Trying to decide on HOLEP, not 100% sure I need an operation

Also most of the minimally invasive procedures require general or spinal anesthesia. If you are taking antiplatelet medication spinal is not an option. That is one reason I decided against TURP-I have a phobia about general anesthesia.

A holep report, in case of use, though not same circ's as yours  : age 49, volume 22cc so not large.  Many issues pre-op, but not to the point of retention.  Op wasn't too bad, only in for one night.  Removal of cath was painful, couldn't pee for 2 hours after - scarey - then I could. 

End of week 5 post-HOLEP, and it's gone like this : week 1, 2 : no bleeding (after leaving hospital), no clots.  Urgency, frequency issues ameliorated slowly but surely (not completely, mind).  Worked from home – soft seating worked best.  Dysuria persisted, seemed less if kept drinking water at night; fading out end week 2.   Flow rate end week 2 very good. 

Week 3 : back to office … various hard chairs to sit on, unlike at home : sore down there, sometimes felt like sitting on a lump.  Light bleeding all week, a few small clots, flow rate seemed down a little.  Maintained 24/7 drinking (of H2O) to clear out the clots, and avoid infection. 

Start of week 4 briefly saw some MUCH heavier bleeding and two large clots (~20x10x3mm), many medium clots, and increased (but not bad) discomfort when sitting.  I read this is within the range of what’s normal, so didn’t bother the uro'; instead I took 4 days’ annual leave, took some iron pills, and tried to not do much, to give it time to heal, whilst still drinking a lot (as throughout).  Result : by late week 4, all was good; visible bleeding had ceased. 

Week 5: very pleased; all good.  Still no scabs - maybe the odd tiny bit of tissue.    Best-yet flow rate : might well peak at 20 ml/s.  Still mild discomfort “down there” when sitting on other than well-padded seats, and very mild discomfort on peeing.  Activities : jogged slowly (0.6 miles) which felt fine; given the bleeding last week, prudently avoiding cycling (obviously), most lifting, petrol-lawn-mowing, and sex.  No problem avoiding these things until it feels like all has settled down – my aim/hope is to be 100% back to normal by start of August, i.e. week 8, ready for annual vacation.  Experience of erections since the op indicates no difficulties will arise there.  Frequency and urgency issues have faded away – last night I slept for 6 hours before needing a pee (best for ~8 years).  With just a little further improvement, I hope I’ll sleep right through – have just stopped drinking water overnight, given that there are no clots to clear, and infection risk is presumably low now (still drinking copiously during the day; was doing so at night). Pleased with the op.  Urologists don't really say much about recovery; mine just said something about 2 weeks and that was that - but really, it's just a few weeks of bother.  I still need to work up to voiding more than 220 ml a go - I need to train my bladder to not feel full too soon.  Am trying !

Tom said previously: In the meantime, don't give up on the CIC - you can get used to it, but you will have to use a hydrophilic catheter. Most companies that sell/make them will send you free samples. Use the smallest one that will work - 14 fr (French) size might work. 12 fr is too small. 16 is "normal". The curved tip (coude tip) is painful for a first time user, but some like it. It didn't work for me and was what my urologist gave me for my first try. 

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Of course individual experiences may vary, but "16" French is not "normal" in the sense that it is the first size most physicians recommend. The starting size is usually 14 French. Also the "coude tip" should not be any more painful than the straight tip for "first time users" in fact, the reason coude tips are often recommended for those with large prostates is because they are less painful and tend not to stick the prostate but instead the curved shape allows them to go around the prostate.

Lots more about CIC in the self catherization threads.

Jim