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Had FLA on Feb 8th.

Posted , 17 users are following.

richard11472
richard11472

I finally headed down to Houston and got to meet Dr. Karamanian in person for my pre-procedure. As everyone else has reported, both he and Donnie are very professional and obviously very caring toward their patients. The next morning I arrived at 6am, was preped by Donnie and finished with the ablation about 3 hours later. No real pain at all and I was in and out with the sedation throughout the precedure. I found the catheter to be very uncomfortable, it really causing pain at the end of the urethra each time I moved. I got very little sleep that first night.

The next day we had the post procedure brief in the office, along with a shot of antibiotics. Dr. Karamanian was able to point out the results of the ablation. I would make them available for review but forgot to ask for a copy.

We flew home after two more days in Houston and everything went well. I emptied the bag just prior to boarding and once during the 3 hour flight.

The catheter continued to irritate the urethra so much I was dreading the removal. It proved to be anti-climatic as there was only a little stinging as I withdrew it. I wax very concerned that I might not be able to pee and would have to have a catheter reinserted. I was pleased that I had a urine flow--actually a dribble that had contined after 5 days, maybe getting a little better. Hopefully it will continue to improve in the weeks ahead.

I am now a happy membet of the "K" club. Dr. K also mentioned that I was his 100th patient (no, there was no prize), I don't know what number BPH patient I was.

I will continue to post with my progress in the weeks ahead. My main hoal is to get completely off flomax.

1 like, 69 replies

69 Replies

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  • steve45288
    steve45288 richard11472

    Posted

    I discontinued Flomax after 6 weeks. I noticed a little more retention for a couple of days and then it seemed to be the same as when I was on the medication. As Dr. K has probably explained, the area he ablated will be swollen for some time. I noticed a huge difference after 8 weeks. I am now at 9 months and to be quite honest I feel I am still improving. I am 66 years old and this procedure was a godsend for me. Am I the same as in my twenties, no. But I would say I am the same as when I was in my forties and I am thrilled! 
    • j12080
      j12080 steve45288

      Posted

      I'm glad to hear your comment Steve that you feel like you're still improving at 9 months. I can honestly say I felt like I was still improving right up to the 12th month. I am at 15 months now and I feel finally stable with little to no more improvement . I always felt each month as I went along that the improvement had finished but then I realized it was still getting better. I don't really know how to explain it maybe it wasn't getting better it was just getting more and more normal. Show I can now relate to how you are feeling good luck and keep up the good work.

  • martin_victor
    martin_victor richard11472

    Posted

    Richard: I had my focal laser ablation for BPH on Jan. 9th and am a proud member of the K Club. I did find the spasms caused by the catheter extremely uncomfortable, ... despite the Uribel, but after a few days they got better especially when not crouching down on the toilet where the balloon of the catheter might press on the bladder. I was on the catheter for 8 days. I had difficulty in peeing for 4 nights. If one just tries to delay urination for 5 minutes after waking up (which might be difficult considering urgency), the urine will flow much easier. My third problem was a UTI which is more common for those older than 65. I am 75. My suggestion is to take d-mannose with Cranactin on a daily basis ..one scoop of powder. The Urinary Tract Infection might have set me back a few days. Today, I am doing absolutely great. No stop and starting, great flow, and no more blood in the urine except for the  release of ejaculate which by the way resulted in a climax as good as anything I can remember when I was 30 years old. Approx 30% of my 50 gram prostate was removed in 3 areas...especially that of the median lobe protrusion into the bladder. I still get up two and rarely 3x at night, but I imagine some of this might involve bladder retraining using Kegel and pelvic floor exercises. Of course, I have many months to go of improvement as my prostate becomes less inflamed and ablated tissue is removed. 

    Good luck to you Richard and many sweet days ahead of recuperation.

  • Howard31850
    Howard31850 richard11472

    Posted

    Congratulations Richard on your procedure. I wish you continued improvement.

    I wish to ask all the K-Club members here if they are aware of the FLA procedure also helping BPH patients WITHOUT a large obstructing median lobe? It seems all the success stories surround the removal of the median lobe but many men, including myself do not have a median lobe - just large side lobes.

    Thanks and good luck to all. Howard

    • j12080
      j12080 Howard31850

      Posted

      Yes Howard there are some men who did not have the median lobe issue. I don't know who tonight but I will find it tomorrow and try to get you in contact with them.

    • Tim-B
      Tim-B Howard31850

      Posted

      Howard,

      My prostate was <30cc at the time I had FLA and I did not/do not have a median lobe. If you contact Dr K he can give you more specifics on the number of patients he has treated similar to your situation.

      -Tim

    • richard11472
      richard11472 Howard31850

      Posted

      Howard, I did not have a large median lobe, so we can see hoe I progress in the weeks ahead.

    • Howard31850
      Howard31850 richard11472

      Posted

      Hi Richard - With no median lobe and such a small prostate (by BPH standards) did Dr. K explain to you what was the cause of your inability to void naturally  and how he fixed it?

      I wish you all the best and continued improvement - may the flow be with you! Howard

    • Howard31850
      Howard31850 Tim-B

      Posted

      Hi Tim - glad to hear things are improving for you. I wanted to ask you the same question I asked Richard. With such a small prostate as yours (by BPH standards) and no median lobe, what was the cause of your urethral constriction that had to be fixed by FLA? In my case I also have no median lobe protruding into the bladder neck, but I have very large side lobes that constrict the urethra between the internal and external sphincter muscles. I currently CIC. Good luck to you. Howard
    • Tim-B
      Tim-B Howard31850

      Posted

      From what I've been told, there is no direct correlation between prostate size and LUTS. I had been dealing with traditional symptoms of weak stream, hesitancy and PVR for years. Alpha blockers provided no relief, so I had a cystoscopy in 2016 which showed a narrowing of the prostatic urethra on both sides. I had several MRIs for PCa active surveillance and there was no evidence of the traditional BPH nodules, but Dr K and Dr Busch saw early signs of BPH in some areas, but nothing they could point to and say 'That's the problem', but Dr Busch always used the term 'dirty gland' when he reviewed my scans, referring to prostatitis.

      Personally, I think it was a combination of 3 things:

      Long term non-bacterial prostatitis

      Narrowing of the prostatic urethra

      Stretching of the bladder over many years when I was younger

      While I had very little nocturia (maybe 20% of the time I would get up once during the night), my primary issue was the amount of time to start in the morning, or anytime I was sitting/inactive for more than 2 to 3 hours (flying on a plane), long and incomplete voiding. When this happened it could take a while to void and then not completely, which made travel problematic at times. On a few occasions I had AUR (acute urinary retention), which was disconcerting and unpleasant. The symptoms would vary over time, getting better for a while and then reverse.

      FLA had always been my plan 'B' for the PCa should it progress, so it was a combination of the two which would be the tipping point - LUTS and PCa until I finally decided to address them both. While I will need to continue on active surveillance with annual MRIs, the quality of life improvement from the LUTS makes managing that and everything else - much easier. No more hesitancy - when I get up in the morning, it takes <5 seconds to start a stream which is stronger than it has been in many years. While I still have a little PVR (~50cc), that is likely due to a weakened bladder which hopefully will improve with time. Overall, I am very pleased with the results and may see some additional improvement over the next few months.

    • Howard31850
      Howard31850 Tim-B

      Posted

      Thanks Tim for that very informative update. Could you elaborate a little on the cancerous lesion(s). Where were they located and what size were they? When were you first diagnosed that these lesions were cancerous - was it by a targeted fusion biopsy? And what grade were they (Gleason score)? Hope you don't mind all these questions but I went through a similar scare a few years ago. Is Dr. K confident he got good margins? All the best to you. Howard

    • Tim-B
      Tim-B Howard31850

      Posted

      One visible lesion in the left peripheral zone near the nerve. MRI guided biopsy, 7 cores 3 in the lesion, 2 each in the other most common locations used during TRUS. Only those in the lesion came back positive for 3+3. Initial max length estimated at 10mm. Biopsy results confirmed by second pathologist.

      In year 2, I began consulting Dr Busch who told me he believed the initial biopsy did not sample the area he believed was 3+4, but as long as the lesion showed no progression he was ok with continued AS, which I did. Quarterly PSA and annual MRI were stable/consistent.  In Q2 2017 PSA showed an increase to 2.2 (first time above 1.8). Q3 back to 1.9. Annual MRI showed small increase in lesion volume according to Dr K. Since it wasn't going to grow away from the nerve, only closer - I opted to move forward with FLA, biopsy the one area (which came back 3+4) ablate the lesion and open up the prostatic urethra. Quarterly PSA and annual MRI / AS protocol to continue.

  • richard11472
    richard11472

    Posted

    Quick update. Today is 3 weeks post procedure and 2 weeks post foley catheter. I spoke with Dr. K yesterday for a followup and he thinks I am doing great. My pre-procedure prostate was about 59cc without a significant median lobe and I think he said he ablated about half of that together with a spot identified on the first MRI.

    My urine flow was good for the first 4-5 days post catheter and got difficult at the one week point for about 3 days. This past Wednesday night I had a noticable improvement, an actual small "stream" rather than dribbling and this seems to be improving for the past 2 days. I am not back to pre-procedure levels yet but am slowly getting there as the inflammation and swelling reduce. I think Dr. K said that happens at about the 5 week point, will let you know in 2 more weeks.

    I plan on reducing my tamsylosin from 2 to 1 tablet perday once things improve a little more with hope to stop completely in the not too distant future.

    Rick

    • kenneth1955
      kenneth1955 richard11472

      Posted

      Hey Richard.  Glad your doing good.  I think in a few week you should be able to get of all med's.  It will still take time for the inflammation to go down.  That is when you should be good as gold.  Take care  Ken

    • richard11472
      richard11472 kenneth1955

      Posted

      Well, today is the 4 week mark since my FLA. I continue to make slow improvement in my urine flow and cutting down nightly trips to the bathroom. One week post catheter removal my urine flow had diminished to a very slow trickle. Since then it has improved to an actual small stream. I am not quite back to where I was before the procedure, but expect to be in a couple of more weeks.

      Last Thursday I decided to try ejaculating as Dr. K said that was necessary to help with the healing. There was no pain and due to long term tamsulosin use no noticable discharge, hopefully this will improve once off this drug. I had some blood at the start of each urination for the next 3-4 days and the urine was always a pink color. This continued until Tuesday when the color was back to normal. I am curious if I will have a similar bleeding issue this time. I will keep everyone informed.

    • martin_victor
      martin_victor richard11472

      Posted

      Congrats Richard: You seem to be doing well. I think by your 40th-45th day you will see dramatic improvement in urine flow as inflammation goes down. Today is my 60th day and I am amazed by how easy it is to urinate with strong flow. 
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