending is still abrupt and incomplete, but weirdly it means I'm ready to go again relatively soon, which hasn't been true since I was maybe 20 years old.
I'd still have the surgery, as I needed it to, y'know, pee, but I do wonder if removing the ducts was necessary or overkill. There's an interesting twist to this I hadn't predicted. When I described what my orgasms are like now, my wife said "Maybe your orgasms are a little more like a woman's now." Given all that I've heard about those over the years, that's not the worst possibility.