FLA for BPH and Chronic Prostatitis.... Long Post

Posted , 25 users are following.

Hey men, as some of you know, I am scheduled for FLA (focal laser ablation) with Dr. K in Houston TX next Thursday

A little back ground, I am 54 with a 45 gm prostate that has the dreaded median lobe.  I had a failed PAE in Jan 2016, I had a really bad allergic reaction during/following the procedure, and it took months to get over it. Myself and the Pae Doc assumed since it took so long to clear up that it was a reaction to the beads used. HOWEVER yesterday in prep for the FLA procedure, I took ONE Bactrim (which I had  taken tons of several years ago with no problems. ) And within 2 hours my whole upper body was covered in blisters and hives. Went straight to the Doc, and he started me on a IV of prednisone, and then gave me a second round 4 hours later, and a 3rd round this morning. It seems to have helped tremendously, and stopped the spots from blistering and peeling this time.

So needless to say Dr K has switched me to a different oral antibiotic.

Dr K is going to be trying something new with me, in addition to the FLA for the BPH, he is going to try and cure my chronic prostatis at the same time,he says obviously that is causing lots of scar tissue in my prostate,

Step one, I sent a sample of my prostate fluid for a DNA result. To my surprise, even tho I had no current symptoms that I could notice. I had medium bacterial load, with 3 different bacteria present in the prostate fluid.

I sent the results to DR K, and actually called and discussed the results with the CEO to get his recommendations.  I have NEVER seen a doc do something like that So needless to say I really feel like he goes above and beyond. He gave ne a call, and said the antibiotic that he strongly recommended was VERY expensive, and his cost was $1,000 he was very apologetic for having to charge extra, but I was totally fine with it. Most men with chronic prostatits  would pay anything for the possibility of actually curing it.

Here is the current plan:

Cefdinir 300mg orally twice a day for two weeks starting two days before the procedure

Invanz IV the day before the day of and the day after the procedure

Ceftriaxone 1 gram intraprostatic the day of the procedure

He is going to inject that last one directly into the prostate after he finishes with the ablation.

The hope is LOTS of the bacteria will be killed by the ablation itself, and the follow up with all the other meds will completely get rid of any that remains.

And hopefully since he will be removing most if not all of the blockages in my prostate, it will not be as easy for bacteria to set up shop again.

Even tho this is a very expensive approach, and its not clear if insurance will cover any of it, even tho they gave a pre-approval letter. Dr K says not to get my hopes up, but I am sure gonna try to turn it in.

Thanks to John and all of the other men who give such great support.

I will keep everybody up to date.

 

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  • Posted

    Joe, Good luck with this.  Dr K will not let you down that's one thing all of us in the K Club know for sure. 

    Let's us know how it goes. 

    Pete Kline

    HONG KONG

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  • Posted

    Hi Joe,

    Detailed workup = best chance for great results. Sounds to me like you took charge of your situation and I commend you for that! I'm not a doctor but your plan sounds great. You are in very good hands with Dr. Karamanian. Keep us updated.

    I'll update my own situation in my own thread later, 4 weeks post Dr. K, doing very well.

    Best,

    Pete 

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    • Posted

      Thanks Pete, the good thing about Dr K is he is open-minded to try new thngs. If this works ro actually heal chronic prostarits also, he will have men lined up for months. I know I didnt hesitate to pay the extra for the chan e it might work.

      Glad to hear you are still doing well. That helps a lot.

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  • Posted

    I have tried everything. Would love to find something that would help me also,  Steve
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    • Posted

      Hey Steven I am with you on tryi.g everything. I think the problem is we never get completely rid of whatever is causing it. I was really surprised when I got the DNA results be k just how bacteria was present, even tho I had apparent symptoms. The good thing about the DNA testing is that even if the bacteria die.on the way to the lab,the DNA is still there. So pretty much urine, and even culture samples are pretty useless because by the time they reach the lab, they have died, and therefore do not grow a culture.

      I will let you know how it goes.

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  • Posted

    I hope all works out for you.  I know you want everything fixed but at 54 do you have any concerns on ending up with retro ejaculation.  I know that there were some men on here that had FLA but did not get it but there all ways is that chance.  Good luck  Ken 
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    • Posted

      Hey Ken it is always a possibility of course, but I really trust Dr K and he assures me that he does not get even close to the area that causes retro. And I haven't seen anyone on here who has been to him have that problem, most actually say it.is better. On the other hand every medication I have ever tried with the exception of cialis daily (whuch insurance would not cover)caused retro. Not to mention all of the other side effects.

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    • Posted

      Kenneth, I had FLA. No retrograde but reduced amount of seamen which I am very happy to live with. I do not know of anyone who has come away with retrograde from FLA. Anyone here know if I am I correct about this or not?

      Pete Kline

      Hong Kong

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    • Posted

      Yes I know that Dr. K have helped many men who have had FLA with him .  Maybe one day you can get off all meds and get back to some kind of normal.  God Bless you and good luck  Ken
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    • Posted

      Fla didn't work for me. I'm the same as when I went in. Been over 6 months. Had a scope and still shows my urethra is still pinched off by prostate. Only shows a small dimple on the right side.

      Jim

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    • Posted

      Jim  Sorry that FLA did not work  It has worked for many men.  How much of the prostate is still left.  Can they do like a mini Urolift and put a clip there to open it up.  Just thinking  Ken
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    • Posted

      Hi Jim, where on the urethra is the prostate still pinching ? Is it closer to the bladder or furthest away from the bladder (at or near external sphincter) ?  Do you have any idea why it was not ablated ? Thanks. Hank
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    • Posted

      If the doctor did the maping of the prostate right he should have not had a problem.  The only thing I can think of is the doctor did not want to get to close to the bladder neck.  ?????  Ken
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    • Posted

      Hank, going to get another 3tmri. To see what was removed. Dr K show me a pic of what he removed and it looked like a lot. We will see.. All I saw on the scope was the prostate wash still pinching or narrowing down the urethra.. Dr K says he can take out more at half the cost..Hate to spend that kind of money with no results. I am pretty discouraged at the moment..
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    • Posted

      I haven't given up yet. I will be sending him dr k my new MRI and going to compare the new one with the older one with my urologist. Urologist seems to be very interested.. I do like Dr k just a little un sure if he is as good as i thought the first time around. Was just reading how some one said dr k showed him the results and he was very please cause that is exactly what he told me. Funny how after 6 weeks or so everything worked great and when i tried to get off meds it was all down hill from there.

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    • Posted

      Dr K said he could get closer to the bladder neck, but might get retro grade. At this point I don't rely care as meds do the same. Just hate to spend another 11,000. Plus travel for nothing.

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    • Posted

      Jim

      I am REALLY sorry to learn this. I had the FLA in Houston in July and it has worked like a dream. This is the very first I've heard of a fail from DrK. Has anyone else had poor results that you know of?

      Pete

      ________

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    • Posted

      Could you not find out from the scope where the obstruction is, approximately ? I guess it is not a stricture otherwise they would have told you. How are you talking care of your BPH symptoms now ? Hank
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    • Posted

      Jim  This does not make any since being he saw the problem before the procedure was done.  It should have been mapped out.  Ever a hair would have did some good.  But now he wants to give you a deal to fix the problem that should have been done all ready.  I hate to say this because he has helped many men on this site.  But I think he is getting to big for his procedure.  It seams like money is the answer.  What he should have done it tell you I can go in and take care of it for you no charge  Good luck  Ken  
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    • Posted

      Jim,

      Feeling so bad for you. Wishing we K club members could have a whip around to help sort you out.  My prostate was really big: 185cc and I was in the op for nearly 3 hours but I think its shape was fairly normal. I did notice from the small print DrK does cover himself from things not going as expected. My guess is, from the price of the laser and the cost of rental for the MRI theatre he is offering the re-do at cost.

      Keep us informed.

      Pete

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    • Posted

      Hank, not sure exactly where but I don't think it's close to the bladder neck. Doc. Said it was just a small opening and acted surprised that I had anything done. I'm on 8mg flowmax and fenisteride. Which is working better than before fla.

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    • Posted

      Jim was just thinking   When Dr. K did the mapping and showed you what he was going to do was that on the MRI or did he cause it in some way???  Just thing out of the box.  It should have worked the first time.  That was a lot of money for it not to work  Ken
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    • Posted

      OK. At least you're in the USA. As you probably know I came from Hong Kong and I've just been talking to a guy who's travelling from New Zealand for the operation in December. But of course, you still have the same hotel bills and flights etc. 

      This must be a big disappointment for you. I found Dr K to be a really straight shooter. I'm actually hoping that this fail does not dent his reputation too badly because I'm 100% sure of his commitment and feel his heart is in the right place. I have really never met a Dr who was willing to give so much time and resources to an individual patient. However Jim, I truly understand this does not help you out of your situation and appreciate how you must be feeling. Hoping you get this sorted out, it must be very disheartening. 

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    • Posted

      Hey buddy I don't mean to do that but it should have been taking care of in the first procedure. Not say I will give you a deal to fix it.   From all the other guys he does seam like he cares but with you he mess up. Maybe you need to relax and just wait till the other MRI comes in.  If your married.  Take your wife out and have some fun and forget about the problem.  Enjoy your self  Ken

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    • Posted

      Yes Dr K seems to be a good doc. I have spent much time talking with him. He does seem concerned and will give a good deal on redo. Just not as sure as i was the first time around. If you now what I mean..
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    • Posted

      Being a good doctor he should not have to give you a deal. it should have been taking care of the first procedure.  Maybe he is getting to over worked.  Ken
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    • Posted

      I am completely sympathetic to a patient who did not find the results he sought. But you post Kenneth Way out of line.

      There is no factual basis for your defamatory comments. A doctor who is willing to stick his neck out and offer an innovative procedure to men, some of whom had no other good choices earns every penny he charges. It is not Dr K's fault insurance companies will not cover the fee, if they did no one would be bitching about the cost. Aim your bullets where they are deserved.

      Reading this kind of post about Dr K in a sea of posts about doctors who truly could give a crap about anything other than their paycheck is so disappointing. Despicable really.  

      Any reader who wants a direct honest opinion about Dr K from someone he treated, message me.  He is caring, accessible and gifted, and he changed my life. 

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    • Posted

      You can't even spell and yet you have the training and experience to say "it should have been taking care of in the first procedure".  

      Once more WAY OUT OF LINE. Stop defaming a good and decent physician!

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    • Posted

      OUT OF LINE

      " It should have worked the first time.  That was a lot of money for it not to work  Ken"

      You have no credentials nor familiarity with Jim's case to make these defamatory claims!

      Sick of seeing a good man disparaged with no basis in fact!

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    • Posted

      Pete, you are so right. I have been holding my tongue all day out of respect for Jim because I am deeply saddened he was not successful with his operation, but for Ken to disparage Dr K like this without knowing any details is completely out of order.

      Jim we are all rooting for you and wish it could have a different outcome. Whatever you decide to do I am hoping it will be successful. Keep us in the loop.

      Pete Kline

      Hong Kong

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    • Posted

      Pete.  I'm sorry you feel that I am against Dr. K.  But I am just saying that I feel for Jim he went in this procedure thinking all will be great and now he has to have another procedure.  Dr. K is a very good doctor and I think he will take care of Jim but I think something went wrong that it was not done right the first time.  Maybe the MRI text did not do it right.  Who knows.  I was just saying what Jim was writing about what he is going through.  Lets hope the new MRI give him a better understanding of what went wrong.  Ken

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    • Posted

      Guy's I'm rooting for Jim to.  No man should have to go through 2 procedures We do not know what happen that is true  Dr. K. is a good doctor but in the back of your mine what went wrong that it was not done the first time. I feel that Jim will have a good out come next time  Ken  

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    • Posted

      I'm with you Ken. I was thinking (probably not) maybe the machine wasnt working right or Dr. K had an of day. Only the new mri will tell. The pic dr k showed me looked li ke it was all cleared out. Wish i could add pic here and show everyone.

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    • Posted

      Hello Peter,

      Everyone wants to see everyone else "fixed" and happy. I feel very bad for Jim. And with that said, for all the horror stories, crap workups/diagnosis, outright scams ("gat goren", UGH!), and doctors who will not pick up a phone, to make these terrible baseless uninformed comments about Dr Karamanian is despicable.

      Dr K talked to me, arranged for an out of state 3T MRI, identified my problem areas immediately, performed an innovative procedure on me that took my IPSS from the 20's to single digits in 8 weeks with no negative effects. Direct personal contact the whole way along. HOW MANY DOCTORS LIKE THIS IN THE WORLD? You disparage Dr K, you'll get push-back from me every time. 

      BTW Peter, 8 weeks post-op I CONTINUE to improve! It's crazy. I've never had this (urinary) quality of life, ever. Thanks to Dr K. I think you are the same, and I hope so.

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    • Posted

      Pete

      You are right.  I have never looked back since the operation. I have almost forgotten I ever had prostate problems, and my problems were really bad.

      I am still in touch with John and Ross who were my buddies throughout the procedure and while I was in recovery. Even now we provide what knowledge and assistance we can to others who are considering the operation with Dr K so I guess you might call me a true believer.  If there is a better operation out there to cure BPH I certainly haven't heard about it. 

      I'm happy you are well and hope things work out better for Jim next time. I just wish there was more we could do.

      Pete Kline

      Hong Kong

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    • Posted

      Every Man is different, results will vary. Dr. Karamanian should disclose how many procedures for Bph and list results positive and negative. Procedure is a lot of $$$ to many.

      Cost for Fla is 20k. Pae 6k to 13k. Pae requires much larger team in hospital. 

      Fla requires Dr., Nurse, Mri cost, Laser cost.  

      Dr. Karamanian seems caring, lets not forget he is making decent money for this procedure. He markets his procedures for a living.

      If he did not disclose it could fail, he needs to fix it on his dime.  

       

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    • Posted

      Hell Jim,

                    may I ask what your prostate condition was before your FLA? thanks and here's hoping for a happy outcome all the very very best.

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    • Posted

      Regarding cost, if I'm not mistaken, the laser tip that is used to do the actual removal costs about $6K. and its one time use. I may be wrong with that figure but it sticks in my head. Dr K is far cheaper than Dr. Sperling and Dr K is very accessible. I got the bum's rush when I tried to contact Sperling. 

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    • Posted

      Brian,

      My prostate was not that large. Thought it be an easy fix. Just need to get that new 3tmri to hopefully see what happened . I'll let y'all know what the outcome is.. Thanks for the good thoughts.

      Jim

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    • Posted

      Docs never guarantee their work. I agree if he doesn't want negative results he should make it right. He is a good guy.

      He is the only doc I know that will spend time on the phone with you. In my line of work if the customer is unhappy ill fix it at no cost.. As long as they are reasonable complaints..

      Jim

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    • Posted

      I don't think any Dr. is going to guarantee results. Way too many variables. If you decide to have another shot at it, maybe Dr K will give you a great price but I really don't think he's obligated to do so. I highly doubt he half-assed or hurried your procedure. I do wish you the best. 

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    • Posted

      Jim  That is true.  My urologist will tell you the same thing.  They can suggest a procedure that may work but they do not know if it will until it's done.  Which I think is not right because once it's done it's done.  They say if it don't work we will fix the problem.  Dr. K is like my doctor I have no problem getting a hold of him if I have a problem.  Lets help all works out  Ken

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    • Posted

      That's hope.  That is true Uncle.  No doctor will give you a guarantee on any procedure.  Let's just hope Jim get's this work out where he will get the result he want  Ken

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    • Posted

      Question for all. Would y'all do it again f la that is. If I do again that will mean I'll have about 38,000. In Fla with Dr K. With no guarantee. Wife says I'm crazy if I do again.

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    • Posted

      For one thing it should have be done right in the first place.  That is to much money to dish out.  When your prostate is mapped out before the procedure.  You can see everything that should be taking care of.  If Dr. K missed it.  You should do it at no charge.  He should take a lose. not charge you again.  Ken
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    • Posted

      I would have a look at new Mri, maybe a second fla opinion. Its almost obscene on the price out of pocket. I'll bet he returns his calls "muy pronto Señor" thats good money.

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    • Posted

      I tend to agree with your wife. How bad are your symptoms? Do you pee good enough to wait a year or 2 for other procedures to be proven? Sounds like aquablation is looking pretty good if you're willing to gamble retro. What about urolift? 

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    • Posted

      Jim  What Uncle is saying is true. Do you still pee or do you still have a problem.  See what the other MRI said.  Maybe they can clip it open so you can pee better.  The Urolift would be much easier.  Here's hoping it all works itself out  Ken 

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    • Posted

      I agree Unckle, no Doctor can gurantee anything, necause everybody is different.  And as amatter of fact, when I met with Dr. k the day before the procedure, he made that clear. He said " I really think I can help you but there are no gurantees". And of course I agreed to go ahead with it. He even told me that day, that if I wanted to try urolift first, he would refund my money.  Another urologist had told me that I did not qualify for urolift because of a large median lobe. Dr K showed me on my MRI that I in fact did not have a large median lobe at all.

       

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    • Posted

      Jim  Now that he got rid of the median lobe you can have the Urolift.  Maybe that would fix the problem.  Wait when you see the MRI.  Time will tell Urolift would be a lot cheaper.  We all on here what the best for you  Ken 
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    • Posted

      Hey Jim, sorry it has not worked out for you. I am just abot 3 weeks out on mine, so its hard to say if it does not work, if I would do it again. 

      I know you are awaiting another 3T, and I guess it really depends on if Dr K or someone else can point to the MRI, and say here is your problem, and here is how it can be fixed. Otherwise I would agree with your wife.

      I know when my PAE was declared a complete failure, that Doc offered me a redo, AT FULL PRICE, and couldnt give me any reason why the second one would work, since the first one did nothing. Needless to say I said no thanks.

      Dr K is probably being fair offering to redo at half price, I am sure that's pretty much his cost. And as good of a guy as he is, he obviously has bills to pay just like the rest of us do. So to those that say he is in it for the money, I am betting they do not go to work every day for free.

      Keep us up to date on the new MRI.

      Joe

       

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    • Posted

      Check with a doctor there are other pills that may help you and will not cause that problem.  I want the best for you for what you have been going through.  Ken 
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    • Posted

      "..the pills arent going to be working much long..."

      Jim, how can you be sure about this ? I think you might have been scared unnecessary. People  can stay on meds for a long time. You can always increase the dosage, or change meds. Low libido ? How about Viagra or Cilalis ? 

       Then there is always self cathing (CIC). It may work for you. It may not. I would give it a try. Don't rush into anything.

      I am taking Doxazosin and finasteride. Self Cath once a day before bedtime. 

      Hank

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    • Posted

      Thanks Ken, Hoping it all works out good. Which ever dicsion I make. For now pills work. MRI will tell. I will keep on pills as long as I can.. Once I get MRI I will talk with uro and Dr. K..Trouble with me it's hard to be patient..

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    • Posted

      What pills are you taking? Fernasteride and similar pills slow the growth of the prostate. So giving those up probably won't have much effect on peeing for now. If you're on Flowmax, maybe you should give daily cialis a try. It helps with urine flow and erections. Win/Win in my book.

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    • Posted

      Jim - the 5-alpha reductase inhibitors like finasteride have proved very difficult to stop after a year. The hormone they block, DHT comes roaring back and causes the prostate to grow again - BPH. Many of us cannot get off that awful drug short of removing the prostate. Your FLA likely worked ok until you stopped the drug. The DHT works very fast when given the chance - just days. Your experience is not uncommon. Good luck.
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    • Posted

      Has anyone on here gone straight to having an FLA for BPH without having been on fenesteride for a period of time? Does the FLA reduce the size of the prostate enough so that you do not need to be on flowmax and/or fenesteride following the procedure?
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    • Posted

      Dale, I had not taken a course of Flomax until I had the FLA procedure. However, Dr K prescribes a course of Flomax that should be started a week (I think) before the operation and stopped when the supply runs out. My answer to the last part of your question would be, you do not need to be on Flowmax after the course prescribed has run out.  It is 5 months now since I had the procedure and I'm not taking, nor do I need to take anything.

      I hope this helps.

      Pete Kline

      HONG KONG

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    • Posted

      Neil have you heard this before. Dr K never mentioned this to me. I talked with Dr K a few days ago.. If I go in for a redo im going to stop finesteride 3 weeks or so before i go in. I will catheter if I ha 've to once off. Hoping that will make the deference..

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    • Posted

      Hi Jim and Dale - I have asked Dr. K and other IRs this question. I don't get a great answer from them but have been told that sometimes men can get off proscHiJim and Dale - I have asked Dr. K and other IRs this question. I don't ar/Avodart ok if they haven't been on it too long which means a few years. The problem is that these drugs suppress production of a powerful growth hormone (DHT) so when the drug is stopped for a while the DHT production goes crazy which causes hyperplasia.

      I know a few men roaring backkkwho had a successful PAE and were great until they stopped this drug and then the BPH came

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    • Posted

      sorry for the break - there is so much advertising now that my link hangs up after a few lines - frustrating.

      Anyway, Dr. K said that within the FLA community a few men could get off the drugs but he didn't elaborate. The kicker is that after 5 years these drugs stop working but the side effects remain and we are hooked to it. All the PAE guys I know could not get off it even though the PAE worked for them (mine didn't help).

      This Friday I will have the Gat-Goren procedure for my varicoceles and hopefully to reducce myc

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    • Posted

       ... frustrating ..

      Anyway, Gat-Goren just published a paper where they said that men who had the varicocele embolization and saw their BPH improve still could not get off Avodart. My prostate was 90gm when I started it in 2004. It helped for 5 years but now it is 240gm!! And I still cannot get off it! I CIC 4 times/day. There needs to be a proper study on this drug. Good luck. PM me with your email as this site is broken. Neil

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