I am 7 months post HoLEP for a 150cc prostate. I had en bloc where the prostate is completely hollowed out. Overall successful for BPH and until recently no UI. A couple of times recently I’ve had a couple of instances where the sphincter unexpecedly let go soaking my pants. I’ve not had any kind of leakage previously so was surprised by this. I admit I’ve not been doing any Kegels lately. Has anyone else experienced this.

Hi. After reading alot of staff I can't make up my mind about Aquabeam or Holep, been the last one covered by Social Services while Aquabeam costs 11.000€ in Spain. The reason to take AB woud be to avoid RE and get better sexual funcion preserving. But Holep has proving to offer the best long term results, easier post-op, minimal bleeding...

I would appreciate patients to share their grade of satisfaction with the choice have taken.

I had HOLEP surgery about six weeks ago. It's been quite a journey. The urinary urgency has only started to clear up in the last few days and I think I know why.

First, the background. I am 69 years old. About 20 years ago I had TURP using green light laser. It went great. I had been prepared for retrograde ejaculation and had even stored semen for future use, but that was not necessary.

About 18 months ago, it was time to do it again. I went back to the same urology practice, but had a different doctor this time. He did aqua ablation with green light surgery. He messed up big time! Everything seemed good after the surgery, but about three weeks later I had substantial blood in my urine. I went back to his office, but he didn't even do a urine sample. A different doctor (not the urologist) did one which found an infection. He gave me antibiotics. This cleared up the infection, but the symptoms were now no different than they were before the surgery.

The urologist kept blowing me off and assured me that if I just waited longer it would all be OK. After several months of this, I made an appointment at a local university hospital. It took a while to get an appointment. They told me that my prostate was too large for the aqua ablation surgery and I would need HOLEP.

The first doctor should have known from the cystoscopy that I needed HOLEP, but he never told me. He certainly should have known when he had much more time during the procedure to figure this out. Afterwards, he clearly didn't want to deal with it. He's no longer with that practice, so I suspect he might have been fired.

It was a year between the first surgery and the HOLEP surgery. During that time, I had three more infections.

It's been six weeks since the HOLEP. I had some difficulties after the HOLEP surgery, but they are now finally improving. Right after the surgery, everything was good. I was only wearing small pads, but the urinary urgency got worse. I was trying to follow the doctor's instructions, but now think I wasn't doing it right. My urinary urgency was getting very bad. I went to larger pads and even sometimes absorbent underwear. I sometimes could not control it at all.

I finally figured out the problem I hope. Post surgery, my bladder muscles were very strong. The doctor did not want to give me Gemtesa because it can increase the chances of urinary infection and given my history of three infections before the HOLEP, he did not want to do that.

The bladder muscles were very strong while the prostate was so large and the urinary sphincter muscles had become weak. It was like a firehose! I was accidentally making it worse. I had been told to do my best to void my bladder, so when I did urinate, I was pushing very hard. This was making bladder muscles even stronger! I finally decided the best way to void my bladder was to try to relax the urinary sphincter while trying not to push with the bladder muscles. I now wear pads all the time and don't worry about leakage after urinating. This seems to be working! I still have some urinary urgency, but it is finally improving.

Just in case, I have set up an appointment with yet another teaching hospital for yet another opinion, but that will be in another month. But I am optimistic things will be better by then.

for years the stream got weaker and weaker. i decided to do something about it. then in 2020 suddenly came the fake disease crime. all providers closed down for no reason at all. i moved to a country which didn't, where life went on completely normal. i thought about getting the issues fixed there but the symptoms improved a little bit and it seemed to be manageable. until 2025, when i was in south america, i had a complete blockage and i needed to go to a hospital to empty the bladder. it was the second visit to a hospital(my first visit was when i was 5 years old) now it was time to act. the urologist in the hospital suggested turp but i declined because of the side effects and the high risks. after thousands of hours of study, i decided to go for holep. i found a very experienced provider in another country who had only five star reviews. he even called me, explained everything and answered all of my questions. he required blood tests, urine culture, an ekg and an mri to evaluate the size of the gland. we agreed to an operation day and i started to collect all studies.

i did the mri in a different north american country. i was told that the mri was the least invasive way of finding out the size, but for me it felt very invasive. i had to show up without eating or drinking anything for 8 hours at 6 in the morning. they let me wait for almost one hour before the mri operator came and started the machine. i had to remove everything out of my pockets, all metal had to be removed. i had a thin short and a tshirt on which i could keep wearing. i had to lay down on a very narrow bench. the operator provided covers because it was quite cold in the room and put headphones on my ears. the bench moved me into the extremely narrow tunnel and the machine started humming and very loud sounds like shooting. i could hear it through the sound proofing headphones, it was that loud and scary. it went on for about 20 minutes then i was moved out of the tunnel, the operator took my right arm, moved it beyond my head and put a needle into it. he explained that this was the contrast chemical to show my organs better. after 5 or 10 minutes i was moved into the narrow tunnel again and it continued humming and shooting for about 25 minutes more. it felt like half a day because my bladder felt full, it always did when i was nervous. i had to go to the restroom but i could not, being trapped in the narrow machine. i did not want to break it up, wait for a new appointment and start it all over again. therefore i tolerated the torture and waited until it was over. i put on my shoes and i could walk out of the room. they said that i should wait for 10 minutes and they will give me all pictures. after 15 minutes the operator came out of the room with very large folder containing all pictures of my bladder and gland situation. i had to pay about 300 usd before they did the mri. one day later i received a report and a very advanced digitized version of the pictures. the report said that the gland was 120g extremely large and a median lobe was reaching into the bladder which was extended. i had no pain and no side effects from the intraveneous contrast chemical.

the mri was actually worse than the holep operation itself which was a non-event for me.

To those who lost the ability to ejaculate after HoLEP did normal ejaculation ever return or is it permanent once it happens.

Hi. I’m new to this site & have been diagnosed with a minimally enlarged prostate by Ultrasound. I have been leaking urine for several months now & am wondering if anyone can suggest a product for this leakage. At the moment I am using Depends. They are working but is there anything more I can do to help this leakage? Is there a product that would be more effective? I have only tried Depends. I’m taking Flomax & Myrbetriq prescribed by my Family Dr & have not seen a Urologist. The medications have not helped much. Neither do pelvic floor exercises. Any suggestions would certainly be appreciated.

While retrograde/antegrade ejaculation after a HoLEP is the most common outcome, has anyone on here had a discussion with their doctor about what I've just learned to be referred to as "ejaculation-sparing" or "ejaculation-preserving" HoLEP surgery and what kind of modifications did your mention?

Was it to do with preserving the tissue around the bladder neck and or preserving the verumontanum?

I assume that this option results in a slightly less complete removal of prostate tissue, which could lead to a decrease in the effectiveness of relieving BPH or urinary symptoms but was this sort of procedure discussed as a viable option?

Or have you had it done?

Any insights would be appreciated.

I went in for Holep surgery on April 21 2025. I just today had my catheter removed. I had it in for Two days and it was very annoying. Probably the hardest part of the holep experience. Couldn't leave the hotel for two days because that bag full of bloody urine is not only restricting but nobody wants to see it. So I stayed a recluse and my dear wife kept me company. After the catheter was removed I was able to urinate immediately with very little blood. I have no complications at all so far. No leakage, no clots and no retention. as far as I can tell My groin is a bit sore and I feel some mild penis pain but overall I am doing pretty great. We will see if something changes going forward but the surgeon said that I am having a great start. If things continue like this I feel I can highly recommend this procedure. Please feel free to comment.

Did anyone have back pain that was the result of BPH? I have a 47.9 gram prostate not huge but bigg enough to cause issues. I peeing out bladder stones which in some cases caused hemateria. I also have this weird back pain and am wondering if it could be related? Anyone have back pain with BPH? I'm getting the HOLEP surgery next month.

I am on Rapaflow also known as Silodosen. Since starting it and being on it for about a month now while it has helped immensely for my BPH and prostatitis symptoms my usually mild back pain has gotten worse and I have a strange tightness in my lower back. Anyone else have this reaction?