Going with Focal Laser Ablation for BPH

Hi Martin  , I sent you  PM  ,awaiting your e mail  ,  Cheers ,  Stan

Martin, this is really of great interest to me. I underwent FLA with Dr K almost a year ago after having gone into AUR a couple of times in early 2017. The results have been wonderful and have transformed my quality of life. 

What interested me the most in the above post is that your prostate hasn't grown for 6 years. BPH is an incessantly progressive and miserable disease and the fact that your prostate size has been unchanged for 6 years should be exciting to every reader here on this forum suffering with BPH.

Gat Goren have hypothesized that they are treating the cause of BPH not the symptoms. For that reason I believe we should all be taking an interest in confirming that we do indeed have bilateral varicoceles (GG state this is a given for BPH patients). I have had the testicular ultrasound and have confirmed that I have a right-sided varicocele. GG assert that men with BPH almost always have bilateral varicoceles which become apparent during the repair.

One of my biggest fears is that the FLA will be temporary because like all other surgeries that remove tissue, it is likely with time to grow back. For that reason, I am very encouraged by your post and with a thorough read of the healingwell forum thread on the GG procedure, I am confident that I will go ahead with a bilateral varicocele repair with the hope that I can arrest the contimued growth of my prostate and the return of full BPH symptoms and hopefully experience continued improvements as a result.

Ross

Ross: I know of many who did the Gat Goren procedure. Their prostates shrunk by as much as 50-60%. But they did not have median lobe protrusion. For me, it didn't shrink the prostate, but there was absolutely no progression of enlargement, much to the dismay of my urologist who tried to convince me it didn't work. Yes, it did work. It didn't get larger. This very prominent urologist warned me of damage to my rectal lining prior to my departure to Houston for FLA. Totally clueless. Didn't even know that with the exception of a catheter, the urethra was not involved. There is another Doctor here in South Florida who does FLA. ...Ross...he said to me exactly what you expressed. Embolization of the Internal Spermatic Veins will help stop the enlargement of BPH although their could be other existing factors like Prostatitis combined with other Itis's...That is inflammation associated with bacterial infection like "urethritis, seminal vesiculitis, etc...

I may have mentioned this already. I consulted with Dr. Gat. As an obstetrician and mechanical engineer, he figured out pressure gradients exerted on DHT as it traveled through certain veins and arteries in the complex architecture we call the urological system. With his Harvard trained associate, Dr. Goren an interventional radiologist, ...Dr. Gat realized that Orthodox Jewish men in Israel who had fertility problems also had failed varicoceles.  By sealing the ISV's, they once again were able to have babies. When I arrived at their office, they did a simple test. Dr. Gat measured the temperature of my gonads to see if it was lower than my normal body heat..around 98.6. It was the same temperature. For testosterone to survive in the testis, the temperature must be lower. That's why the gonads hang outside the body and not inside. Dr. Gat knew right away that I had failed varicoceles. The second test was on the operating table. As the interventional radiologist put a catheter into a vein in my right thigh, ....and centered it ultimately into the opening of ISP's, he used a dye. If the valves of the Internal Spermatic Veins were not compromised, the dye would remain where it was. But no, it fell right down the long ISP's. It is the valves, that push testosterone into our circulatory system. When they fail, backwards pressure forces the testosterone and DHT into the prostate causing inflammation and growth. 

Dr. Gat, like our own j10210 (John) was a pioneer. He had his own BPH problem. I presume it was Dr. Goren who did the embolization on him. Dr. Gat's prostate shrunk from 80 grams to 40. Conclusion: Get rid of the inflammation caused by the DHT which is many times greater in the prostate area than in the blood stream and the prostate will shrink.

Note: ISP's .. should be ISV's.

Note: "For testosterone to survive in the testis ...should be for "sperm" to survive in the testis.

Martin, thanks for your response. I don't want to take this thread off topic here and perhaps this is a topic that should have its own thread elsewhere in the prostate section. But this painless procedure could save a lot of pain and suffering for many men.

I am stunned that there is not more research being done on the causes of BPH and the (to me) sound hypothesis that bilateral varicoceles cause the Internal Spermatic Vein (ISV) valves to fail and as a result the prostate is bathed in the backwash of DHT rich blood further causing continual growth of prostatic tissue. Due to perhaps a lack of any pain or discomfort or worse any commonly known correlation to varicoceles and BPH, varicoceles can also be more insidious for many men. Decrease in testosterone causes a change in sexual appetite, mood and physiology and of course infertility. Why isn't this being researched - surely any varicocele patient can be checked for serum DHT and prostate volume before and after the procedure? We'd have all the necessary data in no time.

Martin I too had a large median lobe that Dr K targeted and dealt with. So now I feel I am ready to take the next step to prevent potential regrowth and perhaps even enjoy the benefits of further shrinkage by way of this embolization. You too are a pioneer having done both these procedures and hopefully Martin, you are all set

Is the Dr in S Florida you are referring to Dr Sperling or is this someone new?

Ross...The doctor in question, wanted to remove only a portion of my protruding median lobe and not two other areas in a different zone that were causing my problem. Dr. K with his engineering background  and innate understanding of the mechanics of the problem ablated 3 areas despite my initial objections. His advice: Do what I recommend if you wish to be happy. He knew what he was doing. He was right and the great results speak for themselves. Thanks for your comments. You are spot on.

Dr K does listen and he does know what he is doing.  When he does the mapping of the prostate he will show you what he feel will do the best for you.  He will a void all the good area so you will not have any issues.  When he shows you this.  That is when you ask and voice your opinion and concerns Ken

To all the FLA guys on this thread I have been missing in action. It is a long story that has to do with my Dad and his health. The best part of the story is it has taken a while but it is all worked out and he is back on top of his game. Though I have made him stop his hobby of being an UBER driver in the small town of Tyler TX. He need more recovery and then he can go back to driving the Tyler Junior College kids to the mall when he is bored.

Due to the fact that he lives almost 3 hours from me, I have been staying with him and also driving back and forth for weeks as he improved. It is all good now though and we are getting back to normal. The worse part is during this ordeal, my wife's Mom had two strokes and she has had to be with her a lot at the same time. I am not real good without her at my side. I just get by and that is about it.

No complaining here, just justifying why I have not been answering some of the post that I have received. I am glad to hear about Mike Skier and my "next of kin" in FLA patients, Ross who both recently I have spoken with and the progress of Martin Victor, Light1, Motoman, Trustme, Richard11472,. All of you followed me into the abyss of FLA treatment shortly after I did mine back in December of 2016 and we all seem to be having the hope of being better and of  long term success as we are now experiencing improved conditions with this horrible BPH.

I am really happy to have Martin Victor's input here as we all must look ahead for a possible cure if the glands continue to grow. This is for everyone's observation and it does not matter if it is FLA or Rezum or UROLift as the choice, the gland can still grows.  So, I love the conversation about GAT / Goren and I am watching both my prostate and the progression of this treatment along with hopeful acceptance over here in North America of GC.

As for Stan, I am glad he may soon get the relief he deserves and we all support him and know what he is going through. I understand that Stan is keeping the best amount information of the 20 some odd men who have done this procedure in the last year and half through Dr. K. This should be added to with the reports of the prostate cancer men in some respect as the procedure is the exact same. I understand that in a lot of the current PCa cases, the BPH is now being addressed as much as possible. I will as Mike pointed out uses my connection because of my bad reputation to contact the moderator and see if we have an option of tool through this web site to somehow collect information that would help men in a FLA decision process.

Dr. K is a very compassionate man, especially for a Doctor. And I think like Mike and Martin Victor point out, his Bio Medical Engineering background set him apart from most other Interventional Radiologist when he designs a treatment for the specific prostate he is treating.

Hi Ross,

Excuse my lack of knowledge but in the FLA do you know exactly what passes through the rectal lining and how it does so?

Thanks and best of luck!

Hi Ken  , did you undergo  FLA ?  I think from your comments that  not FLA, but UROLIFT .  As you maybe know I  put all known  patients data to Excel file, so your info  is  appreciated. . Stan , 

Ahoi  John ,  thank you for your continual  stories  and thanks so much for good wishes.  Yes next  Easter Sunday   Im flying from Vienna to Houston for Fla procedure on April 3rd. 

I can share my Excell  table to everybody , but here I dont see possibility to add it ,due to  excell is not allowed format . So pls  write me on  stamar@dowina.eu .   I have another important  info and one very interesting  but crazy - crazy hyphotesis  of  BPH reason .    Thank you all  and be  fit and happy :  .   Stan 

   ( excuse my  poor English )

Hi John,  I have no info about  K- club member   LIGHT 1  , pls send me  some thread to him - 

Anyway in my Excel table you have proud title  " FLA Ambassador " .     

The laser does.  This concerned me before the procedure.   After, I couldn’t  even tell he was down there.  Just my experience.

Hi Stan,

I've been talking with Dr. K quite  bit, but don't think I'm officially a "K-Club" member, as I have not had FLA. I'm still in the decision-making stage. But, due to AUR and chronic urinary retention, I feel I have to do something in the foreseeable future unless I want to go around with catheters for the rest of my life, which I don't. There is the complication of co-existing BPH and PCa, which we have been discussing. I'm sort of inclined to just treat the BPH at this point, but need to go back to UCSF to confirm whether this is prudent. Hopefully will know something soon.

Wishing you the best of luck with your procedure; please keep us posted.

Best wishes,

Fred (Light1)

Yes Stan I had the Urolift done 3 years ago.  I keep some information on all the men and procedures if I can get them.  Have talk with a few of the men that have had FLA and I'm in contact with Dr. K.  He is getting me more information on other patients that have had it done for BPH that are not on here. He is a very nice man.  Also have talked with a Dr. Muir in the UK and I have e-mailed and talk on the phone with one of the inventors of the Urolift.  I have some concerns with some of the doctors adding procedures with the Urolift and saying it was going to make them better but instead made it worst.  He handle it.  I can call him anytime.  Take care  Ken   

Hi Arlington, Dr Karamanian has a you tube video where he goes into some depth about MRI guided focal laser ablation in the treatment of cancer lesions. He says that once the patient is sedated, a needle guide the size of an index finger is inserted into the rectum. Through this - and I guess into the prostate through the rectal lining - a 1.85mm cooling cannula is inserted. The fiber optic laser is inserted into the prostate through the cannula. I would recommend you searching you tube for "Prostate mpMRI and MRI Guided Focal Laser Ablation (FLA): Preserving Quality of Life". This is Dr Karamanian's webinar and goes into some detail.

Stan  I don't know if you have this down but when a man has a Urolift there is no protacal for a catheter.  It is left up to the doctor.  Before I had mine done There were a few men on here after they had it done they were sent home when they peed but right after you are still opened.  But as time goes on the prostate will get swollen and you can't pee.  So you end up going to the hospital and having one put in anyway.  I don't know about you but I would rather have one put in when I am out then one put in when I am awake.  I talked it over with my doctor and I have a problem peeing on demand anyway.  So he put one in anyway.  Had it for 3 days.  Went through the blood clogs and bladder spasm after it was out I had no problem.  Burning the first day but that was it.  I was good to go in a week.  Just a little tip.  Ken 

Ahoi Fred , 

thank you for your reply.  FLA is treating both BPH and PCa  at one procedure, isnt it ?  Im making CIC for more then  1 year  and due to worsening i decided to solve it.   I believe in FLA  ...  Good luck, Stan

Hello Stan.  Just got off the phone with Dr. K very nice guy.  He is going to get me some information that I asked for.  We talk about BPH trails that he is doing.  They will not be out till the end of the year.  Let hope all goes well and we can get more approvals.  Take care all  Ken

Thanks a lot.

Thanks a lot, Ross.  I'll check it out.

SORRY STAN FOR THE MIS-DIRECTION. I THOUGH FRED DID THE FLA. SORRY FRED FOR THE MIS-INFORMATION. I AM JUGGLING A LOT OF BALLS RIGHT NOW BUT IT'S GETTING BETTER. CONTACT ME IF YOU NEED ANYTHING.