Going with Focal Laser Ablation for BPH

No  Mike, I don't know about his mix, I do know that he is one of those doctors who wants to help the man who has nowhere else to get help for bad situations that have gone wrong. He has added Donnie Sartin to his staff and Donnie is the most experience best RN of Interventional Radiology in the business. He is very very good especially with post patient support and work up. He is not the normal RN, he is special. I think this will make the Dream Team in my opinion and I am happy for them. We will hear from the future patients. 

I dropped out for about six weeks getting my as my Dad had both Knees replaced then his heart valve was replaced which was fairly easy but then he got pneumonia and had to get him through that which meant a while in the hospital. I did not leave his side as they will kill you in the hospital. It is a very dangerous place now days and anyone in their needs a full time advocate and mother hen watching everything. That was me!! But we got him through it and he is working out at a gym now 6 days a week and playing bridge 3 times a week along with teaching bridge once a week. He has taken up square dancing some and is driving for UBER some more and loving life. He is 85 going on 14 but he will tell you he is not old just older. Every day is the bonus round for him and it is the best reward I can have. He took care of my mother for nine hard years with Alzheimers which finally took her home. He was the total care taker and let himself go just to give to and take care of her. I want his bonus round to be wonderful and will do anything I can to make that happen. He is my hero. But now I am back as he is doing great and back on his farm in the country near Tyler Tx.

 I am going to talk to Dr. K and see if he is interested in me trying to get him a patient support group (strictly voluntary) of men together that he can refer to potential patients who need to ask real everyday concerns questions of men who have been there. i am sure he will not be opposed and I know you are one of the people who care enough about this horrible condition to participate. Your engineering background and your diligent research lead you in the right direction for you. Hope you are doing great and I will call you and we can catch up. 

It great to hear from you again. 

When say dream team. Not sure what you mean. They (nurse)don't do much during the procedure except comfort you.

Jim

Normally you might be correct, but not in this case. He has tremendous experience in prostate laser treatments he also is the sedation nurse and is superb. He hanled as well, all the procedure work up and the post surgery support at University Texas Medical. He does much more than just hand holding he has years of evperience. I am sure Dr. k can explain the value of this mans experience. But, it is significant and you should inquire as this experience is specific to this procedure. You may quote me as far as where you heard this information if you wish to

with Dr K. 

Hey Jim I have to agree with John about Donnie the nurse. When you talk with him, his knowledge of the prostate, and prostate problems in general is impressive. He worked with the Doc who was doing this same surgery for prostate cancer, before he came to work for DR K. Plus he has told me that he lives within a couple of blocks of my hotel, and will be available all weekend to come to the hotel, if I have any problems with my catheter, which I have never used before.

Ok I believe you two on the nurse. Catheter is not much fun. But wasn't to much o f a problem with me. Just a little irritating.

Jim

Hey Jim, I totally understand about the nurse thing, and I was really looking forward to meeting Samantha myself. I have heard so  much good about her. However after talking with Donnie, it really is refreshing to talk to someone who number one has a prostate, and knows how badly it it can   screw up your world . He really does seem to listen, and was truly interested in the gen ex testing I am doing prior to the the procedure.

With all that being said, somebody on here recommended a hotel that was just a block away from where they do the procedure, and I cant locate it again If you do not mind please send that again. Hotels are very expensive in the area, and I would like to be as close as possible, and still not have to pay an arm and a leg.

 Thanks joe

Hi Joe, how are you after  FLA ? thanks , Stan

Stan, I also think Joe's brother had the FLA done. I think this is the same Joe? 

Hey Stan, thanks for asking. I would have to give mixed reviews. I definitely can empty my bladder completely now, and could not prior to the procedure. However it has not helped with my flow, nor has it helped with the number of times I get up during the night. I still get up 3 times most nights. I also have semi retrograde ejaculation. BUT in all fairness to Dr K I am fairly certain this and possibly the slow flow is related more to chronic prostatitis than it is to BPH. Dr K has been in constant communication with me trying to help with that issue as well. But unfortunately I have had some other unrelated health problems over the last 2 months (kidney failure). And  I have not been able to travel back to Texas for follow up treatment. I am still hopeful things will continue to improve.

My brother also had his procedure in December, he says his flow is also not greatly improved, however he now sleeps thru the night without having to get up ever. And he has no retro.

Thank you very much  Joe, 

I just spoke with Dr. K in Houston  and I m waiting for MR next week and his decision. Adter approval I will fly to US early April  .  Pls let me know ( prior procedure )your   prostate volume, PSA, median lobe ? ,.

If  possible same from your brother.    Im making small statistics  of FLA treatment ( from patients at this forum) all  in Excell table.  Up to now : 12 very successful results, 3 partially  successful,  1 failed   .    Cheers from Central Europe, Stan    

 

Hi Joe,

Personally, as long as you can empty your bladder completely, I would say that "low flow" is a non issue. Urologists tend to focus on that metric because even in failed bph surgeries they can often save face and say, "well, you pee like a horse, right"!  But the reverse is really true. Better pee like a pony with complete bladder emptying than pee like a horse with retention. Retention can impact both bladder and kidneys, flow rate only impacts another 15 seconds or so every time you void. That said, I would periodically check your residual (PVR) with a scanner at the urologists to make sure that the bladder keeps emptying completely.

As far as night time visits to the bathroom (nocturia), there are many causes other than bph, so even the best bph surgery often doesn't fix it. One possiblity is nocturia polyuria, where 40% or more of your void volume is at night. A simple void log can tell you if that's the issue. The fact your brother's FLA solved his night time issue, is not relevant. He may not have nocturia polyuria, or some of the other non bph issues that cause us to get up at night.

As to the "semi retrograde" did you have it before FLA or just after? If you had it just after, like you say the possibility exists that FLA flared your prostatitis and when that's resolved your retro will disappear. The other possibility is that it resulted from the procedure itself. With Rezum, for example, semi retro is not that uncommon. So please keep us posted how the retro resolves or doesn't.

Jim

I also am (or at least was) keeping tabs on FLA results. Maybe we can combine notes. Sent you a Private Message. I also think Hank was keeping tabs at one point as well.

Jim

Hey Jim I agree 100% the fact that it empties completely is the most important thing. we all would like to pee like when we were 16, but unfortunately all the surgeries in the world cant turn the clock back that far lol. That is a good idea on the journal, I just completed a 24 hour urine test this morning, that would have been a good time to have kept up with it.

As far as the retro goes, i did not have any issues before, and i did not have any in the first several weeks after the procedure. So unless something healed, like scar tissue or something like that could be causing it, the more likely scenario, is prostatitis.

Thanks Joe

Oh man Jim thats JUST what I DID NOT want to hear right before I go down for mine lol. I told Dr K, I ALWAYS fall into that 10% where if its gonna fail. it will be me.

Hopefully things will get better for you. Are you regretting having it done?

Thanks Joe

Jim I really hate to hear it took a turn for you please let us know what the MRI says and thank you for sharing what has happened. We needed to know this as it has not happened before as far as I know. We will be pulling for you just let us know what you find out. 

It will be a few month. before I make any decision on a redo. Hoping just giving it a few months will do the trick. Keeping my fingers crossed the new urologist will will be optimistic and have my best interest.

Jim

Hi Jim, I sent you a PM. Hank

Hi Hank,

Answered your questions and thought i sent it off. Let me know if you didnt get it. I could of screwed up. Pushed the wrong button or something. Wouldn't be the first time..

lol..

Jim

I didn't get it. Hank