Severe pain two months after HOLEP

Posted , 7 users are following.

I am 61 and had HOLEP mid-October. Op went well, catheter off  next day, discharged two days after op.  There was the usual post operative bleeding and pain but improved gradually.

Two weeks later the pain increased. An infection was suspected due to prevalent white blood cells.  After two unsuccessful antibiotic courses, the third seemed to work. However the pains continued and became constant.

Since four weeks the pain has intensified, usually when the urge comes, during and up to ten minutes after urinating.    I can barely make it to the loo and have had accidents a few times but I do not wear incontinence pads nor see need to.

My urologist prescribed an anticholinergic (Vesicare) which I could not take because of my glaucoma.  (My older brother who had TURP thinks similar medication worsened his glaucoma.  He has had operation but is being led around now). 

My urologist says the pain is normal and will continue until full healing and prescribed ibuprofen. 

Any suggestions? The pain is 7 on scale 10.

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7 Replies

  • Posted

    I've been following this blog for about a year, and your case is the first I've heard of problems after HoLep.  Infection may well be really unrelated to the op, but unusual in that you usually get antibiotics before hand.  I had HoLep and had no issues other than a little bleeding and leaking for a few weeks.  Thanks for sharing and good luck with your recovery.

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  • Posted

    Hi Young (I'm 80, so 61 seems young to me!)

    AllI can offer is that it took over a year for me to be clear of after-effects of my HoLeP; but these were only leukocytes in my urine. The blood stopped after a few weeks. I pee'd OK soon after and have ever since - tho' I still get up in the night at least once. My uro had said I'd be fine after a few weeks - not the months it took.

    I can't recall any pain after-effect.

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  • Posted

    I am 6 months post ThuLEP ( basically same as HoLEP but different laser) and have had total success. I agree with the reply by paul20443 as HoLEP is now becomming the "gold standard" soon to replace TURP. Hope you solve this soon and share the details.

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  • Posted

    I'm 12 months post HoLEP and apart from a bad hemorrhage 9 days following the procedure all went well with little if any incontinence and no pain however your description of the pain you are suffering points to a severe infection that is refusing to fully respond to antibiotics and I would press your Uro to prescribe a stronger medication to be taken over a much longer period.

    For your Uro to state that the pain is normal is utter rubbish and I would ask him to provide evidence to prove his statement.  From the statistical evidence I found on outcomes for the HoLEP procedure on various medical professional websites, long term pain and discomfort affects less than 5% of patients, so normal it is not.

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  • Posted

    Sorry to hear about your post opt problems.

    Curious if you are still retaining more uriine then you think...and its causing

    pressure...because you said ..Since four weeks the pain has intensified, usually when the urge comes, during and up to ten minutes after urinating.    I can barely make it to the loo.


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  • Posted

    45 yo, had HoLEP 07/11/2016 in USA. Out of hospital the next morning. Had to take antibiotic pills. 1st & 2nd day out of hospital used phenazopyridine, with MD's permission, to manage discomfort. 1st day, IIRC, took a couple of opiate/acetaminophen combo pills, later just acetaminophen. After a couple of weeks I switched to ibuprofen.

    I remember quite a bit of discomfort after urination, but that went away after a week or so. Urgency was somewhat disconcerting first couple of weeks.

    After reading this forum, I started doing Kegels/Pelvic muscle exercises. Maybe they help, gave me something to do for sure.

    Right now - there are nights when I get up to urinate, there are nights when I don't. Might depend on my fluid intake and excercise regime the day before.

    Hope this helps

    By the way, "AZO", aka phenazopyridine, is available OTC in UK

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