Leakage after HoLEP (THULEP)

James..... the leakage should stop in a couple weeks, but you can exercise the sphincter by stopping urine flow, hold it for 15 seconds, and do this again when you can.  I have been very happy with my HoLEP outcome, and wish others could have the same good fortune.  I also had a leakage situation when after urinating, and zipping up, I'd look down and see a big wet spot.  I soon figured out that just like when you turn the spigot off on a hose, there's more liquid that will drain out.  So when you think you're finished, just wait about 30 seconds to 'empty the hose'. This stopped after a few weeks as well. 

Interestingly, the diameter of my urethra must now be way larger than the end of Mr. Wiggly (hate the term penis), as when I start, it's like having a nozzle on the end of a hose..... sort of a spray to start.  Aim well!

Not to late to start the exercises now and as another has already suggested, stopping and restarting your flow mid-stream will help enormously with regaining control

It sounds like you are doing well.  The whole recovery takes I think up to 2 to 3 months for many people, and there seem to be different phases to it.  Exercises might still be uncomfortable for you to do (much) right now.  I did leak (only a bit) for the first 3 weeks after my holep (June 6th), then that stopped; stuff some folded toilet tissue in the pants, or borrow something from the wife, whilst slightly leaking.  This can make you sore though, when combined with a frequency issue.  I only had a small 22cc prostate and was out of hospital/catheter out within 24 hours, so your situation may not be quite as good/quick.  The bleeding may come back when you sit on a hard chair or otherwise strain the operation site; it did for me for a week, including 2 days of heavier bleeding, in week 3, there having been no bleeding at all for the first 2 weeks once out of hospital.  I rested, and the bleeding (plus passing of many small and 2 rather big clots) stopped.  Now in week 6, and the pee comes nice and fast, slows down towards the end (as I expect it does for anyone), then stops when I stop - no after-dribble any more (which I had had before the op).  My only outstanding issue is I only void 220 ml at most daytimes; I am quite sure I am emptying OK (I set the follow up at 2 months, not the usual 1 month, as otherwise I'd just need another one at 2 months to discuss the new stabilised PSA).  I do sleep for 6 hours at night; just need to grit teeth and not go during day when it "feels" like one should (such a distraction, feeling like you need to pee - quite hard to ignore) and hang on for longer to re-calibrate/re-train bladder.  I feel sure that will come with time.  If not, still happy with my HOLEP.  So, I think you're doing well, but it may take a little longer.  If you can do the exercises, good idea too.  

I had my HOLEP last August. After 6 days with an external catheter, I found myself completely 100% incontinent. I had no control at all for a couple weeks and it took me four months to fully recover control over my bladder. I did Kegel exercises several times a day for the full four months. So, from reading the reports of the others who have had HOLEP surgery, it seems like there is a pretty wide variation of post-surgical responses. Everyone seems to have recovered full control though, sooner or later ( I was certainly in the later group and it was no fun!). So the lessen probably is to just keep working at it and it will resolve over time, hopefully sooner for you.

Matt

I would be interested to know how many of the men taking part in this discussion were advised to carry out the "Kegal"/PFM exercises before having the HoLEP procedure and if so how many did so and for how long before the "op" i.e. one month or two.  From those I have spoken to here in the UK who have had a HoLEP nearly all were advised to carry out the exercises before the procedure and nearly all were "dry" within a few days if not within a few hours.  The crucial aspect was that the longer they carried the exercises out before the "op" the better the results and in most cases the men carried on with the exercises for a few weeks afterwards.  Personally, I did both (before and after) and although at the time I only knew one other man who'd had the HoLEP procedure, I already knew the benefits of the exercise would be of use through all the men I've come into contact with over the years who have had a radical prostectomy (either open or robotic) and all agreed that the exercises helped them greatly in recovering bladder control after the removal of their prostate. Thanks