Focal Laser Ablation(FLA) with Dr.Karamanian, for PCa and BPH, 6 months update

Edited , 8 users are following.

It's now 6 months after my FLA, I went for FLA because I had severe BPH problems with potential bladder deterioration and I was Gl4+3. I investigated FLA and other FLA practitioners and decided on Dr.Karamanian after watching the last 3 years as his FLA practice and expertise developed. I am very glad I decided to have him perform FLA. So far results are excellent, my PSA before FLA was 10.3, 6 months after FLA is now at 0.6, my IPSS as far as BPH was at 25, now is 1, only because I need to pee once overnight. My average urine flow 3 months after FLA was 13.6 ml/sec, 4 months after was 16.6ml/sec, I have no urgency, frequency is normal, every 3-4 hrs.

I have no ED, I am fully continent. My most recent prostate 3TMRI as part of 6 months follow up, was carried out and reviewed independently by another radiologist who confirmed I have no residual cancer left, Dr.Karamanian also reviewed my recent MRI and agreed. Thank you, Doctor and Nurse Donnie, you are a great team.

0 likes, 14 replies

Report / Delete

14 Replies

  • Posted

    Thanks for the very positive report Andrew. I appreciate it!

    Report / Delete Reply
  • Posted

    Thanks for your update, and congratulations on your progress! Wishing you continued Good Luck!

    Report / Delete Reply
  • Edited

    Glad to hear things went well, Andrew.

    Did you post details on your recovery (time catheter was in, any events like AUR that caused a trip to the ER, etc.)? If so, would you mind providing a link. If not, I'm sure I would not be the only one who would be most appreciative.

    Report / Delete Reply
    • Posted

      here is a bit more details I posted early Dec/19 on Inspire forum:

      I have had FLA w.Dr.K in early Sept/19, I was there only for three days. I left the day after FLA and flu back home for 4 hrs with the Foley in, I didn't have any issue while traveling, I kept it for 11 days, a day longer than recommended 7-10 days, on removal, (btw, very easy to do it, don't allow anyone else to do it), my peeing was v.limited and still painful due to swelling and 15 ablations so I started self-catheterization for few days and got UTI, couldn't pee and ended up in ER with another Foley for another 14 days as recommended by Dr.K, as soon as I removed the second Foley, my peeing was great, no pain, v.strong stream and no other issues with UTI, which took about 3 days of Bactrim to take care.

      I didn't experience any pain or discomfort during FLA or after when my second Foley was removed, after FLA I got RE but to me, this is no big deal, I had that before due to Flomax and consider a minor price for getting such great results for BPH, you may or may not get it. I had sex after about 3 weeks when my second foley was removed, at that point I had no blood in my urine. In the following 2-3 weeks, I noticed some tiny tissue particles in my urine that came out, but I didn't experience any discomfort when they came out, they were very small, I don't remember any restrictions, but some are obvious, after FLA I was walking with my Foley every day 2-3 miles, there was some discomfort with the Foley tube moving in my urethra but that didn't stop me from walking. Dr.K and Donnie are a great team!!!

      Report / Delete Reply
    • Posted

      Thanks for that info. About 18 months ago, I had a nasty UTI. I tried to get to an ER, but didn't make it. Fortunately, I wasn't totally stopped up and was peeing about 30 mL every 5 to 10 minutes but with incredible pain. As a result, I learned to self cath - the idea being that I could self-cath if I ever found myself in this situation again. But lately I've been wondering if I'll be able to self cath successfully should a UTI close up the urinary tract. You said you wound up in the ER as a result of the UTI. Does that mean that you tried to self cath but weren't successful or did self cathing work but you went to get antibiotics and decided to get a Foley as well or ......

      Report / Delete Reply
    • Posted

      Just wanted to comment on your question about CIC and UTIs. I've been doing CIC for 3 1/2 years now, 4 times/day and have had 4 UTIs. The UTIs do not interfere with my ability to CIC but there can be a little burning so it is very important to just insert it (and remove it) very very slowly. I found the Amoxicilin worked best and very quickly with no side effects for me.

      It is very important to CIC with a UTI as you do not want the infected pee sitting in your bladder where it could migrate up into the kidneys. So nothing to fear ...

      Report / Delete Reply
    • Posted

      I did start self cathing right after my Foley was removed, because I was still swollen from FLA, and in another couple of days I got UTI, I managed to get in about 30 times, but eventually my UTI plus swollen prostate blocked me completely, I wasn't able to insert my catheter, tried 3 different one and end up in ER, took another two weeks of Foley and then everything somehow got open and no issue with peeing any more

      Report / Delete Reply
    • Posted

      I went to Urgent Care (this was before I couldn't pee) and as expected the first drug of choice was Cipro. I declined and asked for amoxicillin. Amoxicillin cleared up most of the UTI but after the 10 (or was it 14) day regimen, I started up again with night sweats. A 2nd culture still showed e-Coli infection, so I was put on cephalexin, which cleared up the UTI completely.

      Report / Delete Reply
    • Posted

      at 3 AM, when I couldn't insert another catheter I decided I had to go to ER, in the first hospital the nurse couldn't insert Foley, I think it was red and too soft, it was not painful when she tried, it was coiling up and not going in, so they told me to go to another one with large urology department, and there was some urologist on call, eventually he showed up, at maybe 9 AM and managed to get it in, size 14, it was a bit stiffer and went in, without much effort or pain, it was almost 10 hrs since I pee last time, no fun, on advise of Dr.K I kept it for two weeks, and remove it, removal is very easy, it almost would fall out by itself, never allow anyone else to do it, after removal I was peeing like 20-30 years ago, great relieve

      Report / Delete Reply
    • Posted

      Dear rdemyan , a UTI could not only close up the urinary tract , usually prostate get infected as well and this is when the urinary tract closes, the infection can go up to the kidneys an also to your blood stream and get sepsis which is the infection in the blood that could nest in all organs , I had a Foley for two weeks and one day I was shivering , had fever and went to the hospital I had to stay 3 days with IV antibiotics until they made sure was not sepsis and not talking about chronic infections from using the same antibiotic the bacteria can be resistant too easy .

      Report / Delete Reply
  • Edited

    Congratulations on your great results. Do you recall the size of your prostate? Was your BPH due to a large median lobe that blocked the bladder neck or some other cause? Thanks for posting.

    Report / Delete Reply
    • Posted

      my prostate before FLA was around 60cc, after MRI calculation shows 24cc, I had medium size median lobe, I don't now exactly what caused me BPH, but my ablation was extensive, had 10 ablation for BPH, 5 for PCa, MRI report says

      "the prostate gland has significantly decreased in volume from comparison MRI"

      down to 24cc

      Report / Delete Reply
  • Edited

    Hi andrewka

    I'm very glad you are doing so well and all the good results you have after 6 months .

    Like you I had FLA with Dr K 5 months ago , I'm doing great and I am 70 % of the time sleeping all night long and only 30 % going once to pee at night , my flow is very good , going every four hours to pee with not urgency , no ED even though at some point I was worried for ED but it was few days an is gone now , I had Gleason 6 ( 3+3) cancer nodule , I have my 6 months follow up MRI and PSA next month but now I do not know if it will be possible due to Covid19 !

    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up