FLA references

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Im 63  suffering  BPH and severe LUTS for 3 years already . Prostate with big median  lobe.  As  reading  in  several discussions  side effects  take a place in  nearly all procedures.  I will be thankfull if  patients after FLA can  share their experiences here.  Many thanks, Stan  

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  • Posted

    I am 61 and suffered with bph and an enlarged median lobe for many years, FLA helped me with the least invasive damage, simply climb into a user friendly mri machine for 3-4 hours while they carefully and accurately laser with a very small laser unimportant prostate tissue (entry through the rectum) that is restricting urine flow while being meticulously careful not to damage the important bits, no pain at all, then simply have a catheter for several days then get on with life, in my case I had immediate improvement and from then on the healing takes up to 1 year all the while the flow continues to improve. One thing I noticed in my case(now approx 10 weeks post FLA) even though the flow is now unrestricted my bladder now needs to be retrained to hold more fluid and longer but still a lot better than before as I was at the stage of almost being blocked up along with pain. But I am now so glad I avoided turp regardless of what type of laser as with a median lobe they will have to compromise your bladder neck and upper sphincter muscle valve which means possible permanent incontinence as no one can guarantee the prostate lower valve will hold urine, simple logic tells us if the bladder neck is cut away it will no longer hold urine, turp also removes about half of the prostate they call it shelling it out, this means removing the waterproof prostate urethra and its surrounding tissue, they rely on the cutting tool to hopefully create a sealed waterproof seal but if it does not seal urine which is now in the prostate 24/7 it will slowly seep into the tissue and that could result in ongoing infection, also your sperm no longer comes out the usual way but goes into your bladder and hopefully exits with urine, also turp can damage the penis urethra and if they use the traditional hot wire they will slice up your penis urethra to prevent damage from the tooling  but turp can cause urethra damage requiring ongoing painful surgery, perhaps they do this with laser tools as well, I don't know, what I do know is I am glad I paid for FLA which like all surgery has risks but is far less invasive and no pain just a few drops of blood with number 2 toilet which quickly heals and a little blood in urine and sperm which is gone after about 2 - 3 weeks, its all so easy and can be approached without fear it really is a walk in the park compared to the horrors of turp for a median lobe. I used Dr Karamanian in Houston you can find him on google, he has a genuine sincerity and highly skilled a very clever and knowledgeable guy I highly recommend him, I could not find a treatment for enlarged median lobe that is painless, accurate, and that really works accept for FLA, do your homework talk to DR K he is happy to talk and is not going to hunt down your wallet like everyone is.

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  • Posted

    Hi Stan,

    Good to hear Fla is working well for you. Do you have a before and after prostate measurement?

    Thank you


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    • Posted

      Hi Katey,

      small misunderstanding .  Im in  decision  period now which method to  select for my treatment .  HOLEP, REZUME, or FLA .  So  my decision is  "dependent " on  FLA patient experience ,too.    Best Wishes, Stan

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  • Posted


    I am 62, diagnosed at 57 with low grade PCa (3+3 and later 3+4) and was on active surveillance for 4.5 years with annual MRIs and quarterly PSA. I also dealt with traditional LUTS since my early 50s.  

    Prior to the PCa diagnosis, my primary care physician did the traditional treatments for BPH - alpha blockers and antibiotics, neither of which helped. Over the years (especially after my dx) I learned more about prostatitis and BPH. I had multiple 3T MRIs as well as a cystoscopy. As a result of these tests, I learned that my urethra was narrowed within the prostatic urethra, but MRI did not show traditional BPH. My prostate was <30cc in volume and showed no major BPH 'nodules'. 

    During this time I consulted with 6 different urologists, all but one did the same things as my primary care - prescribed both selective and non-selective alpha blockers, finasteride and/or antibiotics (none of which helped). I also began consulting with 3 different FLA practitioners, sending them my MRI images.

    I also researched all of the Txxx procedures, Nanoknife, Rezum and Urolift, ruling out all but FLA. (if you want details on why, PM me).

    In Dec 2017 I opted to have FLA to both ablate my one visible and slowly growing lesion as well as to ablate in/around my urethra. I am still early in the process, and will not know how well this dealt with my PCa, but I am urinating better than I have in 25 years. 

    My suggestion to you and any man dealing with these issues is to first, have a 3T MRI performed by one of the facilities that specializes in prostate imaging and read by at least 2 of the radiologists that specialize in this field (Karamanian, Walser, Sperling), AND have a cystoscopy that you record video to provide to the radiologist. Next have a test performed on your semen (this is the most definitive way to determine if you have bacterial infection in your prostate and what antibiotic would be most effective).

    After all this, you should have a much better idea on what is the cause of your LUTS and which treatment is best for you.

    I spent years researching this and am satisfied with the results I've seen so far. If you want more details or to talk on the phone, PM me - I am glad to share more information and to assist you in any way that I can.

    Good luck,


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  • Posted

    Stan is this your post? have I answered you in any other post? This is John I had my FLA in December of 2016. I am 66 and had a 125 cc gland with a large median lobe, I think I have answered you before and do not want to be redundant. I am 15 months out and all is still wonderful with me. Best thing I could have done. No sexual side effects at all. 

    Let me know what else you need. 

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