Going with Focal Laser Ablation for BPH

Jim

Thank you Martin ,  ever pleasure to read about FLA  results  . I'm scheduled   for FLA  with Dr. K  on April  3th.   . Best Wishes from Central Europe, Stan

Did you have an enlarged median lobe prior?  What was the pre-procedure size of your prostate?

Thanks for the info.

Also I wonder if the chronic prostate infection might not put stress on the kidneys also.  I am only 54, and live a very healthy lifestyle.

Thanks Joe

Martin, thanks for this detail up date. My opinion of your recovery from my 18 months after FLA. You are very normal in the results. I think you have just experienced that event where you finally can tell inflammation is greatly reduced. I have called it that "Eureka moment". I had mine 5 weeks after the catheter came out. 

It is unfortunate that you had to deal with the short term UTI. Those things are horrible to deal with and very painful. I am interested in your cleanse (de-tox) information as I want to collect as much information as possible. Orthodox western medicine knows little that is not derived from chemical pharmaceuticals.

I will tell you that I was quite shocked at my recovery as I though it would be final in 4 months. I did not realize until 12 months out that it had continued to change and improve for at least 10 months. I did not know this at the time it was improving as at that time I thought I was great but after the 10 month period I just felt normal again. I am sure it has to do with the fact that burned tissue takes time to heal regardless of inside or out side the body. I also am hoping that with the facts and properties of burned tissue after healing, I will not have regrowth of tissues in the same area that was ablated and removed to free up my bladder and my urethra. For now just a theory but it is very logical to me. We all know the prostate will continue to grow if you have the condition of BHP. Focal Laser Ablation does not cure BHP. As with most western medical procedures, it treats the symptoms of the condition. But due the tissue removal techniques, I am hopeful that my future prostate tissue growth will not reproduce in the area that caused my urination issues. 

I fully agree with you about Doctor Ara Karamanian. He is really an artist and he is so committed to doing an excellent job in each individual patient. NO other doctor I know of spends the time know the specific particular issues with each prostate case he treats. He is an artist as he will designs what he is going to do. Then you come back the next day and he shows you what he actually  did in your prostate. Find another Doctor who does this for his patients. 

I am very happy to hear your results. 

I had a 50 gram prostate with about 60% of the size being a large median lobe. About 35% of the prostate was removed.... and I don't miss any of it. Functionally nothing has changed, but boy can I pee without retrograde and I understand that I have many more months of improvement.

That's great!  There's hope!  Thank you.

1] Just wondering what your prostate size was pre-surgery..?

2] Also, did you have prostatitis pre-surgery, is this why you had the antibiotic injections..?

Cheers- J

But still would love to know if you had prostatitis pre-surgery..?

Thanks- J

​This is Mike Skier, I wrote to you before.  John was #1 in December 16 and I was #2 back in April 6th 2017, so almost a year.  I am glad that you are on the up and up and a movin forward.  My prostate was 185cc with an enlarged medium lobe.  I am now 71 and I had some issues with Retro Grade Ejaculation prior to the procedure and I still have problems with it.  I hate to say anything about it because a couple weeks from now someone will write that there is a guy on here that got R/E from his FLA, which is not true.  There are a few people that are on these forums for some reason are trying to condemn the procedure.  You also have a lot of people that bounce from forum to forum and are asking the same questions over and over.  For a while there it was just turning into a social media with no purpose.  That is why I am not as active as I once was.  Now that John is going to start new forum for just the people that have had the procedure.  This will be great.  The clinical study took in about 12 patients and Dr K has about another 12 that have had this procedure just for BPH, we might include the PC patients as well to see if any of them had BPH along with their cancer, we can track them just like the strictly BPH patients, as long as they know the size of their prostate and how much was removed, then of course, do they still have BPH after their cancer procedure.  I need to talk with John to see how he wants to set this up.  We do want it to be primary for long term results besides his Clinical Trail.  This seems what is really missing that insurance companies are also asking about. I think Stan has an excel spreadsheet of quite a few of the patients and some of their statistics.  We need to bring it all together.  There is another patient out there that sent around a questionnaire awhile ago.  It would be nice if we can see that and compile that information as well.  We have to be careful where we are not giving out information that can be used against a patient in his future life for security purposes.  Maybe we could use a different name in the forum vs your screen name that you are currently using, example:  Your procedure date and your initials.  That way you could know their timeline without really knowing who they are.  Possibly there is a way that working with Dr K, we might be able to have the information support his clinical trail, in a non official capacity.  We are not being tracked with data required at certain intervals under a standard Trail format, plus it was not started with us and prior knowledge before our procedure.  The standard questions people keep asking, when did you have it?  How big was it?  How were you after the catheter came out?  What was your flow at 1 month, etc.  Quite a bit of the repeated questions could be answered by referring people to the other forum for their answers.  Like I said, these conversations just keep going around and around for no reason and a lot of it is bull.  If someone is really interested in finding out about this procedure, they could go to one forum for most of their answers, plus if they had specific questions, that could ask the individuals that actually had the procedure.  This would stop a lot of the MISINFORMATION that is out there right now.  

​Continue with your great recovery.  If you want to PM for the information you have on the questions I asked, that would be great.

​Good Luck,  Mike

.   

You are amazing at 75 and still have good semen flow.  You are becoming a cult figure yourself on this forum with all your detailed information and your holistic medicinal knowledge.  I noticed that you and your wife have done lots of medical informational studies and she has an MS.  Like John, and his wife is into holistic medicine.  I am interested in your Detox and Cleanse information as well.  Are there some good websites that you use in particular?    

Very good idea Mike  .  My excell table is jut basic  one , where are nicknames of  FLA  patients and divided to :  " ambassadors "  of FLA,   good,  mixed  , poor  results . With some notes  taken  from  FLA patients.  Totally  18 patients , I will be the next in  3 weeks. 

    Your suggestiion to  increasee the quantity of dates in time will be very  usefull  generally. 

In my Excell file are  also  patients cured by   REZUM .UROLIFT,..  but not a lot of them ,due to  I decided for FLA so this is matter of my interest firstly.   I can share  this table  , just PM to me who is interested in. Stan          

​I will contact John to see if he wants to do this or at least has some information that can help.  Maybe you can send me what you have or to John to see what you have started on an excel sheet.  It may just need to be tweaked and then it can be the base form.  He is the one that mentioned that he might start another forum for just the K club people.  There is another guy I think it was Hank1953 that sent around a survey and should have quite a bit of information.  So between what you have Martin, John and Hank, it should be quite a bit to get started.  I think that naming the people by their procedure date and their 1st and last initial would let everyone know the date that they can relate their questions to or just to gather information. somehow we need a centralized place to gather the information and then if someone has a question, we can refer them to the forum and they can search for themselves.  anonymity is key during this procedure.  That way we will get more people to contribute.  Once we come up with a good idea, we can pass it by Dr K for his input.  It sure would help support his study at least indirectly.  Maybe to go out and roust up more financial contributors for his next trail.  Ideally we can get this procedure approved so it can become affordable to more people, where their insurance or Medicare will cover it.  Just like Dr Bagla and his PAE procedure, it is not approved but he is writing it up in a way and there is enough information, that insurances are paying at least a large portion of the costs until that procedure is fully approved.  

​Contacts:  Stan (stan98754), Mike (MikeSkier), John (j12080), Hank (Hank1953), Martin (martin victor),  Jim (jimjames) would be a good source for some information, because he has been on here longer than John and Myself, but has not had the procedure.  I think Jim has talked to almost everyone that has made an entry on all of these forums and is very medically knowledgeable.

We have one guy that is a K Club member, Ross, he is an accountant on Long Island.  He might be interested in putting something together.

Stan

​Where in Europe do you live.  I lived near Kaiserslautern, Germany for 3 1/2 years, also near Stuttgart, and in Graz, Austria.  I was in the Air Force over there and then in the Automotive Industry for years going to Europe, Brazil and Mexico.  My wife works for Delta Airlines and flies to Europe quite a bit.  Plus we have lots of friends over there.  

Mike  

John,

?First of all don't get all excited.  You had mentioned about possibly starting another forum just for the K Club members so we and others could track their progress.  So we don't have to keep writing all these letters to people and the information could stay consistent.  If it was on a spread sheet format, Dr K could use the information at least when he is approaching people to contribute to a Clinical Trail, etc.  Also, I told you that I talked to my Insurance company, United Health Care, and they said that if they had some longer term results that looked good, they might not even wait until the procedure is approved to at least pay part.  Of course that could be BULL, no insurance company wants to pay money, But the Key is if it can SAVE them Money!!! There are two things that on this site have got my goat, one is that other procedures may not be approved, but doctors are getting their patients at least partially covered or the procedure gets quick approval like REZUM and .  Then, It is a pain in the ass when I start reading on the forum that someone has put out miss information maybe by mistake or on purpose.  I don't know how many people on these forums, you end up writing the same thing to them as you have 30 other people.  If they want actual information, your idea of a separate forum would be excellent.  Then instead of writing a page to everyone, refer them to the forum.

?I talked to Stan and he has started a excel spread sheet that he has on about 18 people.  Then there is Hank1953 that sent around that survey, he should have lots of information.  If we make the references on the forum anonymous, like the date of their procedure and their 1st and last initial.  Then if they personally want to tell people who they are in a message, that is their business.  I think when Hank was sending his survey out, he ran into people that did not want their information on the forum, but in code is different.  Might get more willing people to submit their information that way.  Of course we need to come up with the headings on the spread sheet that would cover most of the questions people would have, Example (10 columns in landscape):  MH4/6/17, size , condition, Initial problems, other procedures they have tried, 1 month condition, 3 month, 6 month, 9 month, 1 year.  Just throwing some things out there.  Can't have too many headings, set the sheet up with word wrap, so they could write maybe a sentence or two and it would stay in the columns.  The thing is, there will not be that many people total, so the spread sheet will only get longer based on how wordy people get.  That could be edited as well and make that one of the disclaimers for the instructions.  

?Maybe you send out a short memo to the names of the people you have, and even ask if they might want to keep track of the input for a certain amount of time.  If we run out of people to do it, then it would stop right there, but it is still a document that people can look at no matter how far it gets carried out. 

You have talked to the forum administrator a few times, maybe they could help with some ideas that might work on their site without be wiped out.  They might even be willing to help.  I notice they keep updating this site, so it must be that we are creating enough interest that they are accommodating us indirectly anyway.  There might be a slick way that the format could be fixed, with instructions and let the people fill in their own information.  I don't know, just an idea.

?Want to call you anyway in the next few days, while you have lots of time to talk, Ha!

Your Bud,

?Mike   

Stan

?I will contact John to see if he wants to do this or at least has some information that can help.  Maybe you can send me what you have or to John to see what you have started on an excel sheet.  It may just need to be tweaked and then it can be the base form.  He is the one that mentioned that he might start another forum for just the K club people.  There is another guy I think it was Hank1953 that sent around a survey and should have quite a bit of information.  So between what you have Martin, John and Hank, it should be quite a bit to get started.  I think that naming the people by their procedure date and their 1st and last initial would let everyone know the date that they can relate their questions to or just to gather information. somehow we need a centralized place to gather the information and then if someone has a question, we can refer them to the forum and they can search for themselves.  anonymity is key during this procedure.  That way we will get more people to contribute.  Once we come up with a good idea, we can pass it by Dr K for his input.  It sure would help support his study at least indirectly.  Maybe to go out and roust up more financial contributors for his next trail.  Ideally we can get this procedure approved so it can become affordable to more people, where their insurance of Medicare will cover it.  Just like Dr Bagla and his PAE procedure, it is not approved but he is writing it up in a way and there is enough information, that insurances are paying at least a large portion of the costs until that procedure is fully approved.  

?Contacts:  Stan (stan98754), Mike (MikeSkier), John (j12080), Hank (Hank1953), Martin (martin victor),  Jim (jimjames) would be a good source for some information, because he has been on here longer than John and Myself, but has not had the procedure.  I think Jim has talked to almost everyone that has made an entry on all of these forums and is very medically knowledgeable.

?We have one guy that is a K Club member, Ross, he is an accountant on Long Island.  He might even be interested in putting something together.

To the moderators. Even though I immensely appreciate this website, I find it downright disconcerting that important information that I post is censored. I know you might be trying to protect your advertisers, but this level of censorship prevents important information from helping other like minded people.  Sincerely, Martin Victor

my PVR is 200-300 ml  and must 2 times a day self cathing, about noon and midnight.  If not I have no chance to sleep more then 1 hour  and nocturia will  take a place. In average I sleep totally 3-4  hours what is critically unsufficient.    D - Mannose  is great tool  .  I take it for  2 months  already - clean powder  4 grams  3 times a day.  in case that  URI starts attack   ( pain and turbid -dim urine ) I doubled  the dose. And it really works !   In last year I suffered twice with serious Infection cured with hard ATB ,   now I see  D -Mannose is great prevention.  

But I think  after  FLA I must to take  ATB due to  large imflamation of coagulated tissues. Isnt it ?

Best Wishes, Stan

Hi Mike- Another VERY important factor for the FLA charting would be pre and post-surgery flow rates. If the pre-surgery flow rate is not available, then the post-surgery flow rate would be acceptable. Just someone saying, "I can pee great now," has no meaning. If a patient shows up for surgery in full retention, then even a peak flow rate of 9-10 mils/second would seem great in comparison. [In the Aquablation study, the average patient had a pre-surgery peak flow rate of 9.4 mils/second.] So, even though 9-10 mils/second may be an improvement, it is still actually not very good as the prostate is still occluded, and this will cause further bladder trabeculation/jdamage. There's no way to know your flow rate without doing a flow test. Most Urologists can do this test in their office. Cheers

Thanks for the reply, Martin. Interesting that Dr. K is now doing prostatic antibiotic injections as part of his procedure and as a prophylaxis.

 I actually suggested this to Dr. K because of my ongoing prostatitis problems, both pre and post FLA surgery., I came across a Dr. Bahn's [in 

Ventura, California] website. He treats patients for prostatitis using direct prostate antibiotic injections through the perineum over a 2 week period. At one point in one of my talks with Dr. K [post FLA surgery] I suggested that he could do this at the end of his surgeries because his 'tool' was already inserted and ready to go. Interesting that he is now doing this. 

Best- J

I am just curious if your FLA seemed to help your prostatitis at all?

I am awaiting the results of my 3rd DNA test on my prostate fluid. 

Also curious if anybody with  this affliction had ever had any dealings with a Dr in Florida at the Central Florida Cancer institute by the name of Vladamir Mouraviev? I have been reading he is doing some good work with chronic prostatitis.

Thanks Joe

Good afternoon Stan and others.  What I have found out is when a man get's prostatitis you can never  get rid of it Even a man that has his prostate taken out will still have some of the symptoms because it is still in the area.  I hope one day they come up with a cure we will know in time.  For now we all have to deal with the flare ups.  Ken  PS  Good luck on the 3rd Stan 

What about your  progress ?    Stan 

Hey Stan.  There are many Ken's on here  I had the Urolift 3 years ago.  Still wide open.  I have talk with many FLA patients of Dr. K's and they are all please with him.  I got a e-mail from him the other day.  He will be getting back to me with some information after he come back from vacation.  He is a very nice guy.  And he seams like he cares about his patients.  I wish you well and try to relax It will go great  Ken  

Stan: I am really rooting for you. Sleeping 3-4 hours must be very difficult.  A major European double blind clinical study has shown Advil to be more effective than antibiotics in clearing up a UTI. Just Google "Ibuprofen could provide alternative to antibiotics for uncomplicated UTIs". I could not figure out what ATB stands for. For the last 2 months I have been taking an assortment of probiotics as the 2 antibiotics shots and series of pills prescribed by Dr. K can wreck havoc on your digestive system and bowel for some susceptible people. Best to take the Lactobacillus Rhamnosus and Lactobacillus Reuteri strains for urinary health. 

Jim

My prostate was relatively small at 47 , but Dr K made the comment when it started the procedure that my prostate was very hard. i have no idea what if any significance that is.

As far as the median lobe goes, I was turned down for the uro lift procedure, because the urologist told me I had a huge median lobe. However Dr K told me during the consultation, that I did NOT have a large median lobe.

My PVR a couple weeks after the procedure was almost nothing, and I could sleep thru the night. Now I can tell it is significant, and I am up usually 3 times per night.

I have the utmost confidence in DR K even tho mine was not a success. He was willing to at least try, knowing up front that I had the prostatitis problem, and had also had a failed PAE.

It was a lot of money to invest, and I wish it had worked, but thats the chances we take. I do not regret doing it at all. And DR K is the best I have ever dealt with by far.

Feel free to ask me anything. Hope this helps.

Joe

That is interesting that your prostate was described as hard, that is the same as mine, and a couple others, I think Jay111 is one also. Mine was small as well, maybe hard goes along with a small prostate, it hasn’t become spongy like the bigger ones.

Have you had any relief from the procedure? Sounds like it worked, now isn’t working? Are you cathing? I had it done in February of last year, so one of the earlier patients.

Interesting about different views  at your median lobe ML .  I can send you pics of  my ML  from MR scann .  There is evident how it  totally blocks  bladder neck . Can you send me yours ? just PM  me.   

Btw  can you share with some details  pre and after FLA ?  prostate volume,  PVR, CIC, median lobe , stream flow , prostatitis , PSA ,e.t.c...   Im working with   Excell table  entering more and more data  inside.  Thank you , Stan   

As far as relief goes, I would have to agree with your statement. I did get really good relief in the first 6-10 weeks. Now I would say that I am pretty much back where I was prior to the procedure.

I have never had to self cath. I can almost always get mostly emptied out, I just have to work at it for a few minutes lol.

I also read your recent post which is very interesting. I don’t think I have prostatitis, but I am doing the DNA test within the next week. If I have had prostatitis, it has never bothered me. 

I had FLA with Dr. K on 4/28/17.   Greatly improved stream.  ZERO side effects.   Would do it again in a heartbeat.

Hi Joe... just had a thought about your last post. It sounds like as your prostatitis returned, your flow decreased. Maybe there's a correlation. Perhaps treat the prostatitis before trying a different surgery. Cheers- J

Cheers- J

This was my situation  maybe 2 years ago  , no CIC,  PVR  100-150 ,poor flow.  Now is situation worsened    200-350 PVR  , CIC  twice a day   ,so my recovery will be probably  longer .  Looking forward to America after 10 years.    Best Wishes, Stan

Are you coming in a day early and staying a few days afterward. I highly recommend it.

Where do you live in central Europe? I lived in West Berlin in the mid 80s.

Rick

Hi Rick ,  Flying  at April 1st  Easter Sunday  to Houston, ( Vienna- Istanbul-Houston )  procedure on April 3rd and flying back  April 8th.  Did you have big median  lobe ?  My is very big , see  sketch in my image.   I'm Slovak  Bratislava living just 45 km from  Vienna airport .  Hoping in my return to life, Stan

Jay and Joe: My son pretty much eliminated his very severe prostatitis using the research from Dr. Shoskes at the Cleveland Clinic: The program involves dissolving the calculi or nodules that contain the bacteria, that are part and parcel of the problem. And then using an antibiotic to kill the bacteria.

http://www.prostate.org/pdf/shoskesurology.pdf

Stan with you flying back maybe you should have them should you how to do CIC just in case.  You don't know how the prostate is going to react after the catheter comes out  Take with Dr. K and see what he thinks Ken

thanks Joe

Hi Stan- I had the FLA with Dr. K in July of 2017. I live in Australia. To get home, I flew from Houston to Auckland, New Zealand, had a 4 hour layover, then flew home to Brisbane, Australia, for a total of about 20 hours travel time. I was cathetered the entire time, and it was not a problem. MUCH WORSE would be to go into full retention [from swelling] while you are flying, as you could not get any sort of help from anyone. Unless you become really good at self-cathing, I'd recommend flying with the Foley catheter in place. I'd also recommend staying in Houston for 5 days post-surgery, in case you have any problems Dr. K can then help you. Cheers- J

thank you for your advice.  Yes I will stay  5 days  in Houston after  FLA and just then  fly home  ( 17 hours )  with catheter.   BTW did you  read my  direct e-mail ?  Thank you , Stan    

Hey Mike,

Did we every get a Dr K club? It would be great to get all the info together. I myself dont have much time in here which makes it hard to write alot about my 2 Fla's.

Jim

Hi Jim,

Nice to hear from you. I would love to hear about your 2 FLA's. I think you had the 2nd one in January, right? How are you doing???

Best wishes,

Fred

Hi Stan- I didn't see your email, but I did a search in my email account and found it, and I have responded... Sorry I did not see it sooner.

Cheers- J