Going with Focal Laser Ablation for BPH

Hi Jim,

I think FLA looks very promising, but any prostate reduction can only produce results commensurate with the condition of your prostate and bladder going in. Have you had a full bank of diagnostic tests including bladder/kidney scans, cystoscopy and urodynamics. The latter will help determine if you bladder is strong enough to empty even if the FLA removes the obstruction.

Jim

Yes been through it all. Dr says Im a prime candidate

"The latter will help determine if you bladder is strong enough to empty even if the FLA removes the obstruction."

Except in my case. I failed urodynamics and was diagnosed with an atonic bladder. 

Dr K said different about my bladder, and he was right. He can view the condition of the bladder by looking at the MRI. 

FLA has worked great for me so far. Maybe you should try it, and get off the catheters. It has been very liberating. 

All the best with your FLA.

Jim

It's a complicated system and urodynamics isn't perfect. Also, a lot depends on who does it and how it's done. I was unimpressed my urodynamic study but didn't know a lot then. To do it over again, I'd have insisted on video urodynamics at a place that believes in them rather than just doing it. 

From what I've read, I have a lot of respect for Dr. K., but what he can see with his 3T MRI isnt the same as evaluating voiding function via urodynamics.

You said; "FLA has worked great for me so far. Maybe you should try it, and get off the catheters. It has been very liberating. "

I haven't had to self cath going on four months now with very acceptable PVRs, no urgency and few if any night time trips to the toilet. That's just from self cathing rehabbing my bladder. FWIW I found self cathing very liberating. YMMV.

One day, if things change, FLA would probably be on my short list, depending on new patient data and what new procedures may be on the market.

Very happy that FLA worked out so well for you.

Jim

 

Well for what it is worth, I put zero (0) credibility into the urodynamics test after my results with it. The results almost made me do a TURP, or have a TENS unit implanted to help me go to the bathroom. It would stimulate the opening of the sphincter. 

To be fair, all of the doctors I have seen have said any removal of obstruction will make it easier to pass urine. I think we are seeing that with several of us on here after the FLA procedure. 

Self cathing was not liberating. It helped to relieve me, but I was not doing that out in the open in front of people. Try doing that in a work environment, or doing that out on a boys trip in front of your buddies and tell me how liberating that is. Guys don't want to talk about that or admit that kind of stuff to other people...Here it is anonymous.

"....The results (of urodynamic testing) almost made me do a TURP"

Not following you here. If urodynamics showed sufficient bladder tone then it would greenlight any prostate reduction surgery including FLA, not just TURP. If urodynamics showed your bladder was shot, then TURP would not have been recommended, or it shouldn't have been.

Again, I've got nothing against FLA and have stated many good things about the procedure here, and you had a good result which is great.

All I'm saying is that any prostate reduction procedure, including FLA, is dependent on the condtion of the bladder going in. This isn't an opinion, it's true of any prostate reduction procedure, and in fact Dr. K. has said similar to one of his patients recently who is still in recovery.

We can agree to disagree on how liberating (or not) self cathing is. I am not alone in my opinion as others have posted the same feeling of being liberated and being in control without the trauma and risks of surgery. They and myself are anonymous just like you, so if they say it's liberating no reason to doubt them.

And again, I haven't had to self cath for four months now and I'll put my IPSS score up against anyone who has had a surgery, including surgery. But even if I was still self cathing, as of today I would still extend my watch n' wait with self cathing over having a surgery, but I truly understand why some would not. 

What is it that the suit guy on tv used to say, something like "the educated consumer is my best customer". That's all we can do is educate ourselves as best as possible and then make whatever decision we think is best for ourselves.

Jim 

 

"....The results (of urodynamic testing) almost made me do a TURP"

Not following you here. If urodynamics showed sufficient bladder tone then it would greenlight any prostate reduction surgery including FLA, not just TURP. If urodynamics showed your bladder was shot, then TURP would not have been recommended, or it shouldn't have been.

it it did not show sufficient Bladder tone, that is the point. But every Dr I have seen has said that removing any obstruction would be an improvement  over doing nothing. TURP is the only thing offered where I live. I was scared, and almost went forward with the TURP because I couldn't imagine life on catheters, as great as you make it sound.

The IPSS is totally subjective, so take it for what it is worth, which isn't much, since we can all deal with things differently.

Of course any surgery will be dependent on the condition of the Bladder. But what you are telling people is bordering on saying don't do anything and buy catheters if you have a weak bladder. I disagree with this, and feel people should know there have been success stories even though there was failed urodynamics testing. I speak from experience. I can't speak for Mike588, but I would be willing to bet he has improved since having the FLA procedure, and is happy he had it done. And his condition was pretty bad.

I have no problem with getting as much information as possible. That is why I am here. This place has helped me a great deal.

Motorman: [color=#3a2e28]Of course any surgery will be dependent on the condition of the Bladder. But what you are telling people is bordering on saying don't do anything and buy catheters if you have a weak bladder. I disagree with this, and feel people should know there have been success stories even though there was failed urodynamics testing.[/color][color=#3a2e28] 

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

That's not my position and that's not what I'm telling people. I'm offering an alternative based on my research and personal experience and the fact that newer procedures are coming out all the time, FLA is one example.

There are certainly any number of people here recommending this procedure (just as enthused about their procedure as you and John are about FLA) and hopefully there is room for another opinion. In the end, we're all grown ups and can make our own decisions.

Yes, there have been success stories where people failed urodynamics but the opposite is also true where people have had the operation and still can't void but now have problems than going in such as retro. And not everyone can afford FLA where ejaculation is preserved.

I think it's fine we disagree on when to pull the trigger and what risks are acceptable. The more opinions and info the better for everyone.

Jim[/color]

 

Thanks Jimjames. Going In at 6am tomorrow...

All the best Jim! Good luck and my best to Dr K

All the best with your FLA. From all accounts you are in good hands.

Jim

Wishing you the best Jim

Thanks guys for your kind words. Day 1 Procedure went well, peace of cake. Catheter is not fun and is causing some pain. Hoping it will get a little better or it might be a rough 7 days..

Dr K and Sam are great. Going In for a follow up tomorrow. Going to stay in Houston tell next Tuesday. 20,000. For F la for bph. Hoping money will spent.

Good luck JIM. PM me if I can help with any questions

I'm good just a little burning and some pain from catheter. This is a great group in here..

Thank you Trustme

Good luck 

Jim if you need anything, as in guestions or concerns about what is going on or "is this normal", don't hesitate to ask. You are now in the K Club and I as well as anyone else who has been through this, understand these questions and I am happy to support you through your recovery. I know that 5 or 6 weeks from now looks a long way off. But it will fly and the day to day improvement will add up fast. As the changes occur and questions arise Dr 

K's support and nurturing will be invaluable and something that I have never experienced before. 

I am am currently in the hospital with my 85 year old Dad as he had a bilateral full knees replaced two days ago and I wish I could get that level of care for him. 

Let me me know if I can help in any way.

john

Thank you John.. So far so good, just dealing with this catheter..You were one that i followed which helped in my decision for Fla..Hope your dad's doing ok.

Jim

Hi Jim,

I am only 2 weeks out as of today and like John and the others, will be happy to help you with any questions you might have. 

Ross

Doing good Ross. Grabbing a bite to eat. I'm about 10 hrs out from F la. Kinda sore with a little bladder pain. No fun with catheter. Appreciate your help. Almost one day in..

Jim

Living on Uribel..

Jim,

I know that feeling well, in fact I had the worst bladder spasms for the first 24 hours and discovered that I have reactions to silicone catheters. Once changed for a latex one, I was fine. If you're having painful uregency and spasms, ask Dr K to swap it out. I know he has latex catheters now precisely because of what happened to me.

Ross

Thanks Ross. Day 2 so far so good no bladder pain at the moment, just a little burning on the end where It goes in at the weiner. Havnt had any blood to speak of. Really only blood was at the end so I washed it an d have been applying Vaseline. He did 4 ablations mainly around the urethra. Medium lobe was fine.. Only 6 more days till it come out.

Can't wait for that day..

Jim

HeyJim,

So glad you're tolerating the catheter well. The first night i slept all of zero minutes due to the constant agony of the catheter causing bladder spasms. It makes all the difference to be comfortable. I also bought a donut cushion to sit as I felt somewhat sore when I sat for too long. It was well worth it for the flight home!

Don't expect any miracles when it comes out but I must confess, having gone to this procedure having suffered AUR twice in a week, it WAS a miracle to be peeing on my own again!

I am trying to be patient as improvements are very slow but this mornng I had a very good stream and wondered who the hell I was looking at

Be well and easy recovery my friend.

Ross

Ross, nothing like a couple pain pills and a Xanax to get through the night. Had these left over from knee surgery.. You hang in there Ross I'm right behind you

Hey thats good news Ross. Hope it only gets better for you. Met with Dr. K for the follow up showed me all pics and what a great job he did. He is such a great guy he not only showed pics, he took the t ime to explain how it all works all the Angles it takes to set the probe just right. He showed that the prostate can be hard and how it can curve the angle and how he adjusts it.Really amazing stuff. It's funny how we talk about how he knows all you. Told him he needs to say some words in here more often. Said he would. Must admit I was a little skeptical of him at first but he truly is as good doc and person. Ravine and Samantha do a great job also. Samantha gives the greatest hugs. So far on day 2 i am very pleased.

Can't say enough about Dr. K. All docs could learn from him on how to be with patients.

Jim

Hey Ross,

Day 4 is about the same. Still talking Uribel. Not much bladder pain anymore. Prostate seems to be a little more sore today. Will be looking forward to pulling out catheter this Thursday morning. Guess that will be the next hurdle.

Jim

Hi Jim,

Glad to hear that you are comfortable. The soreness does go away but don't expect anything to happen overnight. I am on day 17 and I can now go up 3 hours and change before I need to pee, although it seems to deteriorate in the afternoon. My average volume is around 200ml now and my stream is sometimes quite good and sometimes as it probably should be at this stage, a little weaker and more consistent with someone with a swollen prostate. It's still early days for me but i am SO grateful to be peeing so well given how bad things were immediately prior to my procedure.

You're on your way Jim and I am excited for you removing the catheter on Thursday. It'll be such a relief!

Ross

Thank you Ross for writing me back... Appreciate the kindness and the encouragement...One day at a time..

Jim

Hey Jim, This is John, I am glad you got through the first part of the procedure and you are working to get to the point where you get to pull the catheter!!  After the cath is out, then the recovery time starts.

Speaking of knee surgery, I have been out with my Dad who, out of the blue, called me up and told me he had scheduled double knee surgery AND then he had it done last Tuesday. So tomorrow he is one week out of surgery. He is 85 years old and he admitted today that he might have bit off more than chew. 

I have been with him the whole time and he lives by himself on a small farm about 3 hours from me. So I have had my hands full and I have him now in a rehab hospital for the next 10 days I hope. Then I don't know what I will do. 

Glad to hear all is going in the right direction with you. Good luck. 

John

Jim, yes you are so correct and it is great to hear your comments. I have embrarrassed myself so much on this site talking about Dr. K and trying to relate to people what a unusal doctor he is as he cares so much and he is so passionate about his work on prostate treatments to help men. He really goes above and beyond any medical professional I have ever known.  He really cares more about the patient than any doctor I have ever known. I am so glad you comfirm this as I felt strange telling people how unreal that man was. Now we have about 12 to 15 men who are just as amazed at him as I was. It make it easier. 

From the moment I frist called him and started asking all the questions I could tell the difference. He was not interested in money from me, he only wanted to educate me regardless of the decision I made for treatement Then his attention and support was the diffence maker in my success treatment. I had no network of guys to ask about the issues of recovery in the weeks that followed. He was it, and he supported me to the fullest. Other doctors do not do this, especially any Urologist. We are all very blessed to have him and that he has chosen treating men's protate issues as his specialty. 

Thanks, John

Hey John, sounds like your dad is a tough old guy. Best of luck to him and you for taking care of him..

Your name and a few others came up while talking with Dr. K.. He showed me after pics and looks like he did a great job on removing the areas of prostate around my urethra..

Have 3 more days on catheter..Hoping once removed it doesn't have to go back in. Kiinda stressing on that..Doc did say it takes about 3 weeks just to get back to before it was ablated. I have noticed that my bladder pain has mostly gone other than the catheter. Catheter has been a bit of a challenge .

Going back to California tomorrow.

Jim

Good luck on your travels. Don't rush the removal of the catheter. That seems to be the secert in this as the prostate is very swollen and will be so for about 3 weeks. I think Ross can also speak to that. The longer it is in the more healing and the better the flow will be.  I returned to base line rather quickly but that was not that impressive as my base line was not that good. Timing on events should be measured from the date of the catheter removal in my opinion as that catheter is really part of the procedure. Then the count down starts. So, 4 to 5 weeks after the cath is out it will be really good and it will feel a lot different. You should feel swollen now inside and you may need a cushion or pillow or something to sit on during your flight. Again, Ross just did this to NY and can tell you about that also.  I drove my car for six hours the fifth day after surgery and I did it with the cath still in me. I could feel the swollen gland. I learned that way that I needed a cushion. I think everyone feels it though in this stage, it does not hurt just uncomfortable and you are aware the prostate is there. It stays swollen for several weeks though you do not feel it like you should right now. I am going to PM you my contact outside of this site and if you need to discuss or have any questions you can call me anytime. I have lots of down time right now with my Dad or I would be on the golf course as the weather is perfect now.

My retirement is right around the corner and they are letting me go as much as I need or want right now. This is because I have a young man trained for my job and they want me to let him have some leash. They also are trying hard to get me to consult on an ongoing small time basis after July. I don't know, I am considering it and that is one reason they are being so nice right now. They have been really good to me. 

Stay up with that Uribel, it is your best friend right now.  

John

Thank you John and I did get your pm. My only real concern is pulling the catheter on the 7th day or maybe waiting 1 more day. Just hate the thought of it going back in. Hoping I can pee enough to keep it out. Tough decision..Dr. K did get quite a smile when I told he had a fan club..

Jim

Well, wait and see how you feel on day 7. Make the decision then. If you are not having bladder pains, I would even consider waiting up to 10 days. Maybe until even Monday of next week. It will only get better and improve the stream and flow. I could have waited more than the 5 days I did and I would wait more now knowing what I know about the swelling and the reduction of the swelling each day. Ask Dr. K. he will tell you what he thinks.

Good morning John, made it home just fine. Had about a 2 hr delay in LA. Prostate was a bit sore from sitting on it all day. Glad to be home.. Going to pull catheter tomorrow that will be 8 days. Do you know if anyone had to put it back in cause they could go pee?

Jim

I had mine out after one day. Could not pee, back in for a week. I was able to pee a little for the next week. But I did self cathing 2-3 times a day for the first week after the Foley was out. Don't know if I would have made it without being able to do that. 

There have been a couple others that had to have the Foley put back in. It helps if you know how to self cath.

Good luck with the recovery.

Hey Jim,

I was so nervous about pulling my catheter. I also left it 8 days but as I had 2 acute urinanry retention episodes in the first week of May, I was catheterized for a total of 19 days; 11 days prior and 8 days post. I couldn't imagine that I was going to handle swelling that well given my pre-procedure conditon. But I did OK! A brief middle of the night scare mid second week that resolved itself. 

Take it easy, recovery is slow and probably should be looked at on a week by week basis as opposed to day by day. PM me if you need any help.

Good luck tomorrow. It feels SO good to be free

Ross