My recent HoLep journey

Men's health
1

I thought I would briefly share my recent HoLep procedure (performed 11/5/20).
SYMPTOMS: My prostate was approximately 70cc, I had experienced inconvenience (for a day or 2 over the last 2 years) but didn’t have a catheter in place as I learned how to self catheter - tamsulosin, for the most part kept me flowing but I didn’t like the side effects. In addition I also had the usual enlarged prostate symptoms of weak stream, frequent urination, yada, yada yada.
Putting my prostate issue aside I am in good health and therefore elected to have the HoLep procedure done now rather then later.
I live in Sarasota Florida and noted that the procedure is preformed at the Mayo in Jacksonville Florida (4 hours away), why this procedure at this institution gets little exposure I don’t know. Dr. Dora has performed over 800 HoLep’s , so I thought he had a respective tract record and worth my consideration in this regard. The whole process was seamless, starting with my initial video conference through recovery.
THE PROCESS: I arrived at the facility on Wednesday morning and had all the pre tests done like a military maneuver, except everyone was polite . Every test (8) had a specific time and all test were done as outlined
PROCEDURE: On the day of the procedure (11/5/20) I arrived at 9:30, for a scheduled procedure time of 11AM. At 10:15AM I was taken back and treated with kid gloves relieving most of my anxiety. At this point I lost track of time and awoke in the recovery area around 3:30PM and brought to my private room around 5PM with the 3 way catheter in place and ready to eat, which I did (soup and sandwich). That night was typical hospital maneuvers with people coming in all through the night to check my vitals and to empty the catheter bag.
The next morning the catheter was removed at 7AM and I was told to drink a lot of fluids, as I had to relieve myself twice before they would consider releasing me. By 8AM I had to relieve my self and to my surprise I passed 600ml with little discomfort. By 9:30AM I needed to relieve myself again and to my surprise I matched my previous performance. With these two efforts behind me they approved my release and I was out the door by 11:30 AM and eating lunch before noon.
I continued to hydrate and had no problem reliving myself every 2 to 3 hours with little pain or discomfort. The next few days passed with little change to this process and on Sunday morning I drove home (they want you to stay in the area for 72 hours after the procedure as most issues related to the procedure will occur during this time frame).
Post Op: It has know been I week since my HoLep and my recovery is going better then I expected. I only need to wear a men’s shield as I do have some stress leakage but each day there is less blood in my urine. My urine flow is great and on demand. As for the pain, I have had to take no medication in this regard. My only surprise has been that I still have to urinate frequently but Dr. Dora told me that will change over time.
BOTTOM LINE: For me, this procedure was fantastic, with my fears not even approaching reality. I would recommend Dr. Dora and his staff at the Mayo Clinic in Jacksonville, FL to anyone whom may be considering this procedure.

Blessings to all

Frank Santoro

2

Thanks for sharing. How did you arrive with the decision of HoLep, which by far is the best procedure, imho? Most urologists would recommend turp, which is not bad, or Urolift, which is a rip off. Hank

3

I've always figured if I have to have something done, it would be HOLEP or FLA. Since FLA isn't coverd by insurance it would be HOLEP. I hoping the one of the injectables becomes available but I don't have a lot of hope for that

4

Thanks for the detailed description. I may not be that far behind you. I am currently taking tamsulosin and hate the side effects too! Which bothered you the most?

5

I had a HoLep done on my 85 gram prostate 11/05/2020 too! Your description is similar to my experience with these exceptions:

I. I asked for a spinal block instead of general anesthesia, with some sedation during the prodeedure. Very satisfied with the experience.

  1. I had moderate pain (5/10) in the form of aching during the over-night stay that was treated with oxycontin. Once the foley catheter was removed the next morning, pain went to zero.

  2. My bleeding and blood spotting stopped about 3 days post op.

  3. My proceedure was done at St. Joeseph Mercy Hospital in Ann Arbor, MI.

6

70 yr old with 230g size Prostate; Is HoLEP good for a large P?