Going with Focal Laser Ablation for BPH

Hi Jim,

Very sorry to hear you're having problems. I was just about ready to sign up, but this will cause me to have 2nd thoughts. Can you tell me how large your prostate was? Mine's around 85-90 grams. No median lobe, but I think the problem is bladder neck obstruction. Will look forward to hearing from you and hope that you have success in improving your situation.

Best wishes,

I'm hoping for the best, will do it again. Doc. said he was at 6 mm of urethra and can get as close as 2mm. Not sure why he didn't. I did get really good relief all the way around. Not sure on my prostate size other than it wasn't really big. Went in cause meds weren't working good anymore and bladder pain. Most all that's gone since back on meds. I wouldn't let my case stop you. Talk with Dr K. I'm sure he will have your best interest.

Jim

Hi Jim, did you have urodynamics before FLA ? Did you have chronic retention (not the 100% acute retention which happens once and went away) ? How much were you retaining ?

What I am after is that for some, bladder is the main problem and procedures  won't help. Hank

Hank, all I know is that the urologist wanted to do a uralift and said once I fixed my prostate I'd be peeing good. I was a good candidate for Fla according to Dr. K. My urologist didn't like me going with fla..

Jim 

I am having a similar experience. I had great results from about month 1 until month 3 or 4. Then things started to slow a little. More hesitancy, start, stop, weaker stream, etc. I am now up 2 times, sometimes 3 times per night, where before the procedure and after, it was only one time per night.

Dr thought it might be. UTI, so took a month of antibiotics, which didn't do anything. I am also back on Terazosin daily, which is an alpha blocker I was on before the procedure. But a much smaller dose than before the procedure. 

This seems to be helping a bit, and I am still better than before the procedure overall, just not where it was a few months ago.

I had a small prostate at 45 grams, but I wonder if it is growing rapidly? DR K doesn't think so, and thinks it could be prostatitis which doesn't look to be easily solvable. I was so happy to be off the meds, so it is kind of a let down at this point, but the good news is I know I was able get good relief for a while. Maybe during the healing process something closed in on the urethra? 

I will probably go see a urologist soon to look inside and see if there is any blockage if I don't see any improvement.

 

Hi Jim,

Best of luck on the redo.

Before the procedure did you have:

- acute retention?

- an enlarged median lobe?

 

Best of luck, Motoman.

Before the procedure did you have:

- acute retention?

- an enlarged median lobe?

Yes I will be asking the new urologist what he thinks and maybe take a look inside. That is something I will not look forward to. It was kinda brutal.

Maybe another MRI at least I hope to figure what happened..

Jim

No

No I did not have an enlarged median lobe. I did have a few retention instances. I learned how to self cath, and did that on occasion when I would have a problem. 

Thanks a lot, Motoman.

Jim, my uro wanted to do Urolift on me too but I don't trust him because he did not give me any tests, no ultrasound, no cystoscopy, except for sticking his finger in my butt. Hank

Moto, have you considered it may be the bladder ? Hank

Arlington, why are you concerned with acute retention (AUR) so much ? I think we all have (or will have) AUR at least once, usually triggered by too much liquid intake. Most of the times, after it is taken care of, we are back to normal, until the next time. Chronic retention (CUR), on the other hand, indicates more serious issues at play.

Hank

Have to watch those urologists.. some just want your money..

I've discovered that when considering procedures/treatments it's very important to compare apples w/ apples.  In order to do this I need to ask the docs their success w/ people in a very similar condition to me.  My condition is that I have an enlarged median lobe and I'm in AUR and haven't peed naturally (at all) for 18 months.  The success of these procedures is VERY different dependent on whether the patients are or are not in total AUR. 

Arlington, technically, you have CUR with 100% retention. If it was AUR, you would all good after a cath. Hank

The advantage we Brits have with the NHS is that they are basically salaried and no procedure we have gets them more money. Though they all do private work as well. 

I AM good after I cath - until the next time I have to cath!  I guess it's just semantics, but, according to the defn.(below), I'm in AUR.  With CUR, you can still go (some) naturally.  Either way, it sucks! 

"Chronic urinary retention (CUR). usually develops over months or years. It is usually not painful. The symptoms of chronic urinary retention can include:

Frequent or painful urination

Difficulty beginning to urinate

A weak or interrupted urine stream

Leaking in between trips to the bathroom

Feeling an urgent need to urinate, but not being able to go

Still needing to urinate after finishing

Pain or discomfort in the lower abdomen and urinary tract (usually mild and ongoing).

Sometimes these symptoms aren’t worrisome enough for people to seek medical care. However, the risk of not seeking care is that these people may be more likely to have complications from untreated urinary retention. These complications can include urinary tract infection (UTI) or acute urinary retention.

Acute urinary retention has different symptoms and requires immediate medical care. The symptoms may include:

Complete inability to urinate

A need to urinate that is painful and urgent

Painful or uncomfortable lower abdomen

Bloated lower abdomen."

Hank,

it may be the Bladder, but I have had two different procedures now, Itind and FLA that have given me great relief for a few months. I was peeing like I did in my twenties for a short period of time with Itind, and a longer period of time with FLA. That points me away from the Bladder. But I did fail the pressure test a few years ago for my Bladder. 

It looked fine when they scoped me, and Dr K said it looked fine on the MRI. So I am guessing that it must be some type of blockage.

jwr just started a discussion "I flunked urodynamic test." Basically, his uro told him that his bladder is toast, don't bother to have any procedure. I wonder if that applies to us as well, to a certain degree. I hope not, but trying to be realistic here. Hank

Yes, and I replied that I don't believe it applies to me and why. I am peeing after failing that test, and was peeing fine like a younger version of myself for months after the procedures. 

My Uro wanted me to do a procedure, thinking that removing any obstruction would be an improvement. I agree with him, but didn't want to domthenTURP he could do. He offered to refer me to any other procedure, but I did my own research and landed at this site.

This is not the place to come to nowadays as it is naturally populated by patients who have not been helped by whatever procedure they had and now have a gripe and those who are indecisive and frightened by the failure of others. 

Your best route is to Google for medical papers and reports of medical conferences where experts talk to experts.

There is a lot of information under related Information to the right of this screen. We can't decide what is best for us nor can anyone on this Forum tell you.

Hi Jim, Thanks for your reply. I hope your situation will resolve and you'll be able to carry on without having to worry about prostate issues. It certainly does take a lot of time and effort. Wishing you the best! I will try to talk with Dr. K this week, as I sent my MRI records last week and he should be getting them..

Fred  

Derek,

I really have to ask why you are on this site then? Which category do you fall into?

I am a big boy and able to decide what info from here is useful, and what is not. Of course the site will be overweighted with people who are having problems. The ones that aren't usually move on.

I am not sure about the troll comments either. Who comes to a site like this to troll? Gotta be better ways to spend time unless it is someone from the medical industry.

I stay here to try and help others. I had GL PVP in 2004 and Thulium/Holmium in 2013. Both were trouble free so I try to spread the word amongst the doubters. .

Hank,

AUR is when you can't void without a catheter.  If I read it correctly, Arlington has been in AUR for 18 months. Frank has the same condition. If you're not self cathing, AUR is a medical emergency and requires a visit to the doc or ER.  I think you're talking about "episodes" of AUR and not the condition itself. 

Some of us, including myself, have episodes of AUR, but that is quite different from what Arlington and Frank has. Episodes of AUR usually (but not always) go along with incomplete bladder emptying (CUR). They are certainly not normal, except in with folks who have BPH/LUTS, the exception being if caused by certain medications. 

Jim

Derek,

I got to agree mostly with Motoman here. Of course you have to read the medical studies, papers, etc, but the information you get in forums like this is a highly valuable adjunct. As to how weighted these forums are with people having problems, the studies have their own limitations as well.

I will say this, however, as much as I use these forums for information, I am often shocked as to how many people seem to rely on the anecdotal information presented as fact, and often the only fact. You really have to check everything not just twice, but multiple times, which requires time both in back reading posts by others and/or reading all the studies and papers that Derek mentions. 

Jim

I found my references about AUR the way I think but I like what Arlington said, it's just a matter of semantics. 

BTW, welcome back. Hank

Jim, sorry I am late on the response to you of the blood work I had that you ask for. I had my wife looking for it so I had to be patient with her. She went back and found the first lab done by my cardio when I started the Whole Food Plant Based program with Esselstyn and the followup blood test that was approximately 6 weeks later after being on the program in his book. 

I have no way to attach it but I did produce the numbers below

Cleveland Clinic - Ohio

Test Collection Date 9-15-14

Results Return Date 9-17-14

Component Results

Component                      Your Value                Standard Range

Cholesterol, Total            269 mg/dl                   100-199 mg/dl

Triglyceride                      242 mg/dl                   0-149    mg/dl 

MH HDL Cholesterol         37 mg/dl                    >39       mg/dl

VLDL      Cholesterol         48 mg/dl                    5-40      mg/dl

LDL         Cholesterol       184 mg/dl                   0-99      mg/dl  

Got on the program and in approximately six weeks Dr. Esselstyn ask me to do another blood test.

Baylor University Hospital  Dallas

Test Collection Date 9-15-14

Results Return Date 9-17-14

Component Results

Component                      Your Value                Standard Range

Cholesterol, Total            139  mg/dl                   100-199 mg/dl

Triglyceride                      84 mg/dl                   0-149    mg/dl 

MH HDL Cholesterol         40 mg/dl                    >39       mg/dl

VLDL      Cholesterol         17 mg/dl                    5-40      mg/dl

LDL         Cholesterol         82 mg/dl                   0-99      mg/dl  

I have been on this program now for three years. It is now my life style. I no longer get these type of blood test I get the new VAP tests and they are much more extensive with breaking down the percentage of size molecules in the cholesterol. I do still have issue with the higher range LDL numbers. Dr. Esselstyn says to stop worrying about that so much and that exercise is the number one thing. I have told you I total hate the gym. I walk as much as I can in golf and try to convince myself it is enough. I must do better. I have no more angina or winded symptoms from my blockages. I am happy I did not have the four way bypass. 

FLA is still doing good and will be a year on the 19th of this month! I think I will start a new thread post and try to collect all the FLA for BPH people who have done this and see what the consensus comments are now that we are down the road. I did talk to Dr. Karamanian last week and he said he is still offering his clinical trial price as he has not filled it up. He said it has been difficult to get men that qualify though he has completed over 20 FLA procedures for BPH and has three more to do this month. He is very pleased with the results but I want to collect the facts from the actual patient that I can reach. 

Have a wonderful holiday and I hope the above numbers you ask for are what you are looking for. If you need more info just ask. 

 

Jim correction on the Baylor dates for the retesting. They were in November 26, 2014 and results received back on December, 1, 2014.  Sorry about that, I just got going too fast on my typing. I wish this typing counted for exercise! My wife said no to that. 

You can put me down on the negivetive on Fla. Sometimes the truth hurts.

Jim

real sorry it did not work for you but I also hope you have a back up plan that will. Good luck let us know what happens.

I'm working on it. Hoping for better results on what ever I do.. Merry Christmas..

Hey Jim  Sorry the FLA did not work.  Did the doctor tell you why?  All the other men on here that had it done.  They have had good out comes  Good luck  Ken

Sent Dr K. New MRI and should know he reasons on Monday. Hope its a good and easy answer..

Please let us know.  I hope it is a easy fix  Ken

Hi John,

Thanks for the numbers. Very impressive!!!  I wish I could get my numbers down like that on your diet, but we all metabolize food differently. That said, I'm trying. Obviously, whatever you are doing works, so keep it up. And your LDL is pretty good, so would not worry. That said, as long as you're getting more sophisticated tests you might ask for a "direct" LDL versus the less precise "calculated" LDL, which I assume you've been getting.

A happy and healthy holiday season to you.

Jim

 

I understand Jim. Since you have read his book, prevent and reverse heart disease, you may want to call him with specific metabolic directed questions. He has been doing this since 1984. Caldwell Esselstyn is very easy to contact and he will gladly discuss your position. I am sure he has dealt with it all in his 60 + years of practice. His secretary is named Jackie and she will have him call you to discuss the metabolic side of the situation. Just a thought. 

Thanks John, might do it at some point. I'm currently on a diet somewhere between Esselstyn and Pritikin. I will get some numbers in a few weeks and then reassess.

Jim

Hi Jim,

Details?

Thanks and good luck,

Fred

@John: FLA is still doing good and will be a year on the 19th of this month! I think I will start a new thread post and try to collect all the FLA for BPH people who have done this and see what the consensus comments are now that we are down the road.

--------------

I'm glad your FLA is still going well! That said, the overall functional results to date seem no better than any other prostate reduction surgery. I count 8 good results, 2 marginal results and 2 failures. Maybe you can update on this. This is not surprising because we already know from past prostate reduction surgeries that simply freeing up the obstruction will not help everyone. Dr. K. himself, in another forum, suggested it was unrealistic to expect more than a 70% success rate with FLA, based on TURP's rates.

Hopefully you will temper your enthusiasm for both FLA and Dr. K. with this information when presenting to the forum.

Jim

I still like FLA because of its precision and lack of sexual side effects, however I think it's important that in your enthusiasm for the procedure and Dr. K., that i

Sorry about the bad edit. My point is that FLA's strength so far seems to be its precision and lack of sexual side effects. And for me this is a biggie. However, in the past it seemed to be presented as a slam dunk to cure bph/luts and IMO that was never a realistic claim and the patient data now bears that out.

Jim