Another HoLEP completed - May 2023 - Texas - Dr. Tsai

Background: 60 Years old, BPH/LUTS. PSA gradually increased from "8" a few years ago to the most recent test showing above "11". Last ultrasound put me at 120 gms.

Visited several urologists whose recommendations ranged from "Stay away from chocolate and caffeine"

to current regiment of tamsulosin (flomax) and finasteride (Proscar, Propecia) and avoidance of all antihistamines.

Urine stream got progressively weaker, resulting in complete retention and having an indwelling catheter for the last 6 months, along with the added oxybutynin (Ditropan) for the bladder spasms.

Did LOTS of research. Narrowed selection to Dr. Marawan El Tayeb (Temple Texas) and Dr. Lawrence Tsai (Austin Texas)

I ended up choosing Dr. Tsai.

We had an initial tele-med session on the laptop. I had pages of questions to ask him. From the basics to what to expect post-op to timelines of recovery, to sexual functionality, to long-term effects. Then I had an in-office cystocopy (camera view of urethra and bladder) prior to the procedure.

I did several weeks of pelvic floor exercises, and added added more fiber to my diet, and reduced meat intake, as preparation for post op care. Week before procedure added stool softener to daily meds.

Operation went as planned.

Fasted from midnight the night before, Was given some drugs, next thing, I woke up in post-op.

Spent the night in hospital, I had a full dinner (there were no restrictions), I went through several bags of saline, continuously flushing out my bladder for any remaining tissue and clots.

Next morning, had breakfast, had post-op catheter removed, a while later, walked around the room a few times, walked into the bathroom and pee'd like I was 17 years old.

I was expecting the pain to be somewhere between "tenderness" and "seeing stars", but there was no pain, no discomfort. nothing.

Urine was the color of fruit punch, which was expected.

(I thought there still might be some pain killers in me, masking pain, but even after drinking considerably more water, and peeing a few more times over the next several hours, I still experienced no pain)

In follow up bathroom visits, I stopped and started my flow, to test things out, and there were no issues.

My PVR was tested several times, where I measured below 40ml every time.

(140gm of tissue were removed.)

I was discharged from the hospital the morning after my procedure.

I wore adult diapers for about a week, just "in case" I experienced any incontinence, but I did not.

(Stress or otherwise).

I am still drinking a lot of water to make sure I am flushing the pipes often and keeping things clear.

Stream is extremely strong, and volume is usually 2/300ml.

I have passed a few (very) small clots/scabs but that has been it. I had larger clots showing up in my catheter bag. My stream is now clear.

Overall, I am extremely pleased with the outcome.

If a Texas hospital is within your realm of possibilities and travel, consider giving him a call.

Feel free to ask me ANY you have about my HoLEP, I am more than happy to try answer them.

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