For patients
Recovery after HoLEP: what to expect and when to seek help
Dr. Fernando Gómez Sancha · ICUA
Dr. Fernando Gómez Sancha · YouTube
Language: English. Editorial classification in the patient catalog.
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About this video
What can you expect after HoLEP prostate surgery? I’m Dr Fernando Gómez Sancha, a urologist at ICUA. In this video, I explain recovery in stages, from the catheter and your first visits to the toilet to returning home.
We look at urgency, stinging, blood in the urine and small leaks, as well as how the bladder adjusts and how everyday activities fit into recovery. There can be better and worse days along the way. I also explain warning signs, including fever, heavy bleeding that does not stop or being unable to pass urine, and when to seek medical attention.
Documented details and sources
Only details explicitly stated in the sources. Missing information does not mean it did not occur.
No clinical case details have been extracted for this video.
Original title and description on YouTubeSource checked: 2026-10-04.
Video moments
- After HoLEP: what happens on day one?
- Your first week at home after HoLEP
- Like a tooth extraction: what to avoid after HoLEP
- Blood in the urine three weeks later?
- Sport, sex and pelvic floor after HoLEP
- When do you see the final result of HoLEP?
- Recovery after HoLEP: what to expect and when to seek help · 0:00
- Recovery after HoLEP: what to expect and when to seek help · 0:40
- Recovery after HoLEP: what to expect and when to seek help · 1:22
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- Recovery after HoLEP: what to expect and when to seek help · 3:31
- Recovery after HoLEP: what to expect and when to seek help · 4:14
- Recovery after HoLEP: what to expect and when to seek help · 5:00
- Recovery after HoLEP: what to expect and when to seek help · 5:53
- Recovery after HoLEP: what to expect and when to seek help · 6:35
Available transcript · English
Source: subtitles embedded in the published video.
They may contain transcription or translation errors; check the explanation in the video.
- You've just had laser prostate enucleation surgery or you're having it soon and you want to know exactly what to expect. Today I'll talk you through recovery phase by phase, without sugar-coating it, because I believe a well-informed patient recovers better.
- I'm Doctor Fernando Gomez-Sancha, I've been in urology for thirty-two years and I've operated on over ten thousand prostates with lasers and helped thousands of patients recover. I know the process well because I see it every single day.
- On the day of the surgery, you leave the operating theatre with a urinary catheter. It's uncomfortable, uhm, at first, but it is necessary. You'll get out of bed after a few hours or the following morning.
- We operate in the afternoon and our patients have the catheter in overnight. At first, they don't have any pain because the spinal anaesthesia has an effect that removes the pain. Then the anaesthesia wears off from the feet up to the pelvis, so for the first four, five, or six hours, there's practically no pain.
- The night passes and the catheter is removed in the morning. The moment the catheter is removed can be a bit uncomfortable, mainly because we always flush the, the bladder a little with a syringe to remove any clots that might remain and prevent them from making it difficult for you to urinate properly later.
- You can eat as normal. Generally, if you don't have the operation too late, you can even have dinner, if you're operated on in the afternoon. In the vast majority of cases, you're in a regular room, not in an ICU or an intensive care unit, except for very elderly people or those with many underlying conditions.
- The pain is mild, more of a discomfort than actual pain. It's usually managed with paracetamol and an anti-inflammatory. The next day, in most cases, we remove the catheter and everyone looks forward to this moment: urinating for the first time.
- What will you notice? Well, a strong stream, probably stronger than the one you had years ago, uhm, but it's not always strong. Some patients might have a weak initial stream that gradually, over the following days, gains more strength.
- You might also experience urgency, sudden urges to go to the toilet, and possibly some stinging. All of this is normal. If you're urinating well, you'll go home that same day. Normally, the first urination is bloody, then it looks more like red wine, then rosé wine, then white wine.
- The first week at home is -- it can be a little uncomfortable. The urine might have a pinkish tint, or even small clots. It's normal because there's a wound inside the prostate that is healing.
- You'll urinate frequently, probably during the day and sometimes at night. You might have, uhm, urgency, though not as significant at first. It's also true that there might be some minor leakage when coughing, standing up suddenly, or with exertion.
- What to do during this first week? Drink plenty of fluids, walk, avoid intense physical exertion, and don't lift heavy weights. And driving, it depends. Usually, you'll start to feel better.
- I use the analogy of having a tooth pulled. When you have a wisdom tooth out, you have a bit of discomfort, soreness, and swelling. If you spit, a little bit of blood comes out. It's something similar; it's an open wound that gets washed by urine, but it's not actively bleeding.
- Avoid sports, and it's important to avoid coffee, alcohol, and spicy foods that irritate the bladder. Tea also has an effect, uh, of stimulating urgency, of producing urinary urgency.
- From the second to the fourth week, there's usually a progressive improvement. The urine clears up, the frequency decreases, and the urgency improves, although some patients whose bladders are already very damaged by chronic obstruction may have similar urgency or even a bit worse than at, at the start.
- At that point, if necessary, we can provide some temporary pharmacological treatment to, uh, slightly improve the tolerance of these symptoms. The small leaks of droplets that can occur gradually disappear in the vast majority of patients.
- You can start to lead a more normal life, walking, driving, office work, but you must keep on — avoiding intense sport. A moment that can scare many patients, and which can be normal, is that around the second or third week, or at a month, blood can appear when there was no bleeding before.
- Sometimes the little scab that formed over the wound partially detaches, and it's like when a scab falls off a skin wound. You might see blood in the urine for a day or two. If it happens, you drink — mmm, you need to drink more water, rest a bit, and obviously, if the bleeding is very heavy or doesn't stop, you must contact a urologist.
- It's what we call secondary haematuria. From month one to month three is the consolidation phase. The bladder gradually readapts. Remember that your bladder had been working for years against an obst-obstructive prostate; it was exercising, having spasms and bladder contractions to try to gain more strength and overcome the obstruction the prostate was causing.
- That overactive bladder has to learn to function normally again, and that takes time. Urinary frequency normalises, urgency disappears or improves a lot, leaks at this stage practically don't happen anymore, and you can return to normal physical exercise, including the gym, swimming, cycling… Uh, generally after thirty days or six weeks.
- You can also return to sexual relations. We recommend doing pelvic floor exercises when there's that leaking of droplets. They're simple. You must contract the muscle as if you wanted to stop the flow of urine, hold for three seconds, and release.
- Do, for example, several sets of ten contractions a day. This increases sphincter tone and speeds up recovery. When are the final results noticed? And I always tell patients that the result of the operation should be judged between three and six months.
- That's where the final result is usually seen. At three months, ninety-five percent of patients are happy with the result. At six months, almost, almost one hundred percent. There's something I always tell my patients: recovery isn't linear.
- There are better days and worse days. One day you're great and the next day you notice more urgency. It's normal, don't obsess over every urination. The body needs time. If at any point in recovery you have a fever, heavy bleeding that won't stop, or can't urinate, obviously, you must go to A&E or contact the urologist.
- It's not common, but those are the signs of the most important symptoms. Subscribe to the channel if you want to keep receiving this information. And thank you very much for your attention.