HoLEP recovery

Here is my story- was 59 last July when I had the Holep procedure at Mayo Phoenix campus.

I had a relatively small prostate at 55cc. I had no idea about BPH until I got my first bladder infection. I could not resolve the continuous infections, so my cystoscopy
showed I wasn’t emptying my bladder completely. After discussing options, I thought I had decided on a Urolift because of minimal sexual issues. Doctor let me know the durability and long-term outcomes- might need another procedure again in 5 years. This is what made me decide on Holep- long-term solution with very little chance of having any surgery again.

I am in healthy condition with weight etc and never had any urinary issues until now.

Surgery went great. Afterwards, stayed overnight at hotel with Foley catheter. Went back next morning for removal. Then home. No pain, just rested.

I was very fortunate that I did not have any incontinence. Had diapers on hand and didn’t need them. I’ve read a lot of comments of men having incontinence, so I consider myself lucky.

Now, regarding sex- I first masturbated @ 3 weeks after Holep. Masturbation, intercourse etc all feels the same as before Holep. The orgasms, for me, are different.

My short time on Flomax did affect my orgasm quality. This is how my orgasms feel now, post Holep-

The feelings before orgasm are the same (great!) Then you experience the building pressure of an orgasm coming soon. I experience the same build up of tension in my groin and abdomen area on the way to a great release of pressure. At the moment of peak feelings, my orgasm feels like it stops right when it started. I get the same urgent feelings of wanting to explode in ejaculation, but since retrograde ejaculation, it all happens internally. I still get the same great relaxation feelings after orgasm and feel very relaxed afterwards.

My orgasms used to continue a few moments as you are ejaculating, more like a full body orgasm, but the orgasms seem muted- like the power gets cut off prematurely. I still very much enjoy sexual activity, and I still very much have a sexual appetite.

I believe that we all may go through periods of greater sexual arousal, then some days less so. I am very open with my wife. One thing that has changed- I used to masturbate privately, never letting my wife know (sometimes self-care feels good). But since Holep has changed my orgasms, I consider myself on a new sexual journey- I no longer hide. I take my time with myself to explore my body and find out what feels good. As men, we’re not supposed to be so open, but not for me any longer. I tell my wife now when I masturbate, how it went, how it felt etc. We still have a great sex life, but to continue my new journey of exploration, I masturbate to try new things or see what feels good-this is new to me since I was so private before. But being open to my wife helps me explain the differences happening in my body.

I have heard that for some men, prostate stimulation can achieve orgasm. I bought my first sex toy- a prostate massager. Found out really quick that I don’t have a prostate with any feelings.

A side benefit with retrograde ejaculation- no mess to clean up! After sexual activity, I go to the bathroom to pee. I usually take a minute- you can feel urine trying to come out, but sometimes the semen clogs the urethra and then whoosh- a big glob of semen in the toilet. And seeing the semen confirms that I achieved an orgasm.

Sorry for being so long- best advice is your extreme confidence in your surgeon. This is the only way to help ensure good outcomes. Even considering my orgasms have changed, I am still glad I had Holep for long term durability and no future issues.

Only you can make the right decision for you. I am taking this new chapter in my life as a new form of sexual awakening for me, to continue to find what feels good, have as many orgasms of any quality as possible and just be grateful knowing that life could be a lot worse! The best of luck to you and whatever decision you make. Feel free to reach out if any more questions.

@bccook
Just a quick note to say how helpful, your post was for me, in particular, your honesty and hopefulness.

I’ve got BPH and low grade (3+3) prostate cancer. Had PAE done a year ago which has helped the BPH and allowed me to quit taking flowmax (which I disliked because of lack of build/explode/release feeling at orgasm and stop finasteride (which had knocked down libido and seemed to contribute to some ED challenges).

My wife wants to stop with sexual activity for now - I think a combination of my ED and her changes with age - so cautiously stepping back into some 60-year old version of masturbation. It’s different now approaching my body with open curiosity in its new responses.

‘Tis definitely a journey!

@bccook
Thanks. This is exactly what worries me. You described it exactly how it feels on Flomax. “Muted and the power cut off prematurely.” This is why I’m so concerned and wondering if I should delay my HoLEP procedure. And maybe consider Aquablation. However the is still a small chance of retrograde ejaculation with Aquablation. I’m 59 years old and don’t wake up to pee at all. I take OTC prostate supplements and 2.5 mg of Cialis daily. That seems to be working. But I recently had visible blood in my urine. Cystoscopy shows a stone on my prostate. Then the report states stone in my bladder. I also have thickening of the bladder wall. After urinating I still had 202cc of urine in my bladder. So… I need to do something before it gets worse. But I really don’t want to lose my orgasm sensation.