Going with Focal Laser Ablation for BPH

@MV: Note: JimJames....you are too negative on FLA. Pointing out problem of one patient does not make a universe.

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Conversely pointing out the success of one patient also does not make a universe! And for the record, I am not "negative" on FLA. In fact, I have repeatedly called the procedure "promising" but just try and point out that the results are mixed, and that more patient data, including trial data, would be helpful. But with only 15-20 cases reported here, do you think we would be doing the men here a service by not pointing out that one and possibly two people had a sexual issue after FLA? Let the men here looking for information decide if that's important or not. Glad things went well for you.

Jim

happy to hear from you Martin . I have very similar prostate anatomy. 50 ml,  big median lobe . Severe LUTS for 3 years already , BPH maybe for 15 year.  I made record on  excell  file  with results of aprox.  20 patients.  if you have interest just private messega to me.  Im in contact with Dr. K  decided for Fla  but waiting for MRI,  Stan 

jimjames; You keep focusing on  "results being mixed" with focal laser ablation for BPH. I think that statement is nonsense.  Speak to the patients who have had FLA with Dr. Karamanian. They would whole heartedly disagree. You prefer daily catheterization. I would rather commit suicide than have a life of putting a 14 inch tube up my penis every day to urinate and risking a urinary tract infection.  And how long does it take to retrain one's bladder to be functional anyway. Is the time you are spending doing this worthwhile and tell me about the risks one takes from daily catheterization. You must be a good customer for those companies that advertise catheters on the television.

Perhaps you should remind future patients of the many risks of other procedures. Most men as we both know have retrograde ejaculation from both TURP and Greenlight, the two most recognizable treatments for BPH aside from PAE which has mixed results. Retrograde ejaculation is the most common long term complication of TURP and can occur in as many as 90% of cases according to the NHS.uk.  Of course, retrograde ejaculation  is where semen doesnt come out of your penis during sex or masturbation, but flows into your bladder instead. Pretty weird, I say, when for most of our living years since puberty, it comes out just one way. Men here on this forum to my knowledge, don't have this sexual problem with FLA due to the handiwork of Dr. Karamanian. .I have to laugh, when those who suffer from BPH, casually say this about retrograde: "I still get a climax and have no need to make babies anymore." What they may not know is retrograde is caused by damage to the nerves or muscles surrounding the neck of the bladder  which is the point where the urethra connects to the bladder. You can thank your local urologist who would rather use ultra sound rather than a 3T MRI. Ignorance? Expedience, or is it Economics? All 3 I say. Other procedures like the TUIP do carry a lower risk of retrograde, but who needs this kind of risk anyway. And of course urinary incontinence is quite common after TURP. I don't believe having a sudden urge to pass urine and losing control of my bladder to find a toilet is something very pleasurable. My brother had a TURP. He now wears a diaper. Every time he gets up from a sitting position, he passes some urine. Now..., not to mention urinary strictures or narrowing of the urethra which is estimated to occur in up to 4% of TURP cases. It can occur if the urethra is damaged during surgery and becomes scarred. Other risks include persistent bleeding requiring a blood transfusion, and urinary retention where the muscles that control the bladder may be damaged.

Jimjames...Of course, FLA may have its own set of problems that are particular to the procedure. But one must do his research and trust his Doctor. The only one, I would trust  for FLA  of the prostate for BPH or cancer is Dr. Karamanian. 

 

It is 3 weeks out from my FLA and things continue to improve. I actually have a small stream again when I pee rather than the very slow dribbling in the days after catheter removal. Dr. K says i should be back to my before ablation level in a couple of more weeks with continued improvement from there.

Hi Richard,  I intend to visit Dr. K.   a.s.a.p.  .  Be so kind and let us know your progress.  Btw. what is your prostate volume prior to FLA ?   Any madian lobe ?  PSA  ,...  I will gratefull  for every info . Greetings from Europe, Stan   

Martin, that is really outstanding news and especially the term of the results. 50 days out is way ahead of schedule on inflammation and coagulated tissue reduction. This is great news. Dr. K works so hard at improvement of the procedure and our success. He is obviously getting it better. 

I along with many of the men on this site are vey happy to hear of a 75 year old getting this excellent results. Thank you for sharing with us and please continue to update us. 

 

Congrats to j12080. The headline "Going With Focal Laser Ablation for BPH is second on the GOOGLE website to a Dr. Sperling's paid advertisement entitled: "Prostate Focal Laser Ablation/Low Risk-Minimally Invasive."

For someone who is involved in Search Engine Optimization (not me)...this would be an achievement. More people learning about FLA is what us members of the K Club should be encouraging.

P.S. This morning passed 9 oz (275 ml) of urine. In the past 4 oz was average for me and this is only 

53 days since my procedure. 

Good deal Martin. Happy it's working for you.

Jim

Hi Jim,   let us know how are you after 2.nd FLA  , thank you  Stan

Hi Stan,

Its been about 35 days.

Stream seems to be way better.

Still having some bladder pain. I go days without pain and then it's back. Hesitation comes and goes, lately more than less. Kinda the same thing on urgency. Sometimes my d@@@ aches after taking a leak. Still hoping and praying things just keep getting better. Bladder pain is the only thing that kinda bothers me. Still need more time to heal.

Jim

Thanks Martin. I can assure you it just magic to me I don't understand how all that works. I am the only guy I know who has never been on any social media group or program. You know like that facebook or Twitter. I am glad it happened if it help men in there search for some relief from this condition. There are still many more men who have done the FLA for PCA that got relief from BPH than there are straight BPH customers that have used FLA without cancer. I talked with two last week. I very excited you are doing so well. It's going to be a great summer for you.

Hello John

?This is your friend Mike from Michigan.  I see you are on here letting everyone know about the benefits of FLA for BPH.  My procedure was April 6, 2017.  I am coming up to almost one year.  You are at almost 15 months.  Both of our procedures were far above expectations.  I am still going good, especially for a guy that had a 185cc prostate and was having all kinds of problems controlling my bladder situation.  Every once in awhile I get a little lazy and I will have a small accident when I don't pay attention to my body telling me that I have to go and I ignore it and maybe about a 1/2 to an hour later I get some that comes out.  This is the only thing that is different from when I was in my 30's to 40's.  Going 3 or 4 hours with activity is not a problem.  I can go all night but most of the time I get up once after about 5 or 6 hours, but that is all I usually sleep anyway.  The one thing that I thought would happen, getting more sleep my doctor told me that I would improve my metabolism and lose some weight.  That has not happened.  My metabolism is still very bad and I have a good workout most of the time about 3 times a week.  Metabolism is hard to get back once you have lost it.  There maybe other factors involved that is hindering me from getting back on track.  I am wearing a Fitbit monitor now, because I am on a program through the University of Michigan for my PAD.  The fitbit is synced to my cell and then they get a constant update as to how much I am walking everyday.  This is a good program and it will be better once we get out of this crazy winter we are having and I get out doors to do more consistent exercise.  I still have my retrograde ejaculation that I had going into the procedure.  I thought that my turn itself around.  Maybe when I start losing some of this weight it may improve.  The sex is good and sometimes I don't need any assistance from a pill.  That has gotten better since the procedure.    

?So how are you doing?  I have not talked to you in awhile.  We have been busy trying to get a place for an investment in Akumal Mexico.  We should close within the next 2 to 3 weeks.  That will be nice to have in the winter, on the non rental weeks, Deb and I can slip down there and stay for a week.

?Hope things are good with you and your family.  I see that much of the discussions have been about REZUME and not as much about FLA lately.  I would assume that Dr K has finished the patients for his clinical study now and is working on the report to submit.  I think he is going to have to do a follow up study and maybe even one FLA for PCA and BPH combined, to get more financial backing and as a double positive to our prostate cancer friends out there that also have BPH.  This will be a long fight getting the approvals needed, but I have been told that insurance companies do not have to wait for full approval to start paying for some of the costs.  My insurance, United Health Care, said that they would like to see some data and some medium to long term results, but are very interested.  The COSTS are the largest deterrent from more people going with this procedure.  I see that there have been a couple patients that have had to go back for another procedure, but I am seeing a lot more repeats with the other procedures than this.  This procedure gives you the opportunity to have it done again instead on being a one and done deal.   

Keep doing a good job.  I will have to give you a call in the next week or so.

?Good Luck to All your Future FLA for BPH patients.  Dr K is the best along with his procedure.  Do your due diligence and look around and once you have enough information, I know you will go with this procedure.  I see we still have our Urologist on the forum recruiting for REZUME.  That is covered by insurance, but it is still a wild shot in the dark procedure, vs a procedure that the doctor can see very clearly what he is doing and can give the patient the best treatment.  He can remove more of the troublesome prostate size, bulk and where it needs to be removed to facilitate the most positive outcome with the least amount of risk.  I know that any procedure where the doctor can clearly see what he is doing, having a device that has very high precision including avoiding the Seminal Ducks, ejaculator nerves and muscle tissue, has to be the absolute best thing out there in the hands of a highly skilled laser surgeon.  

?Good Luck Guys.

Mike   

Jim: Best of luck. I give you much credit for the second time around. I think you will be happy with your results in a week or so. My stream improved dramatically in just a few days time. j12080 calls it something like the "eureka" moment. I think it happened to me just recently when the inflammation went down.

MV, I guess you've only read my posts on FLA. Next to perhaps Kenneth, I've probably talked about the downside and risks of retro from all the more invasive procedures, and was the first to challenge the low retro figures of Rezum's Phase III trials.

As to 'mixed" results, I think we have seen that in all the prostate reduction procedures, be it TURP, Urolift, Rezum or FLA. Just go through any of those particular threads and you will see both success, moderate results, and some failures. My suggestion has always been for men to take the time and read through the threads and read for themselves.

Sorry you would rather "die" than CIC. Many men have no other option, including one FLA patient, while happy with the procedure, still has to CIC to empty his bladder. But to be honest, I felt the same way you did about CIC when I was first sent home with catheters. I thought my life was over. I felt defeated. I was frankly in shock. Four years later, it's as traumatic as brushing my teeth. I think a lot of men here can attest to that.

Just to clarify again, I'm not against FLA, nor am I for TURP, Rezum, Urolift or any other procedure. I think they all have their pros and cons, and it's up to each man to find the right one for himself. And the more information on this forum, pointing out both the pro's and con's of each procedure, the better decision each man can make.

Jim

Mike its good to hear from you. I was going to call but I thought your where down in Mexico already enjoying that place we discussed. 

Yes I am great. I really feel better than ever and looking back, it took me at least 10 months to feel back to normal in all ways. However just like you, I am still an old man. I was ask the other day if I feel like I am thirty again. This question was in regard to urination and after thinking about the question seriously, I told them NO, I feel like a healthy 66 year should feel. I can also lay a stream out there about two and a half to three feet. I have to admit that is fun and it saves the shoes. 

I read your comments this morning about the occasional slip you have if you wait too long. This made me really laugh as I was on an airplane yesterday and was delayed two hours getting back to Love Field as I walked to the airport parking lot at 10:30 pm to find my truck I realized that I was really needing to go because of all the drinking I had done on the plane as it was delayed so long. While I walked, I thought about how I am going to open the front and back door of my truck and just go in the parking lot before I drive home. Great plan, but I can't find my truck because I forgot where I parked it. The truck horn finally blows for me and speed it up to a double time step to the truck but as I get closer the thought of going takes over and I had a small accident like you described!! Went home with wet pants. So this was so funny to hear your comments this morning as I just did the same. 

I am not trying to sell FLA to men on this site and you are right men need to really do diligence on the procedure they choose. I am happy with mine and would not do anything else. The logic I used in the selection came down to the results that can be achieved with the focus and accuracy of the procedure. Yes REZUME is the flavor of the month here and now. That is fine for anyone else if they want that but I did not want it. My issue with REZUM is that it is inserted up the Urethra then a couple of  holes are punched back through the urethra into the prostate and the tissue is shot. There is know visual way to see what is being shot inside the prostate as they shoot it and the accuracy is not as in FLA which is up to 1 mm. This does not mean it does not work and it is sometimes the only thing some men can afford so it has a place for now in the mix. 

As you know, the success is in large based not he man you choose to do your FLA and no other doctor is like doctor K. Just the fact that his procedures take about 3 hours shows the detail he goes into when he measures, directs, and views the laser as it is in the prostate. No other IR doing FLA do this. They can do it in 45 minutes and then try to get another one in. It's the meat market approach. He could this too if he did not care so much and you experienced that caring first hand. 

He now has a very high percentage success rate by strictly numeric terms but in my opinion Dr. K puts himself in a very precarious situation in a lot of cases. If he feels that he can help a man after he studies their MRI He will take the case and for that reason he takes special cases. He sometimes takes men that he should maybe just turn away because they have pre-existing situations that effect the pure results in procedural results facts. You as much as anyone no about the heart this man has. He does not concern himself with much more than helping men with prostate issues. People on this tread that have never known him, will not believe this but those of us in the K Club, no matter what level of success we can declare, we know the uniqueness of this special man. i also know for a fact he does send certain men to do other procedures and not FLA after he reviews their case. He truly wants the best for them and so he will consult, review, read their MRI and talk with them and never charge them money. The meat market guys won't do that. 

I understand he also has a new procedure he is working on for prostatitis and he hopes this can help the masses of men that are out there with this condition that most urologist will just dismiss and send away if standard antibiotics will not treat. Naturally this will be a cost effect solution as it is not FLA. This would be wonderful. 

To give you an update on the trial cases, he is now finished with the test in number count of patients. He now has to compile, report and submit then write the paper and I figure it will be around the first of the year to release as he has to keep up his day job. 

With regard to FLA on this site, we seem to have a few people that for some reason want to caution men not to consider it strongly and make false claims from time to time on speculations that they are not informed on. We now have over 20 men with Dr. K alone that have done FLA for BPH, So, I am considering starting another thread for men who have had FLA to report their results on BPH as it is important to know. Especially guys like you me Mark, Ross, and Victor who were the first guys to do this procedure. We all have good results but will it last? We need to continue to report the older long term results as it is important to others as much as it is to us. 

An unusual thing has happened in the procedure of FLA. It started in treatment of prostate cancer PCa and was only for that condition. During the process they discovered what it did for BPH. Then they adopted the same procedure and techniques modified and tuned to the procedure specifically to BPH. Now the cancer patients are being consulted on getting the BHP results added to the PCa removal so they are focusing the benefit for the PCa patients on both results as it can all be focused on the specific tissue need for removal during the same procedure. I think this is a wonderful benefit for older guys treating PCa with FLA. Their treatment can be designed so that the cancer is removed and they have BPH successful results after the treatment by design instead of by happenstance. This is good evolution!!

Hope you are doing really good and I want to hear about that Mexico deal. Just be careful down there. Don't be peeing at the airport down there like I did last night.

John

I hope so Martin, this stuff can be very frustrating for me. Hate to have it back in the uros ballpark.

Jim

Fact is jimjames bph can and is a b***h. All procedures have there ups a downs. I think all of us want to be one of the lucky ones were something works. For me it's always a constant worry on what to do.

Jim

Hopefully the 2nd time is a charm. From what I understand, you're still in the healing window, so hopefully your discomfort will start disappearing soon. Keep us posted. And you are correct, all procedures have their ups and downs.

Jim

 

Praying for you jim81578.... you're very brave to have a second go with the FLA, and it sounds like you are doing great for the stage of healing you are at because your flow has improved greatly. Maybe talk to Dr. K about Uribel to ease your bladder pain [spasms?]. Also, after my surgery I had urethral pain in my shaft for about a month, but at the time I was also taking an antibiotic for any potential infections. What you've done is a great experiment for those with a lack of success in the smaller prostate bracket, which is around the 45cc mark. All the Best- J

Thanks Jay,

I'm hanging in. To soon to tell. Just hard or frustrating . I do talk with Dr K. Just have to give it time. Only have pain in the shaft after a good pee. Kinda weird but feels like the pee is coming out faster which causes the pain . Probably just inflamation..

Jim

I have been taking Uribel here and there. It really does help.

Jim

Jim: That pain you are feeling in the shaft can be the beginnings of a urinary tract infection. I suggest taking D-Mannose powder with Cranactin and 4 Advil at night. Clinical research from Europe showed the Advil was much better at destroying bacteria than antibiotics. . A full blown UTI which I had for 3 days from the catheter can be excruciating during urination. Of course, I would consult with Dr. K first. My forceful stream did not occur until around my 40th day. This is your second time around so you know the story, but cleaning out the pipes (ejaculation) seemed to facilitate improvement.