Had FLA for BPH done Feb 13

Neil,

We didn't really discuss what might be the cause of the hard tissue. I brought it up here, as thought someone might have a theory or know more about it like you just replied. I will have to look up stromal tissue.

And yes, I am hoping for good results too. I'm not wearing diapers, and I'm not using catheters at the moment, so I would say things are on the right track.

I think that is great.  Glad your improving.  With sex maybe you should try a condom but don't give it up.  Take care  Ken Is is painful or does it feel good.  I know one time had a prostate infection and it hurt but it still felt great  

Thanks for update it gives me hope that it will be good for me too - I think I had mine the day after you - unfortunately I had some kidney issues so had to keep cathter in, took it out a week and a half ago but I wasn't ready, and turns out I had an infection which didn't help. Tomorrow morning God willing I will take out catheter and hopefully it will stay out this time!

It's a bit painful during and after ejaculation, so I think I need to just take it easy, not too often. I don't think John had even tried by this point in his recovery. 

Well hopefully you will not have any further problems. That is a long time with a Foley in, I could barely take a week. So I did self cath in the second week when needed to make sure I was totally empty. 

Good luck

Thank you - indeed a long time plus I had it in one week before the operation! I hope I don't need to self cath - I don't think it's necessary to be completely empty and with all the problems I've had I doubt whether that will be possible at least not for a while.

Maybe you should have waited.  How soon did you have sex after the procedure.  Heal up my friend  Ken

2.5 weeks

Dr said go for it when I wanted to. Actually, it is not any different now at 5 weeks than it was at 2.5 weeks. But I am thinking a little more patience is a good idea. 

With what you had done I waould have waited at least 4 weeks.  Wait a few more weeks and try again.  It will get better in time  Take it easy  Ken 

Mike,

I am just recuperating on my own. I don't have any plans to see my local urologist. I would if I had to. But so far things are going according to plan. 

I am headed out of the country this week for a couple weeks, so hopefully no complications. We timed my procedure so I could do this trip that I had scheduled since last year.

You have a very large prostate. Good luck with whatever you do.

Hey Mike.  What did Dr. K say when you talked to him.  Will he have to another MRI and maping for your prostate.  His he going to stay away from the ejaculatory ducts and seminal vessel so you don't end up with retro.  I talked with my ologist  He told me to tell you good luck with your procedure but he does not want to step on any toes.  He said to talk with you doctor and he can tell you what ones you can go on that would be best for you.  Good luck and let me know whats going on.  Ken

Thanks Roy

I hope your going someplace warm. My timing is being worked around a trip for my wife. She leaves Thursday morning for Puerto Vallarta for over a week with her sisters. When do I get my vacation?

I talked to Dr K this afternoon. We were interrupted so I didn't ask everything. Basically, I am still in the Trial the 5th of April. He limited his study to a max of 200 ml or cc prostate size.. So I made it under the wire. He did concede that I had a very large prostate and very large median lobe. He is very sceptical of my ultrasound measurement a year and a half ago of 108 ml. He said it is very difficult to get an accurate measurement with ultrasound. He took the length x width x height all devided by 2 to get the approximate size. My MRI results were very clear and detailed. They gave me a disc and a very good viewing program to work through the scans. He said this procedure probably will not get rid of my ED. It may help it some, but because i have cardiovascular disease it will not fix that, but may improve some blood flow. He said it should help my ejaculations and the amount of siemen, which should improve the uforia feeling you get from the ejaculation. I asked him about what the size would be after the healing period. He said it will still be large, because the tissue will come from inside and through healing will be smaller, but the bulk will be gone, especially around the urethra and the ejaculation tubes. So everything will be able to work properly.

You were not part of his trial, but did he tell you whether you need to do any follow-up with him?

I talked to him again how most of his patient response has come from this forum and the importance of it to his FLA/BPH business. Sperling has redone his complete website. When you do a Google search for anything about this procedure, Sperlings name comes to the top, even with ads. Look for 3T-MRI, Sperling comes to the top.

Has anyone heard about the Sperling patient that has come onto this site. If so who is it? We need his feedback.

Have a Good Trip

Mike

Mike,

Dr K is following up with me weekly as it is. But I don't have any plans to go see him again, I doubt I will need to anyway.

I am still progressing well, with a little bit of pain. He put me back on steroids for about 5 days to see if things improve. I thought I was fine, but since I am headed out of country, he thought it was better to do it.

I am not headed anywhere warm. Off to Japan, it is still cold there now.

Have a safe trip  Ken

Motoman,

What kind of pain are you having? In prostate or while urinating ?

I'm still not off catheter, tried on Monday but still blocked - could be some sediment or the like was blocking Urethra or maybe I am healing much slower than normal for some reason. Maybe it just didn't work for me, but too early to come to any conclusions so folks reading this don't worry too much I am probably not a normal case.

Michael

Guys, I just found these posts. Yes I am staying very busy but I also think the site is cutting my out of these for some reason as I am getting all the posts on Turp and PAE and PCa but I have gotten NONE of these!!!

I did not even realize the other people who have done FLA. I would and should be here to support your recovery as much as I can help.

Everyone PLEASE accept my apology. I feel so stupid.

John

Hi John,

There seems to be some issue with the notification system. Personally, I've missed several notifications in various threads, especially new ones. 

Just to get you up to speed, the only FLA patients I'm aware of here are you, Motoman and Mike588. MikeSkier is scheduled for the trial. 

Motoman reports he has improved but has been pub back on steriods temporarily for some pain. Mike588 still cannot void without a catheter. 

Last we heard, you were doing very well. Can you update us on your progress. Any pain? Other issues? Also, do you know anyone else who has had the procedure other than those listed?

Jim

Mike,

it it is just a small amount of pain when urinating, and after urination for 20 minutes or so. It is totally bearable. Dr K happened to call me two days ago, and thought I should be past that now. He thought it could be a UTI. But that was ruled out the same day by a test. Then he suggested doing another dose of steroids could help the healing process.

When I explained all the blood after sex, he could tell I am not totally healed. 

He thinks it is a trade off of how much tissue gets taken out, and how long the results will last. More tissue means longer healing process. 

It could be because I started a new thread, not wanting to clog yours. You won't be notified till you participate. I guess I should have kept it in one thread.

You have been most helpful to me. I know of a couple others who have contacted me that are going to get it done. But they can chime in when they are ready.

Roy

Is it like stinging pain or does it hurt inside the body like the prostate ? Compared to the stinging pain I had with UTI and being blocked and related kidney pain it doesn't sound that bad.

Did you ever see "tissue" coming out in urine? I see what looks like tissue - some kind of sediment - coming out in the night bag when I get up in the morning - not much...

Thanks for your reply.

Hey John.  I was just thinking of you.  I like to know how your doing and how is work are you still looking to retire in June.  I hope your doing well.  Alot of men are having FLA done and all so far have been good. I guess there is a trail going on.  Dr. K is taking men with prostate up to 200ml or cc.  That is good news for men today.  To get off FLA  A couple of men I have been talking to have had the rezum procedure done and they took my suggestion on only having the right side done.  To many men were having boths side done and ended up with retro  One was 45 and the other was 52  Both had the right side done with 2 9 second shots.  Worked fine.  It opened up the urethra to help them pee.  Take care  ken

I think it is prostate pain, but not too bad.

Yes, I do get tissue from time to time. And I also recall seeing it in the Foley, which was kind of strange, since that was coming from the Bladder, before the prostate...

Does Dr K think you should stay on The Foley? I have read about a lot of guys in the Rezum thread staying on the Foley a long time. And lots of people giving them advice to self cath instead, so the Bladder can get used to holding urine again. And then the Bladder can relearn how to force it out. 

Thanks again Motoman - I don't understand why urinating would be prostate pain unless you irritated it by having sex too soon.

My Urologist, when I attempted to explain this procedure to him, told me that the dead tissue would come out in the Urine. Dr K said something about white blood cells carrying it off or absorbing the tissue, I'm a bit confused.

Dr K originally said I should be on catheter till next week anyway, then I think he felt sorry for me so said I could try this last Monday. Next Monday I am scared I won't be able to pee at all, but they will also be teaching me how to self cath so I will take their advice as to whether I need the Foley longer or not. I also want to travel in 2 weeks and not looking forward to having a Foley, but I have to make sure I protect my kidneys so I'll do what I'm told. Of course it's possible that after one good pee when it comes out, and at week 6 I might bot even need to self cath. I'm definitely not counting on that.

I might have had sex too soon, and it does seem to aggravate things, so I will wait some more now. But I am pretty sure it is prostate pain.

And having done self cath and had a Foley, I would much rather do self cath than have a Foley in. So much more freedom. I have traveled all over the world doing self cath including on planes. But I absolutely hated having a Foley and didn't feel like leaving the house. JImjames has a long thread on here about it. 

Good luck

Thanks and I hope you heal quickly as well.

I tried to self cath last Monday when I was totally blocked, failed for whatever reason. Jimjames has been amazing and kind giving me lots of pointers, I sent him some private messages.

Mike588, j12080, jimjames, motoman, kenneth1955

High Guys, This is Mike (mikeskier),

Mike, what were the conditions you had before you had the procedure?  You had yours on Feb 14?  Did you have an exceptionally large prostate like mine (176 ml or cc or gr, they are all the same as they are applied)?  Did you have a different procedure done before the FLA?  Did Dr K have any discussions with you prior to your procedure, where he brought up any particular problems with this procedure for you?  What kind of answers is Dr K giving you now as an explanation.  I guess Mike what I am wondering is, did you have a preexisting condition going in that he explained to you before hand and what is he saying now as a answer to what he thinks maybe wrong.  When you talk to some of the other patients, they seem to think that everything went OK.  Most cathed for less than 2 weeks and John, I think for only 4 or 5 days and had no problems.  

My Trial Procedure is April 6 and I just found out that my Prostate is 176 ml, huge compared to what it was 1 1/2 years ago at 108 ml and much larger than the people I have seen on these forums.  I just had my 3T-MRI on the 13th and Dr K has the disc and and the analysis report from it.  I talked to him on Tuesday about this and wanted to know if something could be causing this rapid growth.  His answer was, I am still in the Trial and that he has set the limits to a Max of 200 ml.  Also, he does not believe that with and ultrasound that the urologist could give a very accurate size evaluation.  Ultrasounds usually under measure.  He takes the 3 dimensions readings at the max points from the far more accurate 3T-MRI times each other L x W x H / 2 all divided by 2 to get his answer.  I am getting a little concerned now that we are finally getting data on the FLA procedure, that some of the after effects are similar to what you read about REZUM, but not as serious.  Some of them are still cathing with problems after 6 months and on again off again.  Several have had to go into emergency because they got backed up so bad they could not pee.  This is even after far better times during the healing process.  So, bottomline, both procedures are destroying internal prostate tissue and your body has to get rid of it someway.  The biggest advantage with the FLA/BPH is the Real Time Detail and the Percission of this laser that gets us a Cleaner and Far Better Procedure overall.  I am beginning to think, that it does not matter how you kill the tissue, the body will have to get rid of it anyway it can either by flushing it out or because it is an inflamation have it attacked by white blood cells and emzimes, but it is the percission and accuracy that Dr K can perform his sculpting.  By doing that, I think that the tissue in the FLA process is much smaller and the Doctor can control it the size he leaves it, so that you do not have large partially ablated tissue left to eventually cause future problems until it is all gone and the prostate is healed.  Theoretically there can be partially ablated tissue left behind that is still attached and will just scar over as it heals in a very ugly form that in itself could cause future problems.  One of my worries, because my Prostate is so large and the doctor said that he would be removing a lot of tissue, this becomes one of my concerns.  He could not tell me exactly how it will end up because of it's size, some smaller on the outside, but the tissue volume could be 30% to 40% less, very subjective.  John's prostate was 125 ml and he had conviced us that this was big until I saw the results of the size of mine about 30% larger.  I asked the doctor about this and he said mine will always be larger but the excess tissues causing my problems will be removed from the inside.  I asked this because in the future we will all go back to our urologist for exams etc.... We he does a digital exam and tells me how huge my prostate is, I needed something in writing to explain that really it is only big on the outside that he can feel, but inside the huge bulk tissue is gone.  So I am going to get some information from Dr K that explains exactly what my situation is and what tests maybe different results for me.  

I am asking for feedback guys, I am not trying to play doctor.  The body is the most complex machine ever built, but it functions in some of the most simplistic and logical ways, like flushing this tissue from our systems.  I guess that is the Engineer in me, way to logical.  I am concerned due to the amout of tissues that my body will have to get rid of and will I be cathing for months down the road?  I also talked to him about my ED.  He said it may improve some, but this procedure will not fix it.  I do have some cardiovascular disease, which is the largest contributor to ED.  Medication (Viagra, Cialis, Lavetra, etc), diet and exercise will help more.  Also, I talked about ejaculation and the amount.  Many of you guys do not realize that the uforic fealing that you get when you do ejaculate has to do with the amount that you were use to ejaculating when you were younger.  I wanted to know if this lack of ejaculate that I have been gradually experiencing over the last 8 years or so would get better.  He did say that this could be a lot better.  I mean just getting erection to have sex is not the best part of it, it is what you are trying to achieve, the Big O.  That gives you the feelings and of course how well you make your partner fell as well.   

Also, I saw and read someplace on one of these prostate forums, that there is a Sperling patient mentioned or is part of one of these forums.  It woudl be very interesting to chat with him and find out more about this procedure from someone elses perspective.  Let me know who he is and get him going.  As far as I know there are currently only these 2 doctors doing this work in the country right now.  

Mike       

Mike,

Yes Feb 14th.

I was almost in retention - bladder is thickened and tribeculated. So when I had operation I was already on a catheter for a week.

Dr K saw my previous MRI from when I did PAE - he showed me how they embolized some prostate but not the right part and the prostate was still very big - I don't know size, I'm guessing 115 - 125. he said he did not see any reason it would not work, and in any case he would never accept a patient if he didn't think he will get results. His explanation is that in my case I might be taking longer to heal because of previous condition - also I had a UTI, could be Urethra is blocked, so many possibilities. There is no guarantee it will work, he told me that from the start but he is still hopeful as am I. Remember before operation I already could not pee properly, after 3 weeks people only get back to break even point. It makes sense even though I am terribly frustrated - but you know what I kind of got used to the catheter and rather that than go through a lot of pain.

I gather you are interested in FLA because you don't want retro. My Urologist was amazed because he said it's not just ejaculatory ducts, it's the way the bladder sphincter shuts after surgery, usually after most surgeries it can't shut like it used to when you have an orgasm and the semen goes backwards to least path of resistance. Dr K says 1-3% chance of retro because he does not blow away too much of the prostate with his precise surgery. So it can shut normally. I believe this is why Rezum is not as good, harder for them to be accurate, the main aim is to take out enough to enable you to pee right?

So I would say if Dr K says he can do it believe him, because the other choice is TURP or Green Light and the like - they will almost guarantee retro, and I don't know enough about REZUM, sounds scary, my father in law tried Urolift and it didn't work, with your prostate it's probably not even an option. Also if your prostate grew so quickly I'd want someone like Dr K to have a good look at it in MRI he might find something no one else will find and take it out as a bonus.

PAE might be an option, but it seems it's hit or miss and a lot of money to spend if it doesn't work - on the other hand no catheter and pain for just one week at the beginning.

Regards,

Michael

Hi Ken 

I am sending out a mass report of where I am at to some of the great guys that I have been chating with.  

I talked to Dr K on Tuesday and I had some questions, especially about my 176 ml or cc or gr prostate.  I talked about that in the attachment at the end of this.  He is going to stay away from the seminal ducts and the ejaculatory ducts.  He does not se any problems even though mine is exceptionally large with a very large median lobe.  John's was 125 cc and that was large, but mine is 30% larger.  So I was concerned.  I am not a small guy, 6' 3" and 240, so that is not that unusuall he said.  We got interupted so he did not tell me about his feelings that mine might grow back  due to the amount of growth in just 1 1/2 years,  He said that most likely my prostate was actually larger than 108 ml, because it was evaluated by ultrasound.  They usually way underestimate the size.  He goes through the 3T-MRI and clearly picks out the Max length x width x height and divides by 2 to get his answer.   ED, he can not do much about, diet, exercise and medication will do more.  Ejaculation, amount and pressure should improve quite a bit and that is important, because that is the uforic feeling you get when you have the Big O.  I am sure my urologist will want to get ahold of me after this procedure, so that he can either say I told you so, or you need a script for that and that.  

Thanks for the feedback.  I will keep all informed.

Mike

 Mike588, j12080, jimjames, motoman, kenneth1955

High Guys, This is Mike (mikeskier),

Mike, what were the conditions you had before you had the procedure?  You had yours on Feb 14?  Did you have an exceptionally large prostate like mine (176 ml or cc or gr, they are all the same as they are applied)?  Did you have a different procedure done before the FLA?  Did Dr K have any discussions with you prior to your procedure, where he brought up any particular problems with this procedure for you?  What kind of answers is Dr K giving you now as an explanation.  I guess Mike what I am wondering is, did you have a preexisting condition going in that he explained to you before hand and what is he saying now as a answer to what he thinks maybe wrong.  When you talk to some of the other patients, they seem to think that everything went OK.  Most cathed for less than 2 weeks and John, I think for only 4 or 5 days and had no problems.  

My Trial Procedure is April 6 and I just found out that my Prostate is 176 ml, huge compared to what it was 1 1/2 years ago at 108 ml and much larger than the people I have seen on these forums.  I just had my 3T-MRI on the 13th and Dr K has the disc and and the analysis report from it.  I talked to him on Tuesday about this and wanted to know if something could be causing this rapid growth.  His answer was, I am still in the Trial and that he has set the limits to a Max of 200 ml.  Also, he does not believe that with and ultrasound that the urologist could give a very accurate size evaluation.  Ultrasounds usually under measure.  He takes the 3 dimensions readings at the max points from the far more accurate 3T-MRI times each other L x W x H / 2 all divided by 2 to get his answer.  I am getting a little concerned now that we are finally getting data on the FLA procedure, that some of the after effects are similar to what you read about REZUM, but not as serious.  Some of them are still cathing with problems after 6 months and on again off again.  Several have had to go into emergency because they got backed up so bad they could not pee.  This is even after far better times during the healing process.  So, bottomline, both procedures are destroying internal prostate tissue and your body has to get rid of it someway.  The biggest advantage with the FLA/BPH is the Real Time Detail and the Percission of this laser that gets us a Cleaner and Far Better Procedure overall.  I am beginning to think, that it does not matter how you kill the tissue, the body will have to get rid of it anyway it can either by flushing it out or because it is an inflamation have it attacked by white blood cells and emzimes, but it is the percission and accuracy that Dr K can perform his sculpting.  By doing that, I think that the tissue in the FLA process is much smaller and the Doctor can control it the size he leaves it, so that you do not have large partially ablated tissue left to eventually cause future problems until it is all gone and the prostate is healed.  Theoretically there can be partially ablated tissue left behind that is still attached and will just scar over as it heals in a very ugly form that in itself could cause future problems.  One of my worries, because my Prostate is so large and the doctor said that he would be removing a lot of tissue, this becomes one of my concerns.  He could not tell me exactly how it will end up because of it's size, some smaller on the outside, but the tissue volume could be 30% to 40% less, very subjective.  John's prostate was 125 ml and he had conviced us that this was big until I saw the results of the size of mine about 30% larger.  I asked the doctor about this and he said mine will always be larger but the excess tissues causing my problems will be removed from the inside.  I asked this because in the future we will all go back to our urologist for exams etc.... We he does a digital exam and tells me how huge my prostate is, I needed something in writing to explain that really it is only big on the outside that he can feel, but inside the huge bulk tissue is gone.  So I am going to get some information from Dr K that explains exactly what my situation is and what tests maybe different results for me.  

I am asking for feedback guys, I am not trying to play doctor.  The body is the most complex machine ever built, but it functions in some of the most simplistic and logical ways, like flushing this tissue from our systems.  I guess that is the Engineer in me, way to logical.  I am concerned due to the amout of tissues that my body will have to get rid of and will I be cathing for months down the road?  I also talked to him about my ED.  He said it may improve some, but this procedure will not fix it.  I do have some cardiovascular disease, which is the largest contributor to ED.  Medication (Viagra, Cialis, Lavetra, etc), diet and exercise will help more.  Also, I talked about ejaculation and the amount.  Many of you guys do not realize that the uforic fealing that you get when you do ejaculate has to do with the amount that you were use to ejaculating when you were younger.  I wanted to know if this lack of ejaculate that I have been gradually experiencing over the last 8 years or so would get better.  He did say that this could be a lot better.  I mean just getting erection to have sex is not the best part of it, it is what you are trying to achieve, the Big O.  That gives you the feelings and of course how well you make your partner fell as well.   

Also, I saw and read someplace on one of these prostate forums, that there is a Sperling patient mentioned or is part of one of these forums.  It woudl be very interesting to chat with him and find out more about this procedure from someone elses perspective.  Let me know who he is and get him going.  As far as I know there are currently only these 2 doctors doing this work in the country right now.  

Mike         

Hi Mike,

I was interested in FLA when I first read about it probably something related to Sterling. When John posted his experience with Dr. K., I became very excited. I liked the idea of a precision MRI guided reduction with no chance of retro.

But since you are calling out for feedback, I have to say that regardless of John's result and persuasive posts, I think it's still too early to call it any sort of magic bullet.

We have only had three reported cases here. John's went very well. Motoman's apparently went well, but given the fact that he is back on steroids for pain, I think it's still to early to make a call. And Mike588 is still in retention and on a catheter. 

As to Mike588, I don't think his situation going in was really that bad. Many of us have trabeculated and stretched bladders or we wouldn't be in this situation to start with. 

As to your case, your prostate probably puts you in the more difficult group as oppose to John. 

I'm not saying go ahead or not. Just that IMO there is not enough patient data to go by. In every other procedure, we all give the advice to wait until the doc has done at least 100 procedures. Why not here a well? Especially since there are only a handful of docs doing it so that the overall database is relatvely small. 

Some have answered that Dr. K. has done well over 100 FLA's for prostate cancer.  I argue that may be different since different amounts of prostatic tissue are being removed and that different results are being sought. 

I don't want to seem negatve on FLA, but if it were me personally, and I could wait a bit, I would wait until more patient data came in. Or at the very least until we hear a little more down the road progress on Mike, Motoman, and the trial participants.

And then there's Dr. Sperling. Apparently, unlike Dr. K., he has done many of these. It would be great if we could get some patient feedback on his patients as well.

Jim

Yes Jim it seems I have missed a lot and I don"t want to be guilty of getting my relief and then disappearing.

I am doing very well. I dont see anymore improvement comming though Dr. K says it will. My question is how could it get better? I am very pleased. I wish my stream would get to the flow of a 20 year old so I could write on the wall but it will not. I am 66 and I have to understand that. The sex is as good as ever. I did get a PSA and it is even higher than before the FLA. But I am positive I do not have Cancer. I did have sex the day before the PSA because I was unaware that my Cardiologist was goint to order a PSA when he did my blood lipid test. other than that, no pain, no discomfort. I do still get up 3 times a night now BUT it is not to pee. It is because I have a bad pinched nerve in my neck and it hurts so bad it wakes me up. Then when I awake and can finally  move, I think about peeing and I always get up an do it so I can go back to sleep. I pee about 400 cc each time I get up. I think that is wonderful. I am now trying to get rid of the neck issue and I think I have it on the run going my way. I did see where Motoman had the blood after sex. I was warned about that and told if it happened it was normal. It scared me so I waited almost 6 weeks to have sex. Regardless of what my wife and my screaming erection were saying to me. I held out because I was scared of the still injured prostate having orgasmic spasms. It did not make sense to do that to me even though Dr. Karamanian told me it wouild be ok and to go ahead I said. NO. When I could hold out no longer, I was surprized to see no blood and have not had any since.

Now I just worry about how long it will last? I am hoping for 10 years and then maybe there will be something else that really cures BPH instead of the symptoms.

I am now glad I found this site and I will help anyone I can with my experience if the need it.

John

Did you see I replied? Easy to do on this site, on my computer the screen moves up and down for some reason making it hard to find the message I'm looking for.

 I am in the trial. Procedure scheduled for 4/28.

Hi John

Thought you dropped off the planet after feeling so good.  Or too much golf.  

I have missed out on some forum feedbacks as well.  You only have a couple months and you will BE RETIRED!  

First of all.  at the end of this chat I am attaching my response to several other of the guys that we communicate with.  So don't take it wrong.  It is an easy way of letting everyone know.  

I just talked to Dr K Tuesday to go over my 3T-MRI and analysis report.  I think I told you that it showed that I will have the Biggest Prostate in Texas, 176 ml, cc, or gr, take your pick they are all the same.  I am sorry John, but my prostate is 30% larger than yours.  This was my concern when I talked to him.  If you remember, 1 1/2 years ago they did and ultrasound and said it was 108 ml then.  Now, in a short time it has grown like a weed out of control, about 40% in size.  First of all, he said from my med records that the 108 done with ultrasound is probably way underestimated.  So it most likely has not grown that much, but a lot since then.  I was just getting into what could cause this growth and because something is driving it, will I be worrying about regrowth after the procedure?  We got interruped and that is where that stayed for later.  He said my ED might be improved some, but not a lot.  Diet, exercise and medications for that, being that I do have cardiovascular disease.  Ejaculation should improve quite a bit.  That is important, because that is where the Big O uforic feeling comes from, based on volume that you remember when you were younger and pressure.  So that is quite important to me, especially if I will not have the thrill of spontaneous erections to get me going.   

I am a little concerned now that there are some results out there on this procedure.  Ablated tissue, or vapor hydration or whatever you want to call it.  This procedure is starting to have some of the similar, but not nearly as extreme as REZUM, the cathing problems and being able to void urine at times.  I followed the REZUM forums quite a bit and still do, the problems of urinating come and go, even over 6 months plus in time.  Both procedures are killing prostate tissue.  The FLA is sculpted much more precisely,but bottom line is that both procedure are destroying tissue inside the prostate and the body has got to get rid of it how ever it can, either flushing it out or letting the white blood cells attack it because it has become and inflamation, so the body tries to kill of get rid of it.  I think the reasons that the post op problems are similar is because to the amount and size of the tissue that needs to be expelled.  I know that FLA is a much cleaner procedure and probably smaller particles to eliminate.  That is why I think the degree of this problem is greater for the REZUM.  I need to ask Dr K about this, because it is important, especially the healing process.  When he ablates Cancer Tissue, does he totally try to vaporize it so there is no remains left?  You would not want cancer to be freed up and spread somewhere else.  John, you had a large prostate, what did he tell you about the expulsion of the waste tissue?  I am hearing different answers to that.  Other than what I said above.  He did tell me that there will be a lot of tissue removed in my case, so is it done in large chunks to make the procedure faster, or small areas at a time?  I am picturing that with REZUM that there could be large pieces still attached, because they can not see what they are doing and that could just get scared over and stay there permanently.  Right now you seem to be the only patiet that has not had cathing issues after the procedure or urination issues.  You have had lots of conversations with him, did you get into much of the post procedure issues that you could possibly expect?   

Mike588, j12080, jimjames, motoman, kenneth1955

High Guys, This is Mike (mikeskier),

Mike, what were the conditions you had before you had the procedure?  You had yours on Feb 14?  Did you have an exceptionally large prostate like mine (176 ml or cc or gr, they are all the same as they are applied)?  Did you have a different procedure done before the FLA?  Did Dr K have any discussions with you prior to your procedure, where he brought up any particular problems with this procedure for you?  What kind of answers is Dr K giving you now as an explanation.  I guess Mike what I am wondering is, did you have a preexisting condition going in that he explained to you before hand and what is he saying now as a answer to what he thinks maybe wrong.  When you talk to some of the other patients, they seem to think that everything went OK.  Most cathed for less than 2 weeks and John, I think for only 4 or 5 days and had no problems.  

My Trial Procedure is April 6 and I just found out that my Prostate is 176 ml, huge compared to what it was 1 1/2 years ago at 108 ml and much larger than the people I have seen on these forums.  I just had my 3T-MRI on the 13th and Dr K has the disc and and the analysis report from it.  I talked to him on Tuesday about this and wanted to know if something could be causing this rapid growth.  His answer was, I am still in the Trial and that he has set the limits to a Max of 200 ml.  Also, he does not believe that with and ultrasound that the urologist could give a very accurate size evaluation.  Ultrasounds usually under measure.  He takes the 3 dimensions readings at the max points from the far more accurate 3T-MRI times each other L x W x H / 2 all divided by 2 to get his answer.  I am getting a little concerned now that we are finally getting data on the FLA procedure, that some of the after effects are similar to what you read about REZUM, but not as serious.  Some of them are still cathing with problems after 6 months and on again off again.  Several have had to go into emergency because they got backed up so bad they could not pee.  This is even after far better times during the healing process.  So, bottomline, both procedures are destroying internal prostate tissue and your body has to get rid of it someway.  The biggest advantage with the FLA/BPH is the Real Time Detail and the Percission of this laser that gets us a Cleaner and Far Better Procedure overall.  I am beginning to think, that it does not matter how you kill the tissue, the body will have to get rid of it anyway it can either by flushing it out or because it is an inflamation have it attacked by white blood cells and emzimes, but it is the percission and accuracy that Dr K can perform his sculpting.  By doing that, I think that the tissue in the FLA process is much smaller and the Doctor can control it the size he leaves it, so that you do not have large partially ablated tissue left to eventually cause future problems until it is all gone and the prostate is healed.  Theoretically there can be partially ablated tissue left behind that is still attached and will just scar over as it heals in a very ugly form that in itself could cause future problems.  One of my worries, because my Prostate is so large and the doctor said that he would be removing a lot of tissue, this becomes one of my concerns.  He could not tell me exactly how it will end up because of it's size, some smaller on the outside, but the tissue volume could be 30% to 40% less, very subjective.  John's prostate was 125 ml and he had conviced us that this was big until I saw the results of the size of mine about 30% larger.  I asked the doctor about this and he said mine will always be larger but the excess tissues causing my problems will be removed from the inside.  I asked this because in the future we will all go back to our urologist for exams etc.... We he does a digital exam and tells me how huge my prostate is, I needed something in writing to explain that really it is only big on the outside that he can feel, but inside the huge bulk tissue is gone.  So I am going to get some information from Dr K that explains exactly what my situation is and what tests maybe different results for me.  

I am asking for feedback guys, I am not trying to play doctor.  The body is the most complex machine ever built, but it functions in some of the most simplistic and logical ways, like flushing this tissue from our systems.  I guess that is the Engineer in me, way to logical.  I am concerned due to the amout of tissues that my body will have to get rid of and will I be cathing for months down the road?  I also talked to him about my ED.  He said it may improve some, but this procedure will not fix it.  I do have some cardiovascular disease, which is the largest contributor to ED.  Medication (Viagra, Cialis, Lavetra, etc), diet and exercise will help more.  Also, I talked about ejaculation and the amount.  Many of you guys do not realize that the uforic fealing that you get when you do ejaculate has to do with the amount that you were use to ejaculating when you were younger.  I wanted to know if this lack of ejaculate that I have been gradually experiencing over the last 8 years or so would get better.  He did say that this could be a lot better.  I mean just getting erection to have sex is not the best part of it, it is what you are trying to achieve, the Big O.  That gives you the feelings and of course how well you make your partner fell as well.   

Also, I saw and read someplace on one of these prostate forums, that there is a Sperling patient mentioned or is part of one of these forums.  It woudl be very interesting to chat with him and find out more about this procedure from someone elses perspective.  Let me know who he is and get him going.  As far as I know there are currently only these 2 doctors doing this work in the country right now.  

Mike          

Jim, Let me add on Sperling. I do not believe them in their claim of doing al the FLA's they say. Just like they say you can leave the procedure without a cath. No way. Ask anyone who has done this procedure and they will tell you . I tried for 5 months to get a list of patients they had done FLA on and I did not expect I would get a bad one. but they claimed they had over 100 people and they could not give me ONE. I call twice a week every week until it was upseting them. They used every excuse. I would have gone with them if they had done this. Thank God they did not produce as Dr. Karamanian was and is a very special person and doctor. I think anyone who has used him will tell you this about him. His post procedrue care is above any thing we expect. I was scared the whole time and if he would not have been there for me after the procedure, I dont know what I would have done. I also know that Sperling is not this way. I do know both Walser and Karamanian are wonderful.

Maybe someone will speak up for Sperling as he claims over 1000 cases now with Prostates but we will see. So far I can not find one and I wanted 5 cases.

Hi Jim

I did not mean to interupt.  Just adding my feedback and am copying some of the guys at the same time.  

Oh, have you heard about there might be a person on this forum that had the procedure from Sperling?  It would be excellent if we could bring him into our discussions to get another view point.  If you know, get his pin so we can contact him.  He has to be the rareist person out there.  80 to 100 procedures done and we can't find a single patient to respond.  

I can hit on a couple topics that will be repeated at the end.

My Prostate broke the Record on this forum anyway.  John's was 125 ml and mine is 176 ml, cc, gr, all the same.  I talked to Dr K on Tuesday, but he thinks my growth rate maybe exaggerated.  about 1 1/2 years ago I had an ultrasound and my prostate was 108 ml then.  so in theory, it has grown 40% in that amount of time.  I did not get to finish our talk because he got a call.  He thinks that with ultrasound that you get heavily underestimated results.  My concern is the amount of tissue that will be removed from inside the prostate, and the evacuation of that tissue, because it will be a lot.  Dr K said I still qualify for the Trial, because he put a limit of 200 ml on the Trial.  I am starting to see a correlation between the REZUM procedure and FLA.  Both are destroying lots of tissue on the inside of the prostate.  It has to go somewhere, either it gets flushed out or is attacked by white blood cells because it is an inflamation that needs to be fixed.  I am also wondering if he treats this procedure differently than his cancer patients.  Does he try to totally ablate and disintergrate all the tissue with cancer, so that there is no chance for it reattaching somewhere else if not killed.  There are urinating and cathing issues starting to show up now that there are a few patients that have had FLA.  The complaints are similar, with not being able to urinate or problems doing so.  REZUM is filled with these issues and it pops back up after they have started feeling better, then all of a sudden they have a blockage and off to emergency.  In this process they can not see very well what they are doing or they are limited to the control of this procedure.  Therefore a distinct advantage for the FLA, but it still exists there too.

Dr K said he will not be able to fix my ED, maybe improve it.  Diet, exercise and medication for that.  I do have a cardiovasclar problem that is the biggest contributor.  My ejaculation volume, pressure and sensation, should be greatly improved.  That is very important because it is your Big O.  

I see we have John back online again now.  He was not getting notifications.       

Mike588, j12080, jimjames, motoman, kenneth1955

High Guys, This is Mike (mikeskier),

Mike, what were the conditions you had before you had the procedure?  You had yours on Feb 14?  Did you have an exceptionally large prostate like mine (176 ml or cc or gr, they are all the same as they are applied)?  Did you have a different procedure done before the FLA?  Did Dr K have any discussions with you prior to your procedure, where he brought up any particular problems with this procedure for you?  What kind of answers is Dr K giving you now as an explanation.  I guess Mike what I am wondering is, did you have a preexisting condition going in that he explained to you before hand and what is he saying now as a answer to what he thinks maybe wrong.  When you talk to some of the other patients, they seem to think that everything went OK.  Most cathed for less than 2 weeks and John, I think for only 4 or 5 days and had no problems.  

My Trial Procedure is April 6 and I just found out that my Prostate is 176 ml, huge compared to what it was 1 1/2 years ago at 108 ml and much larger than the people I have seen on these forums.  I just had my 3T-MRI on the 13th and Dr K has the disc and and the analysis report from it.  I talked to him on Tuesday about this and wanted to know if something could be causing this rapid growth.  His answer was, I am still in the Trial and that he has set the limits to a Max of 200 ml.  Also, he does not believe that with and ultrasound that the urologist could give a very accurate size evaluation.  Ultrasounds usually under measure.  He takes the 3 dimensions readings at the max points from the far more accurate 3T-MRI times each other L x W x H / 2 all divided by 2 to get his answer.  I am getting a little concerned now that we are finally getting data on the FLA procedure, that some of the after effects are similar to what you read about REZUM, but not as serious.  Some of them are still cathing with problems after 6 months and on again off again.  Several have had to go into emergency because they got backed up so bad they could not pee.  This is even after far better times during the healing process.  So, bottomline, both procedures are destroying internal prostate tissue and your body has to get rid of it someway.  The biggest advantage with the FLA/BPH is the Real Time Detail and the Percission of this laser that gets us a Cleaner and Far Better Procedure overall.  I am beginning to think, that it does not matter how you kill the tissue, the body will have to get rid of it anyway it can either by flushing it out or because it is an inflamation have it attacked by white blood cells and emzimes, but it is the percission and accuracy that Dr K can perform his sculpting.  By doing that, I think that the tissue in the FLA process is much smaller and the Doctor can control it the size he leaves it, so that you do not have large partially ablated tissue left to eventually cause future problems until it is all gone and the prostate is healed.  Theoretically there can be partially ablated tissue left behind that is still attached and will just scar over as it heals in a very ugly form that in itself could cause future problems.  One of my worries, because my Prostate is so large and the doctor said that he would be removing a lot of tissue, this becomes one of my concerns.  He could not tell me exactly how it will end up because of it's size, some smaller on the outside, but the tissue volume could be 30% to 40% less, very subjective.  John's prostate was 125 ml and he had conviced us that this was big until I saw the results of the size of mine about 30% larger.  I asked the doctor about this and he said mine will always be larger but the excess tissues causing my problems will be removed from the inside.  I asked this because in the future we will all go back to our urologist for exams etc.... We he does a digital exam and tells me how huge my prostate is, I needed something in writing to explain that really it is only big on the outside that he can feel, but inside the huge bulk tissue is gone.  So I am going to get some information from Dr K that explains exactly what my situation is and what tests maybe different results for me.  

I am asking for feedback guys, I am not trying to play doctor.  The body is the most complex machine ever built, but it functions in some of the most simplistic and logical ways, like flushing this tissue from our systems.  I guess that is the Engineer in me, way to logical.  I am concerned due to the amout of tissues that my body will have to get rid of and will I be cathing for months down the road?  I also talked to him about my ED.  He said it may improve some, but this procedure will not fix it.  I do have some cardiovascular disease, which is the largest contributor to ED.  Medication (Viagra, Cialis, Lavetra, etc), diet and exercise will help more.  Also, I talked about ejaculation and the amount.  Many of you guys do not realize that the uforic fealing that you get when you do ejaculate has to do with the amount that you were use to ejaculating when you were younger.  I wanted to know if this lack of ejaculate that I have been gradually experiencing over the last 8 years or so would get better.  He did say that this could be a lot better.  I mean just getting erection to have sex is not the best part of it, it is what you are trying to achieve, the Big O.  That gives you the feelings and of course how well you make your partner fell as well.   

Also, I saw and read someplace on one of these prostate forums, that there is a Sperling patient mentioned or is part of one of these forums.  It woudl be very interesting to chat with him and find out more about this procedure from someone elses perspective.  Let me know who he is and get him going.  As far as I know there are currently only these 2 doctors doing this work in the country right now.  

Mike       

You have to figure one of the reasons Sperling didn't give you names is do to HIPAA and patient cofidentiality. That said I contacted Sperling a while back with some very basic questions that would have one sentence answers. I never heard anything from him. There is another website were they do praise Sperling but its for prostate cancer treatment. 

I know what you mean with trying follow posts on this site. Due to computer problems I have been ( trying to ) post from my phone for a couple of weeks now. I think the ads keep bouncing the screen up and down. What a PITA

yes I noticed it works better on my Iphone for some reason

My android phone is not compatable with this site at all. Hopefully I've straightened out my computer.

Hi Mike

No, I haven't seen the Sperling guy here, but you would think with all the procedures he has done that one would show up...

I'm just speculating on this, but I'm thinking that FLA for prostate cancer often just removes a very little spot, ie where the cancer is. FLA for BPH, on the other hand, potentially removes a lot more because the aim here is remove obstruction. If this is so, then it supports my contention that we have very little track record on FLA for BPH to go by at this time.

Jim

Hi John,

Points well made. As I mentioned to Mike, you would think that with all the cases Sperling has done, that a few would surface here or on other forums. Still, maybe someone(s) will surface.

But in any event, this if anything just raises concerns about FLA for BPH in general, the primary concern being so few cases to report on. In your case, the result was excellent, but too early IMO to tell with both Motoman and Mike. Y

ou should be commended as being a pioneer, but that still doesn't contradict the advice many have given here which is to ideally wait until a doctor has perfomed at least 100 procedures. And even more so in this case, because so far all the public data seems to be coming just from one doctor.

Jim

Thanks Mike for the clarafication.  You definetely have been through a lot considering you thought you took the best procedure for your condition.  Like I said, I was going to have Bagla do my PAE, but then I met John on this site and with him going through the FLA procedure after going down a similar path to decide what he was going to do.  I have decided on the FLA, but with Karamanian and not Sperling, who I had conversations with their group as well,but no data after all the claims of 80 to 100 BPH procedures done already.  You had your PAE done at UNC didn't you?  Dr Isaccson?  That group has not produced the same results as Dr Bagla.   That does not mean much now because you have done it.  So, what did the doctor that did the procedure have to say?  I can not believe that your IR did not have a solution for your problem.  I know several people that I ran into have had repeat PAE's.  I have a condition in my body that relates to PAE.  I have PAD, peripheral artery disease.  The only thing that has saved me is that I played competive sports all my life.  I think my dad had the same condition.  From my knees down on both legs, there is suppose to be 3 big arteries that split and carry the blood for the whole lower leg.  Well, mine do not have blood running through them.  Apparently my body has made all of these collateral arteries to feed blood to my legs.  (your body fights to survive and when you are putting a huge demand on your legs like I was doing, your body finds a way to get food and blood to the starving part, so it makes new smaller arteries and they keep spreading to meat the need).  I did not know about this until I had bypass surgery 4 years ago.  I am now seeing one of the top vascular surgeons in the country every 6 months to monitor it.  If something happens there, I am in line for the latest technique that is out to fix it.  This is what my vascular doctor is doing at the University of Michigan, are actually growing arteries right now and cloning them and using human growth hormones, but are only strong enough to be veins right now.  Most people that have this by the time they are 60 have had at least a partial leg apputation if not both by then.  I had my left foot smashed back in the 80's and the fantastic surgeon that put it back together did not tell me about it then when I could of had stints put in my legs and I would not have this condition.  Of all people he should have seen the condition.   Anyway, what I am trying to tell you is that the body, if you block off an artery and there is a demand for that blood, it could very easily make collateral arteries around this blockage that they do with PAE.  I wanted the best procedure possible.  That is why I spent so much time researching it.  I came up with urolift, iTind as temporary procedures to get me through until something like PAE would be approved by the FDA and the Insurance Ind.  Then Permanent solution was to be PAE, but after approval or as an option FLA/BPH.  At that time I only knew about Dr Sperling.  My contacts with him did not produce any contact with all of these 80 to 100 procedures he had done.  He wanted $22k up front plus.  There was a list of aditional expenses that you might be obligated for as well.  Then I got to the point I could not put this off any longer until I met John on this forum that had went the same path that I had for over 3 years.  I was following PAE when the first IR performed it in Portugal, then to Sau Paulo Brazil.  I almost went down there because I have a lot of business friends there and they could make all the connections for me.  

Mike, lets stay in touch,  if you want I will PM you with my contact information.  I have quite a few others on this site, because we were getting monitored and deleted too many times using this format.

Good Luck Mike and I will keep you posted.

Mike

Jim,

I respectfully disagree - the only reason they started doing FLA is because they noticed it cured BPH - I assume in cases where they had to ablate tissue that was cancerous and also happened to be right around the urethra.

If it were just a little spot how did the Cancer patients improve ?

Yeh it would be great to have 1000 BPH patients to give us better data, but it has to start somewhere. John was the courageous one and worked out nicely for him :-)

Mike,  The method of tissue removal is the same as HoLEP and GreenLight...a laser.  The laser method has been used for years with good results.  Dr. K uses a less intense laser, Real Time MRI guidance and access through the rectum.  The end result is prostate tissue removal with much more precision.  (ie avoiding vital ducts). You have to realize the recovery is going to vary from person to person but there is going to be some amount of recovery.  My hope is less down time and zero effect on erections or orgasams.  But I have resigned myself to the fact that recovery may take time and cathethers will be involved.  I have also resigned my self to the fact that prostate tissue removal, no matter how it's accomplished, is a risk.

OK sure PM me any time :-)

No I had PAE in Australia, the surgeons there told me they had 100% success rate I must be unlucky, yeh blood maybe rerouted somehow because like you I am sporty and have good clean arteries apparently.

good luck sir. with Holep and Green light I thought they kind of suck out the tissue that is ablated, not sure though. Must be riskier all round.

Mike,

I am aware of how it came about, but my understanding is that it sometimes helped, sometimes it didn't, and I still don't think it's apples and apples in terms of making a decision. 

I agree John was the courageous one, and it worked out well. 

Yes, it does have to "start somewhere" and that is the dilemma early adaptors and trial participants face. I just feel it important, not just for you, but for others to point out that there can be a big difference between early adapter and even trial data, and what actually follows. 

As long that is factored in, I don't think there is a right or wrong decision.

Jim

I am in Dr. K's trial.

 

I went to visit Sperling. I was asked to pay him $250 CASH Only for the 45 discussion. DR Karamanian stayed after his office closed for 2 more hours and met with me and my wife for a total of 3 hours that day. He would not take any payment to do this. He showed us everything including putting my MRI on screen and discussing what he would remove and how. He did also show us two cancer cases and it was clear the removal spots are both small aND large and vary. Remember, they also take out a margin of good tissue just to be safe. He showed us a very complicated case where he removed one tumor that completely encircled a patient's urethra all the way around. He showed us how he accurately removed the tumor and never touched the urethra. That was a large turmor. But, the point is they can be very accurate with the removal. You should call Dr. K and discuss your theory with him. He would love it.

John,

I don't doubt Dr. K. is a wonderful doctor for the reasons you mention.

My "theory" is really not a theory but more or less common wisdom in the surgical/procedural marketplace.  And that is that the more patient data we have, the better decisions can be made. That's why trials are called "trials". I don't think Dr. K., or any doctor disputes this.

Again, I admire and respect anyone being an early adapter or trial participant, just want to point out that there are plusses and minuses with that approach, and no right or wrongs. 

And to be clear, I am certainly not recommending Dr. Sperling over Dr. K. My point was simply that since Sperling reportedly has done more FLA's for BPH, then he should be considered. 

In the whole scheme of things, the $250 consultation fee does not seem like a deal breaker, just a different way of running a practice. On the other hand, if no patient data is available from him, then that is an altogether different story, and just furthers my concerns that we don't have as much data on FLA for BPH as we would like. 

BTW if I needed a bph procedure, and fortunately I don't at this time, Dr. K. would be one of the first calls I would make. It's just that I would wait until after the trial when more specific patient data is available. 

Jim

I agree if you have the luxury to wait and watch by all means do it. But I could not. I was at the of my rope. I peed my pants 3 times a day, I got up to pee 8 times a night. I planned my existence around where bathrooms would by located. I hated my life. Now i am normal. Yes, the inflamation is different for each person son who does the procedure and the coagulated tissue leaves the body at a different pace for each of us. My recovery had its ups and downs. Yes the cath came out by me after 6 days but for a week and a half I had urgenCy and only peed 75 to 150 ml but then it got better slowly. Then 4 weeks out bam! It got really good over one weekend. My recovery wasn't perfect but it was worth it now.

Mike

Trustme is scheduled for FLA with Dr K on April 28th. So he will be part of the Trial. I will ask the doctor the next time I talk to him about the tissue removal. The laser , I believe Burns away most of the tissue, but there is still residue and excess tissue that dies after the procedure that has to bee absorbed or ejected out of the body through the urethra. Like I was saying earlier somewhere, that this procedure has been used for over 4 years for cancer. You don'want to leave any cancerous tissue alive or dead. The chemical and genetic material maybe alive enough to find a place in the body to start all over again. So if they use the same precautions on the BPH procedure, we should be pretty assured that there is minimal tissue , if any is left. behind. it is a good question for the doctor. When I talked to him, he said he is very busy with the prostate cancer procedures. Every one of those is practice for the BPH. If he is.doing 3 to 5 a week, and he has been doing them , I think for about 3 years, is a lot more experience than just about any procedure.

Take it easy.

Mike

Trustme

I just sent Mike a correction about that. What is your name and where are you from? I have not seen your name much on the forum. I followed the patient forums for almost 2. years before I responded the 1st time. You can PM me to get contact information. Being that we are both going in April it will be good to stay in touch.

Mike

First of all trust in Dr K to do a good job.  He did no lie to john.  i think you wll be ok.  if you go to your urologist just don't let him talk  into anything.  you will know that the bulk of the tissue will be gone and you will have most of the schell.  try to relax. please don't stress yourself out.  remember after you have it done you will haf to let it heal and it will firmand come together take care  ken   

Check your messages.  I have sent you a private message before.

Ken, yes, all is very good. Yes retirement is looming and they are starting to cry about it.  It gets really hot here in August and I told them I am leaving for summer. So, I also told them to shut up and leave me alone and I might talk to them about a consulting part time gig when I come back but NO PROMISES,,,  I am very pleased and very blessed with the FLA results.No side effects I just pray it will last 10 more years but regardless, it was the best decision I could have made and well worth my money. Life is really good right now. Not to be picky but I really wish this procedure could have also helped my golf game. At least I don't pee every 3 holes anymore. Maybe once a round but that is it. 

John

Thanks Ken,

Maybe i need to change my style. I am very confident in my choice of this procedure for my symptoms. Everyone needs to make their own decisions on what they want to do. I hope that from these prostate procedure forums, people can gleen enough good information that helps and fortifies their decision on whatever they want to do. Almost 6 years ago, when I started researching what to do about my ED, BPH, low Testosterone and my lack of sexual satisfaction and motivation. I am settling into my decisions that I am taking the right path for my time in life and what choices are available to best take care of my male dysfunctions for a better quality of life. The ride starts April 6th. I would love to has the success level that John has had.

Good luck and I will keep you posted. Trustme is going to have Dr K on the 28th of April. So the numbers are gradually happening. This procedure may take a long time to get the approvals it needs, because it is not a urologist procedure. I have watched very successful PAE Clinical Trials for over 6 years and still no approvals. In other countries, yes. I have also watched the urologist Clinical Trials on procedures like itind, Urolift and REZUM, get approvalsome in a year and a half. Not fair, but that is where the big bucks go. I think the natural progressions that males go through as they age. You see your general practitioners for your annual physicals, then as your prostate starts to screw up when your in your 50's , you are given the name of a urologist to get your PSA, urinary issues like BPH, that you never heard of before, those sexual dysfunction issues. The medical field needs to get educated, there are other procedures and choices out there besides the OLD "GOLD STANDARD" for BPH, Turp.

Mike

I am very happy for you that you picked what you picked and yes every man have the right to pick what he feels would help him.  Not be forced into something the doctor is telling you.  The gold standed was good for it's time but this is a new day and age.  I think FLA will be approved soon for BPH because it has been approved for cancer.  Good luck to all.  I will keep you in my prayers  ken

Don't know if this is related to the missed notifications:

    I noticed that one discussion that I had been following for a long time did not appear in my discussion list. I don't know if I missed any posts. When I went to the discussion, it said I was following it. I clicked unfollow, and then cicked follow again, and after that it reappeared in my discussion list.

I'm having the same problem. It seems to be intermittent.

(FIC) Intermittent Forum Communication

I think I know where your missing emails are. I logged in today and had over 70 emails from Patient! No way to read all those.

I did pass all my pee tests traveling yesterday. Peed on the plane no problem, peed in urinals in busy bathroom no problem. These would have been impossible for me the past three years before the FLA procedure. Was almost always using a catheter to relieve myself on flights.

Things going well

So  you have all my emails? Hand them over

Glad to read that things continue to improve for you, I forget, how long has it been now? I understand about getting out town for the hot summer. My wife would like to retire to Austin or San Antonio, but don't know about the heat, uncomfortable to play golf.

Rick

Thanks Richard. It has been 4.5 months now. I just got home from golf about two hours ago and we had a tunderstorm come over. The bad hail stones just missed us by a half of a mile. When the sirens in the neighborhood went off, we got in my truck and left. We went and sat in a multiple story parking garage. No hail and no tornado for us tonight. We caught a break!!! 

Austin and San Antonio are very nice and beautiful. Between the two cities is where a lot of development is going on. I figure they will be connected with the growth in the next 10 years. Beautiful hill country. You get use to the heat. August and September is the hot months. But you get to have really great weather in the winter. 80 degree Decembers. Mid 70s now. It is beautiful weather. We play golf year round. But the wind got up this afternoon and it ruined the golf. I shot 39 on front nine and 51 on the back. That is what 30mph wind will do to you. I noticed that I only peed one time in 18 holes today. Believe me, that is great and a big difference from before FLA. I did also lost my cell phone somewhere on the course today as it fell out of the cart somewhere, so I have to now deal with that in the morning. As I said before, FLA did not make me any smarter.

John

Just thought I'd update because some were interested in how my FLA went.

So I've been off the Foley for just over a week. Flow is a bit better than before the operation, but not a huge difference to prior to me going into retention - Dr K has been very supportive, calling me and answering all my questions. The first 4-5 days after removing foley I could barely pee and it hurt a lot to initiate a stream, and this was probably because of infection or irritation to Prostate from having Foley in for 7 weeks. I asked if an anti-inflammatory would help, and Dr K agreed to I took an off the shelf one twice a day (not sure if I can mention brand names) and things improved overnight.

Still on Flomax, just found out yesterday that I have an infection so am back on Bactrim for 3 weeks - that might explain why the flow is not better. Considering what I've been through this is much easier and I'm happier and optimistic things will improve further. I still am self cathing to make sure my bladder is not holding too much, and usually it's OK so hopefully after infection clears and flow gets better I can stop the self cathing. Self cathing sounds scary but it's not that bad once you get over the idea and do it a few times. Thanks to Jimjames again for his support and tips.

Despite taking Tamsulosin I have no retro, this is surprizing since I DID have retro before while taking Tamsulosin.

I'll update again when there is something to say, probably in 2-3 weeks.

Mike very happy that these are going well.  Is 7 weeks normal for a catheter for a FLA seam like it was to long.  Glad no retro I bet it was a supprise.  Hope things coutinue to improve  Ken

Hi Mike,

The UTI can account for a lot of things. Did they culture it? Was it the same bacteria strain as before? If so, your doc may not have treated it aggressively enough. I would think you should be on antibiotics for at least two weeks as what you have is categorized as a "complicated UTI" given your history. The antibiotic should also match up to the culture sensitivity panel which is another reason why you need a culture. I would also up the frequency of your fluids and CIC's while on the antibiotics as they are most effective when your bladder is rinsed out and empty. Think washing machine rinse -- load it up with water then rinse with CIC. 

Jim

Whoops. May be getting my washing machine cylces wrong! I think it's rinse with extra fluids and then *drain* with CIC. In other words you want ample fluids to flush out the bacteria and then you want to flush those fluids out as completely and often as possible with CIC.

Jim very smart comment! Yes they cultured last week on Wednesday when I came in to follow up after removing catheter on Monday. Monday they taught me how to self cath with a nurse.

I think it was the same strain, just not as bad as the previous infection - the Urologists's PA did not specify it was a new infection, I understood her to say it was a leftover of the previous one which did not go away completely. I have to take antibiotics for 3 weeks.

So now I am doing CIC 3 times a day, you recommend more than that?

Thanks

Michael

By the way when taking Bactrim they say to drink more anyway, because it can chrystallize if there is not enough fluid - at least that is what pharmacy told me.

Ken thanks,

Just in case you or anyone missed it, I am a unique case - one week before the FLA I went in to retention so had the Foley in the first time - my kidneys were in big danger so even after the procedure Dr K insisted I keep it in another 3 weeks at least until my kidneys were OK - I had a scan and kidneys came back to almost normal and then after 4 weeks we tried to remove the Foley and then again the following week but I wasn't ready - that's why they arranged to teach me how to self cath so I could keep the foley out permanently. So one week prior to surgery and 6 weeks after = 7 weeks. Normally FLA patients have the Foley in for "only" one week.

Regards,

Michael

Thanks Mike.  I must have missed it.  Get well soon  Ken

From what you've told me, three times a day is adequate in terms of your PVRs. My reasoning to increase your frequency had to do with your UTI. The more you flush out the bladder with fluids, the better the antibiiotic will work. More CIC will help this process. Definitely run it by your uro and Dr. K. but let them know the reasoning. Glad they put you on a three week course. Were you on Bactrim the first time, and how long was that course? Also, if you are still symptomatic in a week, you might want to ask for another culture to make sure that the Bactrim is working. If not, they may want to switch antibiotics.

Jim

So, given that you will be taking more fluids, and given you have a UTI, personally I'd increase CIC from 3 to 5 or 6 times a day at least until the UTI goes away.

Jim

Hi Jim,

I was on Bactrim the first time and it was only a 2 week course.

Ugh 6 times a day! I will run it by Dr K and I'll keep in mind to do another culture if I think it's not cleared after a week.

Regards,

Michael

Beyond my pay grade, but logic suggests that if a 2 week course of Bactrim did not clear it the first time, and if you have the same organism this time, then you might think they would try a different antibiotic. Yes, three weeks are better than 2, but two weeks should have done it if the right antibiotic and right dose was selected. If this makes sense, you might want to run this by your doctors. FWIW for a very sticky UTI (actually had epididymitis by then) I was put on a three week course of two different antibiotics.

Jim

Again, you don't need to cath 6x/day because of your retention, but it might help with your UTI. When I had a particularly sticky UTI, the uro said that if the then present antibiotic course didn't work, he would consider putting me on a Foley so my bladder would be continuously emptied and therefore flushed. Cathing 6x/day would be the next closest thing to a Foley in that regard.

Jim

Hi Jim,

Dr K go back to me, he said there are cases regarding infection where it's beneficial to self cath more often but not in my case. So yay only 3 times for the moment.

Re infection, the Uro said it was mostly gone but there was a bit still lingering. I don't know how they quantify a bit vs fully blown infection. So my thinking is that the initial dose must have done something and 3 more weeks should kill it off altogether. I'm sure if they felt I needed a different antibiotic they would have recommended it. They deal with this every day multiple times a day.

Re infection, the Uro said it was mostly gone but there was a bit still lingering. I don't know how they quantify a bit vs fully blown infection...They deal with this every day multiple times a day.

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

The labs I'm aware of generally only report positive bacteria if there are at least 100,000 colony-forming units (CFUs)/mL. So, unless he's basing his diagnosis and treatment on something else, I'm not sure what he's talking about. In any event, no harm doing a culture in a week or so to make sure the bacteria is gone. Then another culture a week or two after treatment ends. All urolgists deal with "this every day multiple times a day"...yet that's no consulation to patients admitted to the hospital every day with sepsis from under treated UTIs, or in my case a bad case of Epididymitis. It's good to have faith in your doctors, but I've learned the hard way to have equal or not more faith in logic and common sense. 

Jim

Hi Jim,

I hear you - I am planning to fly to Australia tomorrow, so I can request a culture over there probably. I looked up Epididymitis as I'd never head of it, sounds really nasty, sorry you had to go through that!

Regards,

Michael

Mike,

At least you have two good docs looking after you and I'm sure they will eventually get it right. In the spirit of caution, I just wanted you to have a better chance of getting it right this time. The silver lining is that your uti may be causing some of your issues and not the FLA, so hopefully things will get better soon. Have a great trip to the land down under and bring a few more catheters than you think you may need. I'm sure it won't be too long before your're giving us a success story like John's. 

Jim

Jim,

Thanks for the good wishes, encouragement and all the tips on CIC and related topics.

Yes I am also hoping and praying that the UTI and having a Foley for 7 weeks is the main reason and that the FLA turns out to be another success story.

I checked it's easy to order catheters "Down Under" if I run out and they don't cost that much more if you take into account the exchange rate.

Michael

Mike, 

Good to hear you are able to pee a little bit on your own, if not more by now. I think the self cathing will be better for you in the long run than a Foley, and a lot more freedom.

I am back from a two week motocycle trip in Japan. Things are going great on the prostate front. It has been 8 weeks since my procedure now, (and Mikes) and pain is gone. Peeing is no problem whatsoever, maybe a little urgency if anything. I had some pain in the prostate when sitting on the motorcycle seat. Dr K thought this would be the case, which is why I had the procedure done when I did. Also maybe a little pain at the end of sex, but it's worth it, LOL. No retro, but not as much volume as before the procedure, when I was on Terazosin. 

I did not have any problem peeing on planes, busy urinals, or when women were walking up next to me at urinals, or behind me at urinals (Japan thing?). I can't remember when I could say that, it's been a long time. Like John, I wish my stream was a little stronger, but maybe that is an age thing. 

Still waiting on my insurance claim. I put one in to see what would happen. It's been a month. I figured what the hell, but it will probably be rejected. 

I am happy I had this done if you cannot tell.

Thanks for update - I haven't improved much since last comment probably because I traveled to Australia and it messed me up a bit ", and I had some kind of "accident" self catching - hopefully I'll see results when my prostate is not swollen - this could be due to Foley catheter for so long plus self catching - it's possible it didn't work as well for me but I am definitely better off than prior to procedure - I'll keep you all updated.