Had FLA for BPH done Feb 13

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I went and had the FLA done on Feb 13 by Dr. K in Houston. After talking with John (J12080) and his good results, I decided I could not wait any longer. 

As some of you know, I tried the Itind procedure about 10 months ago with not so good results. It basically worked a little bit, but eventually I was back to what I was like prior to the procedure. So I felt something needed to be done.

I am 53 years old, and have been dealing with this for about 5 years. My prostate was not overly large, about 45 grams according to Dr. K. But he did say it was very hard, the hardest he had ever worked on. I don't know what that means, but I know he has worked on a lot of prostates. 

This was not a painful procedure, other than the last shot he did, I felt more than the previous 6. I was also feeling the cooling circulating through my Bladder. Maybe it was the medication starting to wear off.

i haven't posted until now, as I was having difficulty peeing until a couple of days ago. I was wearing a Foley catheter for a week, and when it came out it was very difficult to urinate. That lasted for about a week. Just drips at a time. I did self cath 2-3 times a day in addition to dripping to totally relieve myself.

Then on the weekend, things opened up a bit, and I was at least peeing as well as I did before the procedure. 

So I am still a work in progress, with blood still coming out when I pee. I expect things to continue to improve over the next month or so.

I was very impressed with the level of care given by Dr K and his nurse Samantha. They have been following up for the past two weeks checking on me.

 

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  • Posted

    Forgot to add I tried sex with the wife a couple days ago. Remembered that there might be blood. Lucky we were in the shower, LOL. When I ejaculated, it was all blood. That kind of shocked my wife. I'm happy it seems to still work. But since then I seem to have more urinary frequency, and blood in my urine when I start. I guess that is part of the healing process.

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  • Posted

    Glad things are getting better for you.  Did he do the MRI's like John  Would like to see them if you can.  Rest and I hope things get better in time remember all men heal at different rates.  I will say a prayer for you buddy  Ken

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    • Posted

      He was doing MRI as the procedure was being done. I also had one done before going to see him. I don't have them, as I could not understand them anyway.

      He did review them with me before and after the procedure. 

      He and his nurse met us on a Sunday evening in their office after we flew in. What doctor does that? I had the procedure on Monday AM, and flew home on Thursday.

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    • Posted

      No problem  I just would like to have seen them side by side like John were.  Did he tell you how much he took out.  And did he avoid all the good stuff  Ken
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    • Posted

      He said he took a lot out, but I had a small prostate, so it is probably relative to the size. I think he said 6 cuts. These would be along the urethra. He said he stayed away from the urethra and ejaculatory ducts. 

      We will see. Like I said, the first time I had sex it was all blood, no semen, at least that is what it seemed like. This was 2 weeks after the procedure. Maybe I should have waited a little longer, but the Doc said do it when you want to.

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  • Posted

    Thank you for the info and please keep us posted on your progress. I too am considering this procedure. I have spoken with Dr K twice so far, I just have not yet reached that tipping point.
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  • Posted

    Thanks for your review of FLA motoman. Its sounds like your procedure didn't go as smoothly as j12080. Since I pee pretty good now ( I take flowmax ) I'm not sure I like the thought of going backwards. Still FLA seems to be the best procedure out there. What did you mean about you prostate being hard? Just getting the laser to the proper place for ablation? On Dr. Sp____g's website he mentions going home without a catheter. You mentioned the last shot being painful.. Weren't you sedated for the procedure? 

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    • Posted

      Well keep in mind this is still early for me. It has only been 2.5 weeks as of now.  I think if John chimes in, he will say something similar. I was told it would be worse before it gets better, and would take around 3 weeks to get back to where I was when I went in. And then should get progressively better from there. 

      I don't know what a hard prostate means. Like solid hard is what he meant. I just thought that would be worth mentioning. I didn't have an overly large prostate, but being hard, he thought meant it was not very forgiving to urine passing through, etc.

      My biggest hesitation with the procedure was leaving with a Foley. And that was the worst part for me. I asked him for a valve so I could use without a bag. But to be honest, that has it's own issues. He did not want me to self cath for at least a week because of inflammation, and maybe not being able to insert the catheter past inflammation. 

      My wife did mention to him the day after the procedure that I was thinking about removing the Foley before my flight home. He did not recommend that so we removed it right then and there in his office the day after the procedure (Tuesday). He had filled my Bladder first. I couldn't really pee, so a new Foley was inserted (that was really painful!), and I left it in until the following Monday. I don't know how you could walk out without a catheter. I was on steroids for almost a week for inflammation, and then took Aleve for another week for the same thing. 

      Yes, I was sedated for the procedure, and never felt the shots or whatever you call it. But I felt the last one. Like I said, maybe the medication was wearing off.

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    • Posted

      Thanks motoman. I'm sure you'll continue to improve. I know j12080 said Dr. K said it would continue to improve for a month or 2. Were you on flowmax or anything to help you pass urine? Would it even help? Would it help if you left the catheter in longer?

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    • Posted

      I was and still am on Terazosin (Hytrin). Dr K wanted me on Flomax before and after the procedure, but I was already on this, so just kept using it. It is similar to Flomax and Rapaflo, but I don't get Retro with it, and it worked better for me than those. I also tried Cialis without decent results. 

      So yes, I think Flomax would help, as well as leaving the catheter in longer. But I was not going to do that.

      If I did not know how to self cath, I would have needed to go somewhere to have a Foley put back in. I could not urinate enough on my own from week 1 to week 2 out. Which sounds pretty typical, but everyone is different.

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  • Posted

    Hi Motoman,

    Thanks for sharing your experience. This is valuable information for all of us here as so far we just have heard back from John on FLA. 

    Were you part of the trial or did you just go in as a regular patient? I am also quite curious what Dr. K. meant when he said "it was very hard". Next time you see him please ask him if you're up to it. I'm sure he's seen a lot of prostates but probably hasn't done that many FLA's specific for BPH, so it would be interesting to see were the difficulty lay.

    Also, when you're feeling up to it, could you refresh our memories on your symptons and IPSS score prior to iTind, post iTind and of course post FLA when things start to get better which I'm sure they will.

    Are you still self cathing now or is that phase over?

    Jim

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    • Posted

      Jim,

      Dr K did not really have anything to say about the hard prostate either. He did seem to think there was a chance I could get by without the Foley because of it, but that didn't work out.

      When I look up hard prostate, it looks like cancer comes up. But my PSA was 1.35 last time I checked, I just had two MRIs done with no indication of that. 

      I was not part of the study, I had to pay the full amount. I'm OK with that, the new motorcycle will have to wait. Since I had a prior procedure, and had done self cathing, I was not a good candidate. 

      I am not self cathing at the moment, but was last week, and don't know if I am past that phase or not yet. It still feels like I have some recovering to do. What I did notice, using "12 catheters instead of "14 catheters was a lot less painful pushing past the prostate. They are a little less stiff, but hurt less going in. I had some I was not able to use before FLA, but after I figured out they were better. Also the Speedicath compacts are size 12 at the end, and probably 14 at the end by your hand. They worked well, and less painful. Just thought I should pass that on.

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    • Posted

      Hi Motoman,

      I misunderstood. I took "hard" to mean as "difficult". But you're saying he meant hard as in texture. So, it was more of an observation than something that affected the procedure? Did Dr. K. give you any pain meds or steriods for pain and swelling?

      I like the 12's as well. I think you're using Coloplast Speedicaths? Are you using a straight or coude tip? Which catheter worked for you pre FLA? If you are able to stop self cathing, probably a good idea to get your PVR checked via bladderscan with your local uro from time to time, unless you want to check it with CIC. I have similar concerns regarding PVR as I haven't self cathed for over two months now and I'd prefer not to check PVR via CIC as I'd prefer not be colonized which happens to me very easily with CIC. 

      -- Jim

       

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    • Posted

      I was given steroids for about 5 days for inflammation. Didn't really take anything for pain, but did take someAleve after the steroids stopped, for inflammation. Also have a prescription for Uribel which I guess calms the Bladder spasms down. I took that for almost two weeks, but can't really tell the difference.

      I was using straight tip 14 Speedicath. Tried the coude, but they irritated either my sphincter or the prostate. I usually ended up bleeding if I used them. And yes, I had the tip pointed up. 

      Yes, I will probably go see my local uro at some point and tell him about my latest procedure. And get a scan.

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    • Posted

      Moto,

      You sound about as happy to see your "local uro" as I am. smile In fact, I'm looking into purchasing a bladder scanner so I don't have to! Did you get steroid shots or were they pills?

      Jim

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    • Posted

      Jim, a Bladder scanner might be easier and cheaper than going to the doc. And with my deductible, I am usually out of pocket anyway. 

      The steroids were pills, Methylprednisolone, and I didn't take all of them.

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    • Posted

      Moto,

      Medicare pays for my doc visits but my own scanner would be more convenient and I wouldn't need to go through an entire exam every time I just want to check my PVR. Also, given my diverticulum and very periodic episodes of AUR, a scanner might serve an educational purpose as well by showing voiding respective voiding volumes. Also, if I could find another hand or two (or an open minded girlfriend) I think I could get a real time image of what happens during an AUR episode. Sort of like a do-it-yourself video urodynamics. One uro suggested he could do similar, but I would have to time it so that I was in AUR in his office which is not as easy as it sounds, especially given his schedule.

      Jim

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    • Posted

      Hi Motoman, same for me. My system seems to prefer straight over coude. I have a false passage, probably created by a uro nurse the first time she stuff a catheter in me, and it was a Speedicath 12fr coude. Now, everytime I use a coude, it keeps going back into that false passage and refuses to go further. In attempts to avoid this false passage and find the way to the bladder, I ended up poking and twisting the coude catheter and the result is prostate irritation (dull pain for hours) and bleeding (for days after every cath). With a Speedicath 12fr straight catheter, I hardly ever have this problem. I know some people we both know that I will not mention by names smile really love the coude, but at least some of us here do have issues with it. Hank

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    • Posted

      Hi jim, are you changing your stance on colonization ? With your earlier posts, I have the impression that colonization is no big deal. Also, what bladder scanner is good ? I saw some on Ebay for around US$500. Hank

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    • Posted

      Hank said:  I know some people we both know that I will not mention by names  [smile]  really love the coude, but at least some of us here do have issues with it.

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

      Hi Hank,

      I can't figure out who you are talking about smile but here's my two cents. If the straight works, great, but "in general" coudes work better for larger, swollen prostates, strictures and false passages. Just try to visualize a curve versus a spear going through the urethra. Which one do you think will go around corners and tight spaces better? Hint: the curved coude will bounce" off of obstructions, while the spear will stick.

      Anyway, the best catheter to use is the one that works best for you. I wish I could use a straight instead of a coude (really like the convenience of the compacts that only come in straights) but 50% of the time I've uses straights, it sticks right into my prostate. Very unpleasant! smile

      Jim

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    • Posted

      Hi Hank,

      Colonization is "no big deal" and it was never a consideration when I self cathed on a daily basis. That said, everything being equal, I'd prefer not be colonized versus colonized.

      So, since the last time I cathed was 3 months ago, I am reluctant to self cath just to check my PVR when I could check it with a bladder scanner. If I needed to self cath because of AUR (which could happen at any time) then I will not give it a second thought.

      But back to your question, colonization is no big deal and should never be treated with antibiotics while you are self cathing unless you are symptomatic. 

      -- Jim

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