Going with Focal Laser Ablation for BPH

Captain.  I don't kknow if you know this but they do urolift with the medien lobe. They just pin it to the side. It would open you up. They have had good results. I would tfy that out first before i have anything cut out. Also with urolift there is no retro.  Look into it.  Tell your doctor that you want to try this first.  That may be all you need. Ken

Same issue with the medications, dutasteride and Rapaflo take some of the pain away, but have side effects for me that are unacceptable long term. I really want off the meds as primary.

Captain, have you by chance had a 3 TMRI and then had someone pull the MRI up on a screen and show you the  flim thereby showing you the actual pinch Urethra causing urine blockage and he actual large median lobe pushing on your bladder or is this diagnosis just a doctors interpretation of the actual problem as he believes it to be? 

You can see it for your self if you have not and if you want to. I did want to know exactly why I had blockage and I did see it. I gained a lot of confidence when I saw that and knew it needed to be removed. At that same time,  when the doctor could show me exactly how and where he would enter the prostate and where the tissue would be removed, the logic all kicked in and made sense just how and why this procedure worked. Then the next day after the actual procedure,  he showed me the After Procedure MRI and clearly showed me the same spots with that tissue removed. More important to me was he showed me the seminal vesicles and there ejaculator ducts and the nerve bundles of the prostate before he did the procedure and after he did the procedure to show me there was no damage to the, as you say, "important stuff". I don't know of any other doctor or procedure that does this with regard to prostate treatment you may have. It sure made my recovery easier to put up with and gave me peace. AS the inflammation went down I was very pleased and it was a shocking amazement after nine years of BPH events to be back to what felt like a normal life with my urination. This was the depth of investigation I wanted and I think it is why it took me 20 months to pull the trigger. No one else could give me that level of confidence and as I said, I did not want to roll the dice on my sexual functions with the HOLEP or Rezum or Green Light or TURP or any of the others. At UT Southwestern they told me that the large median lobe would not do well with Urolift. I was not interested in that anyway as my prostate was 125 cc and it needed reduction but it needed it in the right focused and controlled manner that FLA gave me. In case you are not aware Urologist are not capable of the FLA as it is an Interventional Radiologic treatment. Not all IR as versed in this prostate specific treatment. But there are some that are specialist. Of those, hands down I am a strong supporter of Dr. Karamanian in Houston. 

Thanks for sharing all of that great information on your decision making process. As I am now looking at options for myself to get out of a Foley, It is great to hear your story.

I am wondering though, during that 20 month investigation period, may I ask if you were managing your condition with medication? What medications were your taking during that period?

Dale, no, during the 20 months I just suffered. I would not try the pills. I read the side effects and did not want that. The worst part for me was at night going sometimes 8 to 12 times a night. During the day I got inncontinent issues as I could not hold it to get to the mens room. This was really an issue at work. I did not have a bad retention issue it just took me several trips to completely void. It was not as bad in the beginning of the 20 month research but as it got worse I realized I had to pull the trigger. 

A Doctor named Issacson who does PAE in North Carolina looked at my MRI and told me that my bladder was starting to have mild to moderate signs of bladder tabeculation. He put his hand on my shoulder and said whether you do something with me or with someone else, it is time you must do something sooner rather than later. Larter that night my wife fell down and broke her knee cap. I loaded her in the car and drove straight back to Texas the next day. She had surgery and started recovery. All the while my BPH was getting worse. She went with me leg in a brace to visit two more cities and two more Doctors with procedures they offered. six weeks later in November of 2016 I decided I had made my decision and I started this thread on this web site. You can go up to the very top of this page and see the post that I had made a decision. Then 21 days later I had the procedure done. 

Best thing I did. Now I am normal. Sleep all night if I don't drink after 4 pm and best news is I don't pee on myself any more. Oh yea also my wife is now fully recovered. With all this and my Dads heart value replacement and his double knee replacement surgery, It was a hard year. 

But now I have a great deal to be thankful for. I wish you and everyone a great Thanksgiving.

John

That's great news, John!

Did you have an enlarged median lobe?

Which Dr. ended up doing your PAE?

I wanted to ask you about the procedure. When they do the FLA they use a transrectal coil to help with the guidance, right? Did they have to inject contrast for the MRI during the procedure?

Dale sorry, I just read this message. No, they use a pelvic coil that lays over your lap. Actually, they do not prefer the rectal coil as it can push against the prostate and distort the image in some cases. This is mainly a concern for PCa patients. Yes they did inject contrast but I have spoken with Dr. K about my concerns with contracts and he said he had two options. First he is ok without the contrast and second, he has a new contrast that does not cause the plaque issues of concern that some people have mentioned. I was concerned about this as I had a total of four MRI's with Contrast in 12 months and did not want to risk an issue. I have not had any as of yet and in my next MRI, I think I will just fly to Houston and let Dr. K do it. He has the best 3T MRI that money can buy at his access. It is the $3.5 million dollar  Siemens machine as opposed to the cheaper ones like Sperling uses (about a $950K machine). I am sure Sperling is very happy but there is a absolute difference in the quality view of the film between these different machines. Even a patient can see the difference between the quality. I did. It is enough that I will buy a ticket and spend a day in Houston to get the best. Houston flights are cheap and I will not stay there long just in and out.  But again, Dr. K says you don't have to use contrast unless you are dealing with cancer lesions. And now he has a new contrast that does not cause the problem. If you want the name of the contrast I will get it or you can just call Donnie in Dr. K's office and he can give you the name of it. The transrectal coil will work fine if the pelvic is not available where you are going. But I found a pelvic coil here and again Donnie help me find it when I asked him. 

Does this help you and did I give you what you are asking for in information?

 This happens usually about 4 to 5 weeks after the catheter comes out rather than after the procedure so you are about two weeks ahead of my experience. Congratulation but don’t go and over do anything just yet. Let some else fix those tractor flats on that farm.

I can not speak for everyone but I will tell you that what you just described is experienced by many of us doing FLA, a lot of us have called it the Eureka Moment. That flipping of a light switch was exactly as I described it when it happened to me on a Friday night and Saturday morning. Just out of the blue within a 24 hour time it happened. I went to bed and woke up better!!  I will tell you my experience was exactly like yours. You will now  stay good and even get better for about 4 more months. You may have some occasional discharge tissue looking or blood clotty substance as both Ross and I did have but what you have experienced we also had this same event. Remember, even though you feel a lot better, you are still inflamed in the prostate and it will be evident later after time passes and you look back at this period. The Gland Swelling will continue to go down. You will continue to get back to normal. Then in six months your mind will connect with the new normal feeling and it will be the everyday norm and you will start to forget how bad the BPH symptoms were on you.

Joe, this is very rewarding to me to hear you and others go through the same pattern of recovery that happened to me and can tell you, the best is yet to come regarding the symptom relief and this is all with the lack of any sexual side effect and that is  the best part blessing. To get the relief without a cost in that area was my intent.

Please stay in touch and give back with information and experience to the other men who are suffering and looking for answers. You and me both remember how lost and scared that time frame is when we are faced with trying to figure out what to do. I am sure FLA is not the answer for everyone but it is what I needed. Good Luck to your brother also and let me know if you need anything or have any questions.

Oh yea and remember, still NO team calf roping or anything crazy for a while! Take care of that prostate and let it heal and reform over the next few months. You are on your way.

John

Joe

Great news on the INSURANCE PAYMENT!! I also got $4,700 from MEDICARE> 

Things are starting to change on this but man is it a hassle and took a year.

Yes it definitely is a hassle. They paid $ 342 for 2 hours under a 3 T MRI lol. I asked the lady feom bcbs if they could tell me anywhere you could even get a 3T done period for that price much less 2 hours in one. Needless to say I am going to appeal it. It's sad you have to waste time doing stuff like this but every little bit helps.