Greenlight versus Acquablation
Posted , 19 users are following.
So I've finally found a doctor I like. I dropped the creepy female uro who wanted really wanted to do a 12-needle biopsy for no damn reason. I got a doctor who came recommended by a friend, He operated on him and got a good result. The guy is a professor of Uro.
Anyway, he wanted to do a Greelight or Acquablation. I asked which one he thought I should have, which one has a better result, etc., and he said the Acqualbation because "it's cooler" cuz it uses a robot. But now my insurance has declined it. My insurance will pay for a Greenlight Lazer. Should I fight the insurance for the acquablation? His office is telling me they are both equal and in fact there's less bleeding with the lazer. Anyone have any thoughts? Thanks.
0 likes, 78 replies
nick67069 Motto
Posted
Acquablation is newer procedure and is not yet approved by FDA, so there very little hope that your insurance would cover it. Results do sound promising compared to other procedure. Have you checked how much would be a out of pocket cost?
tom86211 Motto
Posted
I dropped the creepy female uro who wanted really wanted to do a 12-needle biopsy for no damn reason.
You didn't say but your PSA must be elevated and the reason to do a 12 core biopsy is to check for prostate cancer. You could also do a 3T MRI, but you might have to pay out of pocket for that. I had a 12 core biopsy in 2012 and it came back positive for cancer. A second biopsy a year and a half later showed that the cancer was growing, so I had it treated with radiation - now gone.
Motto tom86211
Posted
I did have a 3T MRI which was negative. But my female URO wanted to biopsy me anyway. She said if not "her practice wouldn't let her do a TURP ." The second URO I saw laughed about it and said my PSA was not high and not a risk for cancer.
Bobcats Motto
Posted
My Uro is a big FAN of aquablation here in Los Angeles. There is some big wig Uro at USC , Dr. Mihir M. Desai, MD ( my uros mentor ) who is teaching the procedure to other uros, however, insurance companies don't like to pay for it so he offered me a TUVP, as opposed to TURP. I am not even sure of what the difference is because I tuned him out!
I asked him about PAE and he said , there is not much benefit to it... I went with PAE 😃
oldbuzzard Bobcats
Posted
Unless/until they can modify aquablation to lessen the bleeding/recovery time, my guess is that it will never catch on.
PAE seems to work best when no enlarged median lobe is present. Along with Rezum, FLA and Urolift, worth doing (which one depends on each case) before considering going under for a full blown surgery.
Motto Bobcats
Posted
and? how was it? results?
mikemh oldbuzzard
Posted
please stop peddling your misinformed prejudices. i had aquablation 3 weeks ago and no bleeding after a couple of days and really quick recovery
oldbuzzard mikemh
Posted
I'm glad you had a good result. My info came from the top urologist at the Cleveland Clinic who said it's a less risky procedure than TURP but typically has an even longer recovery.
Motto mikemh
Posted
And how are your symptoms now?
mikemh Motto
Posted
Things are improving. Still too early to know what the final result will be.
Well I stayed 2 days and nights in hospital while they passed 160 litres of saline through my bladder. After that my urine was light cherry for a couple of days, then it went clear.
About 5 days after the operation, I had awful pain while peeing which felt like I was peeing through some terrible tiny hole caused by a blockage. When not peeing, no pain at all. I was told to "hang on in there". After another week or so, I passed 4 or 5 blood clots with a little blood for an hour or so. Since then the pain has subsided greatly and things seem to be getting better slowly.
My recovery has been better than from my previous urolift surgery!
It is likely that my situation is one of the most difficult as I had a 123+cc prostate with 9 urolift clips.
I have persuaded the urologist that if things do not get to be "wonderful" then he will do a cystoscopy under general anaesthetic to see if there is some way to improve it eg knocking out a blockage or even removing a urolift tag ....
I still have urgency and frequency issues but I know I need to work on training my bladder after so many years (15?) of BPH issues.
It is now 3 weeks and 3 days from discharge form hopsital and overall I am optimistic at the moment.
Motto mikemh
Posted
Thanks for sharing that. I think Buzzard has a point tho and am now re-thinking it. Probably going to see about a Rezum first.
oldbuzzard Motto
Posted
By comparison (to Aquablation), I drove my self home after Rezum and was doing Squats 5 days later.
Motto oldbuzzard
Posted
Did Rezum work for you? Did you stop retaining? Did it hurt sexual function?
Did you need another procedure after?
Thanks.
mikemh Motto
Posted
Best of luck
I am not in the business of trying to persuade anybody what is right for them. I just report things as I experience or here them as faithfully as I can.
My urologist says that removal of prostate tissue is the most effective way (at the moment) of producing long term benefit. I understand that TURP, Greenlight laser, HOLEP and (now) Aquablation all do that but using different techniques.
My previous urolift operations kept me going for a few years until aquablation came along.
rob78162 mikemh
Posted
Hi Mike,
Thanks for posting your Aquablation experience. I am just hearing about this procedure as I am doing this research. I've had BPH for probably 20 years, had a failed and painful recovery from a Urolift in 2015 and now feel that the time has come to attempt something else. I have a fairly small prostate but a prominent median lobe. My doctor told me that the best operation for me would be a TURP because that would be the procedure that would allow the removal of the Urolift clips (I think that I have 4). She said that the clips are now embedded correctly but that if the remove part of the prostate (with any procedure) that it would allow the clips to be sticking out and possibly lead to stones, etc.
Was there any talk with your doctor prior to your Aquablation of what to do with the Urolift clips?
I hope that you continue to feel better!
Rob
mikemh rob78162
Posted
Hi Rob
Very interesting! I have had a hang up about these 9 clips of mine and whether they might cause an issue.
I have repeatedly mentioned this to my urologist who was initially adamant that they would cause no problem.
(Actually I am a little cynical as he did the urolift ops on me and always said that urolift did not preclude any future intervention of any sort)
But now he does admit that they could possibly 'cause flaps of tissue'. I have a possible cystoscopy planned for the near future for him to have a look and see whether there are any blockages or flaps visible and if so to 'tidy up'.
I have not heard about possible leading to stones. I would be grateful if you let me know who and where your urologist is so that I might have some back up to speak again to my surgeon about this.
Cheers Mike
rob78162 mikemh
Posted
Hey Mike,
I am actually seeing 3 urologists right now since my urologist of 20 years just sold his practice to the local university and is still there for a few months before retiring. He has turned me over to 2 younger doctors and one of them actually mentioned the need to get rid of the previous Urolfit clips. However, I saw my old doctor yesterday because I felt that I was getting a UTI and mentioned to him that the new doctor mentioned the need to remove the Urolift clips and he disagreed. He said that they would be no problem to leave in. So, I don't know who to believe and I don't know that I would quote any of them! It just goes to show you how widely the opinions vary from doctor to doctor. I made an appointment with Dr. Desai today to find out about the Aquablation procedure and I'm going to ask him whether the existing Urolift clips are a problem and I'll let you know what he says.
Rob
ken21267 rob78162
Posted
Rob, during my quest for answers I also inquired about Urolift. I had a very similar prostate condition to the one you have. I saw Dr Freedman in Newport Beach and he highly advised against it. So, I continued with my journey to USC and Dr Desai. I strongly agree with your decision. Hopefully, he can remove the clips and proceed with the Aquablation during the same surgery. After all, he did both my bladder diverticulum and Aquablation during the same surgery. My bladder surgery alone was nearly 4 hours. I just cant compliment Dr Desai and his team enough. I cant believe how well I urinate now. I feel like I am holding a fire hose. I start almost instantly and my stream is full , strong, and no dribbling. I also void completely. Ive gone from one extreme to the other. Remember; every other procedure out there is either temporary , inadequate, or has potential serious side effects that will ruin your life. There is a lot of information out there on all of these procedures. I spent months researching everything from medical journals to clinical trials. My friends and family have always commented to me about my pit bull mentality when it comes to research. My contact up north, who also had Aquablation, went through the same process that I did. We both came to the same conclusion and have been thrilled with our results. I will continue to beat the drum for Aquablation. Nothing out there compares to its results and safety. I have a personal contact at the company that I communicated with during my journey. If interested, just private message me. I wish you and every other bph patient out there the best of luck. The right doctor and procedure can change your life; the wrong one can ruin it.