1. Community
  2. Men's health
  3. Prostate Problems

My HoLEP prostatectomy

Posted , 48 users are following.

ianC
ianC

I thought I'd report whilst things are still fresh in my memory.

Well, I got home this afternoon (Thurs) after the op Tues @ 7 p.m. And things seem to be working OK. No more Tamsulosin needed, so that's one benefit right there. I'll update after a few days as the the other possible effects.

The anaesthetist chose a spinal anaesthetic, which I was somewhat chary of, prefering to be totally knocked out. Later I remembered that there'd been some research that found that older people who had anaesthetics died earlier, so he was right on that score. He also told me that this way I had a smaller number of anaesthetics (general meant 14!, this way 1 to 3).

I didn't like the thought of being awake and watching the op, but he assured me I wouldn't feel a thing; I wouldn't see anything; and I'd be able to feed and drink more or less straight afterward rather than many hours later. And so it came to pass. Just numb legs for a while. I really didn't feel anything. All over in about an hour. I even dozed a bit on the op table.

However, that night (Tues) was not good. I had a constant feeling of wanting to sh*t. However, no matter how hard I tried (and I used two laxative suppositories), virtually nothing happened. I later found out this is a side effect of the somewhat larger catheter and balloon that was put in place.

So I found it hard to sleep. But just when I did doze off once, the nurse came in for the fourth time to take my blood pressure (2.00 am?). I was really upset and told her not to do any more (all the previous ones had been OK anyway). But by then I couldn't get back to sleep. So I was wretched all the next day (yesterday).

However, last night I got to sleep about 8:30 pm; and slept right through to breakfast. Bliss.

The surgeon had come in on Weds; told me about the defecation urge origin; said I could go home today if my urine was pretty clear by then and the catheter had come out. I see him again in a couple of weeks, when the result of the biopsy will be with him. He also said only 10% need the op again in 10 years; most are fixed for good. Here's hoping.

I was apprehensive about the removal of the catheter. In the end though, it wasn't too bad. I did most of it myself, easing it and rotating it a bit when it seemed to stick. Whew! Great. Then I pee'd  a couple of times to test things; told I was OK to go. I left.

Home by 3 pm today. Then did a good walk (4 miles) and all's well. Still some blood and bits, but most clear. Good flow. Now to see how I am at night.

 

2 likes, 171 replies

171 Replies

Prev Next
  • ianC
    ianC

    Posted

    I thought to update colleagues on my progress, now some 7 weeks since my HoLEP op. Peeing is still fine, tho. still a bit of initial rustiness at the very start at time.

    I do a urine test strip each day - 10 markers; I still have lots of leukocytes; not much blood; but lately much more protein. I think the latter may be significant, so I'll get on to my GP when I've got the results of my other tests (kidney and bladder cancer molecular markers - I do those monthly). The quarterly cancer marker tests I also do have shown a worrying increase.

    My nmemory is tha tthe urologist said my leukocytes ought to be coming down by now.

    • bob120
      bob120 ianC

      Posted

      Ian,

      Blood and leukocytes lasted about 6 months on the test strips for me. I've had protein my whole adult life +1 or +2.

      Bob

    • RonTexan
      RonTexan ianC

      Posted

      Best of luck to you Ian, my difficulty pales in comparison. Keep us posted, we want to congratulate you heartily when your travail has ended as it will I am confident. 
    • ianC
      ianC RonTexan

      Posted

      Thanks Ron. Alas, my cancer is the bigger worry anyway.
  • bill20925
    bill20925 ianC

    Posted

    FYI, I should have mentioned, before going through HoLEP, I had MANY hospital emergency visits because my prostate stopped all flow so my bladder filled up. It could get very uncomfortable, with 1.5+ liters of liquid (if I recall correctly. I do recall doctors commenting on how surprised they were at how much I voided upon catheter insertion). Anyway, I was told by multiple TURP urologists I would have bladder problems for life due to the streching of it. When I discussed this with Dr Lingeman who did my HoLEP procedure he said the bladdr would return to normal within 6 months, and it appears to have done so. I usually go through the night now with no need to pee. On occasion when I do, it is 1 time, and usually because I stayed up late drinking wine/beer, and water. I can last much longer than most freinds my age (58) on needing to go to the bathroom. And I am in and out much faster too. FYI,
    • bob120
      bob120 bill20925

      Posted

      Hi Bill,

      It looks like lucked out. My first visit to the ER to get cathed, was excruciating, with just 1400ml. That's when I learned to cath myself. But it's an unresolved question whether my hematurias a couple of years later were from cathing, or stones, or just a weakening of veins from the GL. From everything I've heard here, the holep does seem to be a very good choice. Best of luck for continued progress and thanks for sharing.

      Bob

    • bill20925
      bill20925 bob120

      Posted

      For me it got so bad that even doctors couldn't cath me, I had to do a suprapubic (punch hole through abdoman). I don't recall, but later on they were able to get one in. I had to keep it in close to 3 months and was on antibiotics for 6, yikes!

      Hey Ron Texan, just make sure the HoLEP doctor has done at least 30 HoLEP procedures, hopefully more. If not, go to someone else. My guy Lingeman has done close to 3000 of them and has several research reports on the procedure he will share with all of you, just contact his office..

    • bill20925
      bill20925 bob120

      Posted

      Bob, a few Cath observations. 1) make sure that if you feel ANY pain pangs down in your genitals you tell your doctor right away, to make sure you do not have an infection. I failed to figure this out and it cost me dearly (completely unrelated to HoLEP). 2) when using a cath, I found I preferred using the stopper and not a bag most of the time. It was just like urinating normally, and I would use urinals, but I would just pop the plug and go. 3) I did notice a fairly big benefit when I was cath'd that my whole internal system became much more relaxed, ie no stress on the bowels, bladder, etc. Good luck! Bill
    • bob120
      bob120 bill20925

      Posted

      Hi Bill,

      I haven't had to cath since my last surgery in Dec. '13. I had cathed roughly once per month for a year to avoid another scar tissue blockage in the prostate when I got hematuria. Unlike the burgundy colored urine I had experienced on other occasions, this was thick super fast coagulating spaghetti sauce, frank blood. I had three bleeders on my prostate and bladder neck and needed surgery to clean out my bladder which was coated in clots and cauterize the bleeders. During the surgery my uro found bladder stones which he crushed and removed, and he also resected (widened) the bladder neck. For three days, in an effort to avoid surgery, my uro had ordered a three way irrigating cath to flush my bladder continually. On the third day I passed out and my GP who happened to be making rounds at that hospital ordered a hemoglobin test. Mine had dropped from 15 to 6. I got 8 pints of whole blood and an emergency surgery the next day. It was never determined if the hematuria started with my cathing a few days previously, or the bladder stones, or just a weak spot created by the original GL 18 months prior. Once the frank blood started filling up my bladder and blocking it I cathed about 10 times in the shower while waiting for the ambulance. I was inserting the cath, blowing it out with my mouth to clear the clots and reinserting it. I may have caused the second and/or the third hematuria at that time. My wife said the shower and bath looked like a murder scene, blood everywhere. Needless to say, I haven't cathed since.

    • bill20925
      bill20925 bob120

      Posted

      You definitely went through some hassles I did not go through. The first doc who gave me greenlight was recommended by a good doctor friend of mine. He caused me all kinds of problems. I now realize doctors recommend friends of theirs in the same hospital system, a non-optimal method of finding a good doctor for guys with issues like ours.

      Nothing went right with that first urologist, I was a constant mess. But since HoLEP, 2-3 years ago, I have not cath'd since, urination is great, and I can sleep all night.

    • bob120
      bob120 bill20925

      Posted

      Bill,

      You got a great outcome with the holep.

      Bob

    • MichaelVM7
      MichaelVM7 bill20925

      Posted

      Bill,

      I realize this reply is 3 years after your post.  How are you doing this long after HoLEP?

      I have a large prostate: 120 cc. 

      Am considering FLA but that's $20-30,000 out of pocket, HoLEP (Dr. Lingeman at IU) or open prostatectomy (robotic at Mayo).  

      FLA sounds best in terms of rapid recovery and no RE.  But it is a $25,000 gamble.   

      Dr. Lindeman is legendary with HoLEP and insurance will cover. 

      OP is the hardest recovery and is major surgery. 

      My PVR is around 50 cc and I typically void 250-550 cc.  My bladder wall is thickened but not grossly, and I have a protruding median lobe. 

      Negative biopsy and two normal 3T MRIs but elevated PSA.  

      In otherwise good health at 59. 

      So, I am weighing this carefully.  

      I am informed and encouraged by the stories of other men on this forum. 

      Thank you,

      Michael 

    • bob120
      bob120 MichaelVM7

      Posted

      Michael, I've had a turp and two GL lasers in 5 years. When I had my first GL I was in retention with a PVR of 400mls.  I needed to find a bathroom about every 40 minutes all day long, my prostate was measured at 128g. Bladder highly muscularized. 18 months after the GL my prostate was measured at 300g,, with a pvr of 125ml., no retention, and abke to go severa hours without a bathroom, and shortly after I had a second GL for hematuria (needed 8 pints of whole blood) and bladder stones, 18 months later I had a second hematuria  (needed 6 pints of whole blood) and had a turp. My prostate had been measured at 300G again but only had a 32 ml. pvr and no retention, and could last several hours without a bathrrom, day and night. The turp was almost 3 years ago and worked better than the two greenlight lasers. A year after the turp my prostate had grown to 235g. so I started taking dutasteride to slow down the growth and have been on it for about 2 years. Had no side effects from the dutasteride like I had previously had from the flomax. Still had no problems urinating, pvr of 32mls,, last several hours without urinating, day and night.

      What have I learned? 1. The retro I was so fearful of finally happened with the TURP and I never even noticed it. It had no effect on my orgasms, just no fluid as the sperm goes into the bladder instead of out. 2. There was no effect on my stream or pvr when my prostate got up to 300g. It's not the prostate size but the location of the blockage that causes retention and difficulty urinating. With a 50ml PVR I would say you are hardly blocked at all. I now have 235 g. prostate, 32ml pvr and no blockage. 3. Having a procedure won't necessarily last. My prostate grew more in the year after my GL, and my second GL than it had in 65 years of life. My urologist says my prostate grows like a weed, and it's the largest he has ever seen. As long as I can pee OK and my PVR is low, I haave no plans to do anything other than keep taking my dutasteride every day. 4. None of the 3 procedures eliminated my needing to get up 3 times a night. The procedures worked to fix retention and difficulty peeing, but did not stop me from needing to get up. My fix is to have a couple of 1 litre bed side urinals in a basket by my bed so I can go in the dark, sitting on the edge of my bed, and get right back to sleep.

      I realize everyone is different and many people have good results from prostate procedures, but I think they should only be resorted to when you have a pvr over 200 and/or can't urinate easily, or urinate constantly, or are in complete retention and have to self cath. Just some food for thought for those contemplating surgery, to evaluate what it may or may not accomplish.

    • bill20925
      bill20925 MichaelVM7

      Posted

      Hi Michael, HoLEP has worked quite well for me 3+ years on. I pee 0-2 times a night and have no problem vacating.

      If it were me I would seriously look into PAE because it is non-invasive. My libido has definitely dropped off. I cannot say for sure it is from HoLEP because I got a nasty infection just before and after the procedure, but I miss the old days.

      PAE is performed by skilled IR’s, Interventional Radiologists. Nothing is cut out or blasted, they simply inject fiber slivers to reduce flow to the prostate so it shrinks. I do not know where you live but every major hospital has at least a few IR’s. DO NOT exepct your Urologist to talk about PAE or say good things about it, because it competes for the money they make off of you. 2 doctors I know and trust in Illinois are Steve Smith (LaGrange Hospital and a few others) and Bob Vogelzang, both pros. Just make sure whoever you talk to have done at least 30+ PAE procedures.

      Best,

      Bill

    • tommy53199
      tommy53199 MichaelVM7

      Posted

      Hej Michael,

      I had a HoLEP surgery a week ago, last wednesday. I am very happy with the outcome. I ddidn't have any pain after the surgery. My surgery was 8 in the morning, I woke up between 10-11, stayed the night and was released on Thursday. I have no incontinience ,which I am very happy about, and no blood in my urine.

Back to top
Prev Next

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.