As temperatures drop and daily temperature fluctuations increase, more patients begin experiencing worsening symptoms of benign prostatic hyperplasia (BPH). For patients whose symptoms cannot be adequately controlled with medication, surgical treatment may be considered. In recent years, holmium laser enucleation of the prostate (HoLEP) has gained significant attention as one of the most effective surgical options for treating BPH.
Many patients are already familiar with what HoLEP surgery is and how the procedure is performed. However, fewer people are aware of the temporary symptoms that may occur during the recovery period after surgery. Understanding these postoperative symptoms and knowing how to manage them can help patients recover more comfortably.
A useful way to understand postoperative symptoms is to think about how the body heals from a wound. When skin is injured, contact with water can cause stinging or irritation until the wound heals. Similarly, tissues inside the body need time to recover after surgery. HoLEP surgery removes the enlarged prostate tissue completely, which means a temporary surgical wound remains in the area where the tissue was removed.
Typically, it takes about two to three months for this internal wound to fully heal. During this healing period, the surgical area is continuously exposed to urine, which can temporarily irritate the tissue. As a result, patients may experience discomfort while urinating, a frequent urge to urinate, or a sudden strong urge to urinate. In some cases, this irritation may cause urge incontinence, where patients may briefly leak urine before reaching the bathroom.
Fortunately, these symptoms are usually temporary and improve gradually as the surgical site heals. However, patients may feel anxious or uncomfortable while waiting for recovery. For this reason, physicians may prescribe medications to relieve irritation and improve bladder symptoms when necessary.
Before surgery, many patients are particularly concerned about the possibility of urinary incontinence. As mentioned earlier, temporary urge incontinence can occur due to irritation at the surgical site. However, this condition usually improves over time. During HoLEP surgery, an anatomical structure called the verumontanum—located between the surgical area and the urinary sphincter—is clearly visible through the endoscope. When the procedure is performed by an experienced surgeon, the risk of damaging the urinary sphincter is low.
In addition, the holmium laser used during HoLEP penetrates tissue only about 0.4 millimeters deep, which further reduces the likelihood of injury to surrounding structures. Permanent urinary incontinence is more commonly associated with radical prostatectomy for prostate cancer, where the entire prostate is removed. In contrast, HoLEP removes only the enlarged prostate tissue, so the risk of long-term urinary incontinence is generally low.
Another symptom that may occur after HoLEP surgery is hematuria, or blood in the urine. This can appear intermittently for up to about one month after surgery. In most cases, this is a normal part of the healing process and improves gradually with proper care. Patients are usually advised to drink more water than usual, avoid sitting on hard surfaces for extended periods, and refrain from activities such as long-distance cycling during the recovery period.
After HoLEP surgery, patients typically have a urinary catheter inserted for about two to three days. Proper catheter care is important during this time. The tip of the catheter is usually positioned securely within the bladder, so accidental removal is rare. However, in some cases, the catheter may become caught on clothing or objects and be pulled out unexpectedly. If this happens, it may cause urethral irritation, bleeding, or difficulty urinating.
If the catheter is pulled forcefully and the urethra is injured, it may be necessary to keep the catheter in place for a longer period to allow proper healing. Therefore, patients should be careful to avoid pulling or tugging on the catheter.
The urine collection bag connected to the catheter should also be positioned lower than the bladder. If the bag is placed above bladder level, urine may not drain properly and could flow back toward the bladder.
Recovery experiences may vary slightly from patient to patient, and some individuals may experience additional temporary discomfort. If any concerns arise during recovery, patients are encouraged to contact the hospital where the surgery was performed and seek appropriate medical guidance to ensure a safe recovery.
As men age, various urologic conditions can begin to interfere with everyday life. Providing clear and practical information about urologic health can help support a healthier and more comfortable life during middle age and beyond.