Had FLA with Dr K. This morning 4/28/17

I also had a PAE back in 2013 with Dr Bagla at the Inova Hospital in VA. I was accepted as part of an initial study of 36 men suffering with BPH and initially had some symptom relief. My prostate at that time was 100g with a large median lobe. The symptom relief was unfortunately temporary and lasted less than three years. Sadly, my prostate has grown itself a fresh blood supply and has not only grown back but continued to grow and is now a huge 125g along with all the symptomatic misery which comes with that.

It's worth noting that it's impossible for PAE to target specific areas of the prostate. We each have different symptoms precisely because our overgrown prostates restrict and protrude in their own unique ways causing our own specific symptoms and issues. Also does the interventional radiologist performing PAE get all the arteries necessary for you to get the ideal outcome? I have heard that men have emerged from PAE only partially embolized. There's no guarantee that the median lobe will stop blocking the urethra or for that matter whether merely shrinking the gland will relieve the constriction around the urethra. PAE works well for general symptom relief but it is non-targeted and from my own experience and the experience of many others, temporary.

From what I understand about MRI guided FLA, the procedure is the most precise and specific targeting of the prostate tissue that is specifically causing our symptoms. FLA allows the IR to ablate with incredible precision the exact areas where prostate tissue is constricting the urethra or protruding into the bladder. If median lobe is a problem it gets targeted by the laser and the offending tissue is ablated. I don’t know of any other procedure that allows the Dr. to so precisely and strategically plan and tailor the ablation of tissue according to each individual requirement while preserving full sexual function. The few patients posting on these boards that have undergone this procedure appear to be waxing lyrical about their outcomes. But, it’s really expensive and yes I agree there is still little data out there. But that being said, for me anyway, how this procedure works makes perfect sense. FLA like PAE is minimally invasive but unlike PAE is targeted, precise and specific to each person’s needs and therefore potentially has a much better outcome.

Sam, when did you have the PAE?  How are you doing?

I had my PAE wiith Dr. Bagla in Sept 2016, I've gradually returned to my condition prior to the PAE and am now thinking of what to try next.  FLA  gets some positive reviews but like you I feel its too new and has too many risks.

 

A year ago, but no signs of recurrence. I know that it may, but the risk is so low with Dr. Bagla and i would happily go through it again. Took one hour and no foley or pain. I have posted my results along the way in other threads, but was very good

jjjj57989, what are the main risks do you feel FLA has?

Sam,

Glad to hear it went so well. It is random in the atrophy or I would have picked it. I did research it completely. I did go and meet face to face with Bagla and with Isaacson before I chose FLA.

I am as glad as your are about my decision and the results. I would pay five times the cost for this results if it was permenate. Now I will wait and watch the longer term while Gat-Coren or something else come along that will stop the condition instead or treat the symptoms.  We are all watching it first hand now with one of my heros, Neil, on this site. He gets it done on next Tuesday and he will keep us all updated. 

By the way any sexual side effect from FLA would only be because the IR did not know well enough what he was and where he was ablating. Dr. K really knows his stuff and makes sure through 3T MRI that every patient also knows it before and after the treatment. He shows you and tells you everything that will be done and where it will be done precisely. After the procedure he so he did it and the sexual componets of your prostate that he did not get near or effect. I liked that, was impressed and know of no other doctor treating men for this horrible condition that is doing that for us. 

Good luck and enjoy your new found freedom!!

John

Your post is informative, and you should maybe post more often on here, Ross.  THANK you.

Hi Sam,

I'm probably having a PARTY with Dr. Bagla soon. What can you tell me about the details of having a PAE with him?

Thanks,

Neal

Hi Neal,

   I had a PAE w/ Dr B on March 27th. Happy to naswer any questions that you have. You can also see the discussion where I've posted: https://patient.info/forums/discuss/pae-with-dr-bagla-on-03-27-17-582060

Hi Rich,

I got behind in emails and just saw your post and kind offer to answer questions. I'm still scheduled for PAE with Dr. B next Friday. At this point, I only have 3 questions.

1. Why didn't Dr. B give you more of the Pyridium, the urinary tract anesthetic that turns your urine red, to prevent the uninary stinging you had post op, for a longer period of time, since you apparently needed it?

2. What were the restaurants you recommended in the local area?

3. What part of upstate NY are you in? We are near Ithaca.

Thanks again for the updates.

Neal

Hi Neal,

   1. I didn't check in with Dr B's office after I finished the 3 days of Pyridium. The ibuprofen was prescribed for 7 days, with the last 3 noted as "if needed". So when the stinging persisted, I assumed that the ibuprofen was the proper med to take, and it did help. I wasn't aware that the Pyridum was specifically for urinary stinging.

   

     2. Restaurants:

           The Silver Diner at 14375 Smoketown Rd, was a real treat. Very retro diner, immaculate, with super friendly and attentive staff. From their web blurb: "Customizable classic and healthier choices that all share one thing: the highest quality, locally sourced ingredients available".

           If you like Indian food, check out Taste of Tandoor at 13836 Smoketown Rd. It was very good.

           For Tex/Mex, we tried Chuy's at 2641 Prince William Parkway. My wife liked it, I was so so about it.

           One thing that happened that I'll give you a head's up on. We live in a pretty rural area and don't need to have our guard up against or are even aware of different types of scams out there.  While traveling, we had one experience eating out where when the bill came back, the credit card was not returned and I didn't notice. Sure enough, by the time next morning when I noticed it was missing, there were two fraudulent charges on it. My sister who lives in a much more populated area knew all about this type of scam.

          We live in Woodstock in the Catskill Mountain area.

             

           Will you be driving to Woodbridge? I assume you've arranged for a place to stay.

            My symptoms seem to be continuuing to improve. Dr B said 1 to 3 months. I'm almost 2 months post-procedure.

           Best of luck to you on Friday. I'll be thinking about you. Please let us know how things proceed.

Rich

 

 

Hi Again, Rich,

Thanks for the great information, and the fast reply,

I think it would be prudent to ask Dr. B for more Pyridum just in case, and I will do that. Yes, it is specific for uninary tract pain. I believe it can make it difficult to urinate, so I will ask him about that, and that may be why he prescribes so little.

Thanks for the restaurant info. We will use as much of it as we have time for, and as much as I am up for, and thanks for the fraud info. I'll be on the lookout for it.

We will be bringing a dog and a small parrot, so have to stay in a Red Roof Inn just south of Dale City. We spend our summers in up state NY in an RV, and have no one to care for them up here. We will be driving to Woodbridge, arriving on Wednesday night for a Friday 7:30 procedure. We plan to stay until Monday, then drive back on Monday if I am up to it. We might spend Monday night in a motel, if I am not up to the whole trip home. I will have a urinal in the vehicle with us, if necessary. What do you think of the plan?

Please continue to let us know how you are doing. I am concerned that you haven't seen more positive change so far.

I had two PAEs elsewhere previously that were not successful, and your comments sound uncomfortably familiar. I hope I am wrong, and that this will work out well for both of us, as have so many of the procedures that Dr. B. has done.

Thanks again for your help,

Neal

Hi Neal,

Do you still CIC? I am curious why you think a third PAE will work when the other two did not?

Good luck - I guess they say the third time is a charm! Sure hope so.

Neil

Hi Neal,

 

     The plan sounds reasonable to me, and I'm guessing you know your potential reactions from your 2 previous PAE's. Who did you have them with, and what was the outcome? Did Dr B say anything that made you think he would have more success than the other docs?

      I do think I am continuing to improve. I went for a drive and a hike today. It was almost 3.5 hrs since my last pee before we got back to our car, and I didn't really have to go. I did make use of the bathroom before getting back in the car as I didn't want to push my luck (had another hour drive to get home). So that was a really long stretch for me, and it had been 42 hours since my last tamsulosin. I'm going to do a real test in the next couple of days, going from every other day with the tamsulosin to every third day. I'll keep you posted.

       Where do you spend your winters? Your family sounds a bit like ours. We have two animal companions also, a cat and a turtle. Makes travel a bit challenging as neither of them can really come with us.

       

Rich

Hi Neil,

I don't routinely cic. I only did it a few times to find out what my PVR is, and to be sure that I could do it. One trip racing across town to get a catheter when my urination stopped up after a prostate biopsy was enough. Forget about waterboarding. You can get a man to tell you anything with 6 inches of string and a square knot.

Dr. B tells me that in my earlier PAEs the left side of my prostate was never completely embolized. Apparently many prostates including mine are slightly abnormal in construction making the process very difficult, but he swears that he can do it.

Also, dr. B says that the prostates of men with BPH are quite sensitive, and tell us to urinate at times when we really don't need to. He is planning to go after an area of the prostate where those nerves are located and make my prostate less sensitive to that feeling.

Anyway, he thinks that it's worth a shot, and that he can do it. And since the pae is a relatively benign procedure, I have decided to give it one last shot.

And perhaps you are correct. The third time may be the charm.

Neal

Hi Rich,

Please see my previous comment to Neil, that I did a few minutes ago for info on my previous PAEs, and why this one should work better. Let me know if you have trouble finding it or have more questions, and I'll send it to you and answer the questions.

That's wonderful news about your progress. You are doing much better than I had thought. How often are you able to wait that long?

We spend our winters in Gainesville, Fla. Yes, our animal companions do definitely complicate our lives.

Thanks again for your help,

Neal

Hi Neal,

>How often are you able to wait that long?<

I haven't been keeping close track, but it is definitely more often than before PAE. Part of all of this is what I have referred to in some of my other posts as unlearning of habits. Did you see those posts? If not, I'd be happy to describe this in detail again. This also leads me to be very interested in your comment:

>>dr. B says that the prostates of men with BPH are quite sensitive, and tell us to urinate at times when we really don't need to<<

It sounds similar to what I was refering to as unlearning habits, except that prior to the PAE, those signals (in my case) were very much real. If I ignored them, in short order I would experience real urgency and difficulty when I finally did urinate. Now post PAE, the signals make me think that I need to pee right away, but if I ignore them, they can kind of dissipate, and then I can wait another hour, sometimes two, before urinating.

This is different enough from what Dr B told you that I would love to hear DR B's take on my thoughts about unlearning habits. I'm scheduled for another post-op consult with him in about 6 weeks, so I may bring that up with him at that time.

Rich

 

Hi Rich,

Sorry for the delay. We have been traveling to Woodbridge for my procedure on Friday morning.

HOW OFTEN WAIT THAT LONG?

I find it hard sometimes, particularly at night when I'm half asleep, to keep track of when I last urinated. So, I have developed a system of recording, for a few days once in a while, each time I urinate, on an index card (as many as I can get on the card, not a whole card for each trip.) I do this for 24 hours at a time, using a 24 hour clock for the hour, and the closest tenth of an hour for the minutes. If you do it this way, and are really obsessive, you can then enter this information into a spreadsheet, and glean all sorts of information. For example, 10:16 pm would be recorded as 22.3. Each tenth of an hour is 6 minutes. 11: 29 pm would be recorded as 23.5. Therefore, 23.5 minus 22.3 means that I went 1.2 hours, or approximately 1 hour and 12 minutes between utinations. The errors will cancel each other out over time. Or, you can just count the number of times you urinate each 24 hours. Anyway you do it, you end up with some idea of what, if anything, has changed as a result of the procedure.

RETRAINING

I would be interested in hearing what he has to say about that.

Neal

As a retired computer consultant, your method tugs at my life long inclinations. For now, though, I'm just going to track on the fly how much time between urinations. I don't have any figures on this from pre-PAE.

Best of luck to you tomorrow morning. I hope this one is the "charm". You are in really good hands. Please keep us posted on how things progress.

Rich

I, too have a system.   I leave a blank piece of paper in the bathroom and record the time each time I visit during the night.  

In the morning I enter the number of trips (sleep interruptions) on a spread sheet.  A graph on the spread sheet updates to show the nights number.

Looking at the graph I can see if I got up 2,3,4,5,6 times over 8 or 9 hours.  4times/8hours=every two hours

Usually my nighttime frequency corresponds to my daytime frequency.

I also have notation spaces to record whatever medicines or supplements I was taking so if I see a trend starting I can also see what might have caused it.

I'll be happy to send the chart to anyone who pm's me.

@Neal: Also, dr. B says that the prostates of men with BPH are quite sensitive, and tell us to urinate at times when we really don't need to. He is planning to go after an area of the prostate where those nerves are located and make my prostate less sensitive to that feeling.

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

Well sometimes, and that would be overactive bladder syndrome (OAB), which is often associated with BPH. But in more cases, it's just the opposite with BPH, where the nerves fail to send the signal to void because the bladder is too flaccid. That's why some of us turn into 'camels' carrying around large amounts of urine with no sensation at all. 

I have no idea about the pros and cons of going after those nerves, but the thinking behind it gives me pause.  There seems to be other ways to treat OAB such as bladder retraining and other exercises. As to flaccid bladder, you don't want those nerves dulled, you want them brought back to life.

Jim

Hi Rich,

The PAE was a walk i n the park. No real pain worse than a flu shot. No catheter, and the pain in my prostate post op no worse than pre op. That said, I expect today to be worse as my prostate says, "what the heck have you been up to? ".

As for the data, it's only an indication of what's going on, because the sample size is small, but it is interesting.

More on the PAE recovery and results in a few days. The Red Roof Inn in Dale City is a disaster. The tv remote didn't work, so the manager gave us his which did. Toilet ran consistently after flushing until handle was jiggled just right. The room has 2 exterior doors but keys would never open both of them, etc,etc. Motel didn't have, and wouldn't get parts to fix these problems. They finally moved us to another smaller room with 2 full sized beds instead of the king we had reserved. Stay elsewhere.

Neal

Neal, Just a quick note, will write more later. We stayed at the Marriott Residence Inn in Woodbridge, which was really wonderful. I didn't mention it as you had already made arrangements, and I wasn't sure if the Marriot would accommodate the pets.

Hi Neal,

  

   Back again. Happy to hear that the procedure went well. The prednisone and ibuprofen should keep the prostate from complaining too much.

   Sorry I didn't mention anything about the Marriott. Have you tried any of the restaurants yet?

Rich

 

Hi Jjjj,

That looks like a great way to do it.

Neal

Hi again Jim,

I take your point. The question is which is it, OAB or BPH? I don't understand how oab would cause difficulty urinating, which I have, and I also have the frequency which surely could come from either BPH, oab, or both, which, of course could be what's going on. If the PAE cures the difficulty urinating, over time, won't that solve the oab?

Neal

Hi Jim,

    I've been trying to wrap my head around OAB for a while, and not sure how far I've gotten. So I'm going back to square one. The sensation of having to urinate is a sensation that I experience near the end of my penis. So if I'm understanding correctly, when functioining properly, when the bladder reaches a certain level of fullness it sends a signal to the penis. Not sure how the prostate would be involved with this, but that does seem to be what Dr B is saying. And OAB would be a bladder that sends the signal before it is really necessary.

    This leads me to the second part of my query. Prior to my PAE, if I ignored the sensation when it occurred, very soon after I would experience real urgency and often diffilcuty in initiating urination. Since the PAE, I've noticed that the sensation occurs almost as frequently as before, but if I ignore it, I can go another hour or even two before I really need to urinate. Sometimes during that period, the sensation can fade away, or I can feel like I need to go for many stretches. It can be a challenge to ignore it.  I'm guessing that I just need to train myself to ignore the sensation, and hopefully in the future it will become less challenging.

Rich

    

 

Yes, Rich, there were many wonderful places, but they won't take pets. It's a real problem.

Neal

Whoops. Wasn't finished. Also wondering how having a prostate that impinges on the urethra affects this whole signalling process. Woudl love to hear your thoughts.

Rich

How did you sleep last night? I was up many times the first night after the procedure.

Rich

Hi Neal,

First congrads and good luck with your PAE!  It can be both, OAB and BPH/LUTS often coexist although one can be more dominant. Curing one doesn't not necessarily cure the other although it could. If not, there are other strategies for OAB. The point I wanted to make was that if the problem was OAB dominant -- which doesn't sound like your situation -- I would try a less invasive route than PAE first.

Don't know on what basis Dr. B. is asserting that he can cure OAB by working on the nerves via PAE. It's certainly not listed as a treatment anywhere I have seen.

Jim

We tried the diner. It was great. The old music was great too. We're thinking about the Indian place tomorrow.

No real pain now at all beyond some sensitivity in my prostate similar to what I had before. I'm hoping that will go away soon as I heal up. The prednisone etc, have me peeing well.

Neal

Hi Rich,

Just accidently stumbled on your post. Missing notifications again I guess.

It's complicated because BPH/LUTS and OAB can coexist. One question is if the urgency you felt prior to PAE was caused by more incomplete bladder empyting. If so, more PAE/LUTS and less OAB. Maybe now, it's more OAB and less PAE/LUTS as your obstruction has decreased. 

You actually might be a good candidate for a home bladder scanner like I have. They are not only useful to avoid stretching the bladder (Why I got one) but can also be useful for bladder retraining so you if you do "hold it in" you will do so safely and not end up holding too much urine in the bladder. I opened a thread on portable bladder scanners for home use if you want more info.

Jim

Hi Jim,

I discussed this again with my wife who was there for the discussion with Dr. B.

She clarified what he said, and it makes sense to me. He said that I, like many men, have chronic, non infectious prostatitis, e.g. inflammation without a cause that the docs can define or easily cure, as they would have a better chance of doing if it were bacterial. This irritation gives me the sensation that I need to urinate frequently. Going after those nerves in my prostate will make me feel the irritation in my prostate less. It won't cure the irritation; it will only make me feel it less, and help me to urinate less frequently.

Aside from that, he says that the PAE will also shrink my prostate, which will make it easier for me to completely empty my bladder when I do urinate. He is positing nothing about oab.

What do you think?

Neal

Hi Rich,

Yes, I had the same problem with sleeping last night. I urinated a lot, but more, it seemed like I just wasn't tired, or one of the meds was keeping me awake. Most likely, I had slept at Dr. B's for the better part of 4 hours and wasn't very tired. We'll see about tonight.

Neal

I too had many of the same symptoms including needing to go a lot and these were resolved after my pae by dr bagla when he did my pae

Wish you similar success!

Thanks Jim. While searching for your bladder scanner thread, I came across an article: https://patient.info/health/overactive-bladder-syndrome. I will check it out to start educating myself on a condition that I didn't know about until very recently. I will also read through your thread.

Rich

Sounds like you're progressing well. Are you still planning to drive home tomorrow?

Rich

Having slept through a good portion of the procedure day rings a bell as the cause for not sleeping well the first night. I think the prednisone may also be involved, but the dose gets smaller each day, so that should ease up.

Jim,

      I read the article on OAB. The section on bladder training was very interesting.

     I think a complicating factor at this point is that I am still taking Tamsulosin every other day or every third day as per Dr B's recommendation for at least another month. So my symptoms fluctuate, and I'm not sure what is causing the fluctuation on any particular day. As it hopefully will be for just one more month, I think I should wait until I stop the meds before trying to determine what is going on (if anything at all at that point!).

Rich

Hi Rich,

Agreed. I would take it in steps. First, wait out the healing time period and no worry too much what's going on now. Then, decide whether or not you're ready to get off Tamsulosin and if so, do a trial without Tamsolsin. Then, whether on or off Tamsolsin, move forward depending on your symptons at that point. No sense treating now something that may or may not exist in another month or so.

Jim

Jim

Rich,

Getting ahead of myself here, but just want to comment on bladder retraining. It's not, as some seem to think, just "holding it in" longer. It's holding it in longer ONLY if you know your bladder is not full. Otherwise, if you hold it in with a full bladder then you will be creating more problems than you are solving since you will be stretching your bladder. 

Keeping that in mind, it's important to know approximately how much is in your bladder before you start training it. If you're self cathing, you can do reality checks at different times to see if the urge to urinate is being caused by OAB (bladder not full) or if the urge is simply being caused by a full bladder which is normal. If you're not self cathing, that's where a home bladder scanner can help since it will tell you the bladder volume without a catheter.

Of course, you could try and estimate your bladder volume by correlating with bladder scans at your urologist's office, but since your bladder volumes may vary significantly at different points in time, this is no as exact as the other two approaches.

But again, I wouldn't do any of this until your system calms down from PAE.

Jim

Rich,

Just read the article. The approach they use assumes no PVR and therefore you can use void volumes. However, in many cases here, there may be a PVR and therefore following the cookbook technique described can potentially run you into trouble by stretching the bladder too much and causing even more problems. The approachs I mentioned earlier is more exact and safer because it takes into account your actual bladder volume including any PVR.

Jim

Hi Sam, and everyone else. Thanks for the good wishes. I'll let you know how it goes.

Neal

Hi Rich,

We went to the Indian place tonight. It was great, then to the diner, where I taught the Spanish speaking cook to make ice cream sodas.

Neal

Hi Rich,

Yes, we're still planning on driving home tomorrow, about 300 miles. I have 2 urinals so........ We'll see how it goes.

Neal

Thanks Jim for your very clear posts. I will revisit all of this starting the end of June when I will be 3 months post-PAE.

Rich

Hi Neal,

Happy to hear that you enjoyed both eating places. And you certainly sound like you're doing quite well, having dinner at one location and then zipping down Smokehouse Rd for desert!

Rich

Hi Neal,

Rain all day here in the Catskills. Hope your journey goes well. Will you do the trip in one day?

Rich

Hi Rich,

Yes, we got home in one day. My wife did all of the hard driving, and I did a little of the easy stuff.

All went okay. One time we had bad luck finding a filling station for one of my very necessary stops. She was driving. So I got out the urinal, got myself out to use it, and we drove around a curve, and there was a 7-11 store. I zipped up, and we stopped there, and I ran in. Got to the single restroom and found it locked. From outside the door I could hear mommy and 3 year old son inside. It seemed to take FOREVER for them to finish their business, carefully wash their hands, and carefully dry then with the fancy, but useless drier. Only you, and the rest of those reading this can appreciate my agony while waiting. But, I managed to make it until they finally left!

Otherwise the trip home went well, and I am doing well.

Neal

Hi Neal,

Oh yes, I feel for you indeed, and can imgaine the relief you felt when you finally got in the restroom

Glad the rest of the trip went well.

Rich

Hi Rich,

At this point I am experiencing frequent urination, with very little prostate pain when I urinate. Otherwise, it's still a piece of cake. I only hope that it's working, but I know it's still early times,

Neal

Hi Neal,

     Yes, still very early. I think you might still be on the final doses of prednisone at this point.

      Dr B told me it can be 1 to 3 months before the full effects happen. Did he tell you that also?

Rich

Dr. B told me 1 to 4 months. Was that your experience,?

Neal

Interesting. I hope that's the case. I'm just past 2 months post-procedure (had in on 3/27), and still have moderately reduced symptoms, but do hope they continue to improve. I'm still on tamsulosin every other day to every third day, and hope to be able to stop taking it all.

Rich

Hi Neal,

    Wondering how you are doing. I think it will be 2 weeks tomorrow.

Rich

Hi Rich,

I am doing ok. I still have a little minor prostate pain sometimes as I urinate. I take that as a good sign that my prostate is upset at being embolized. My urinary symptoms are basically the same as before I had the procedure. I understand that this is still early times.

Is this what you experienced at this point? How are you doing now?

Neal

Hi Neal,

Here's my post from my day 12:

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

>>>>>Day 12 update:     For the first week or so, I tired pretty easily. When the meds were finished, the mild burning when initiating urination came back. I took ibuprofen 200 mg once a day and that seemed to take the edge off of it. Haven't needed that for a couple of days now, seems like things have turned the corner. My energy is much better and no burning while peeing. Still taking tamsulosin every other day, so hard to know if the procedure has made a difference yet,<<<<

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

At this point (approx 2.5 months), I'm still taking tamsulosin, but every third day. On the day that I take the med, my urination is fabulous, much better than pre-PAE with the med. I barely think about it which is a dramatic chnage. On the day after I take it, things are good. On the third day after, some symptoms beging to resurface.

I don't remember, are you on any meds at this point and were you taking any pre-PAE?

Rich

Hi Rich,

I took the meds, one after another, until each med's awful side effects kicked in. The side effects were worse than the bph. What meds were you taking pre PAE? It looks like you are getting there.

I think my symptoms haven't had a chance to resolve because my prostate is still swollen from the procedure, and that's what the minor pain is telling me. We'll see what happens in the future. Please keep us posted on your progress as will I.

Neal

Neil, have you  tried daily cialis instead of tamsulosin. The side effects a daily cia;is are much better 

Pre-PAE I was taking Tamsulosin. I really needed it every day, but because of the side effects I was taking it every other day. A while back I also took finasteride for 6 mos, but it didn't seem to help much.

I think you're correct that it's too early for you to know.

Rich

Unckle, I agree with you on the side effects. I do not and do not need to take anything after the FLA results. I also do not notice any results on urination from taking the cialis but I do notice the large side effect!

I have a bottle of the 5 mg cialis left over after the FLA procedure and so I now, from time to time, cut them with my pill cutter in half and take one every now and then and Wow. I am shocked at the side effect. I had not had cialis or any of the BPH pharmaceutical medicatons before I did the FLA treatment. And now, other than cialis when the idea hits me, no drugs.  I will be out of cialis soon and then I will not get any more.

Six months now and all seems well. BPH is but a memory that I have sometimes when reminded of those symptom episodes by my wife. She was also suffering watching me go through that. I get up once or maybe twice a night still and during those, my volume is 300 to 400 mils. During the day now I may go 3 to 5 times depending on what and how much I consume. The best is now I can control my urges. 

Hope all is well with you. Enjoy that cialis, I think every man should use that stuff. 

John

Hi John,

   What side effect of vial is are you referring to?

Rich

grrr autocorrect 

i was was trying to write cialis, not vial.

 

Well I am sure you are pulling my chain on this and unfortunately the vial mis-spelling stepped on your joke efforts but what I mean is the side effect they mention on the TV commercials.

They call it a pill for that "special moment" and even the 2.5 mg dose that I have sometimes taken, adds a boost to the penil erection. 

As for the mis-spelled word, you would think that the owner of this site would add a simple spell cheching feature to the use of the system. It is not a costly or difficult thing to add. Unless they have gone the cheap route in providing the text application of this whole process. I don't get it. Some simple ungrades could make this a really nice user friendly system. I will probably get moderated now and put on the naughty list. 

Yes, a spell cheching feature would be nice 😊

Oh,  I wasn't actually trying to joke, just wanted to see if there were any unwelcome side effects that might make cialis not a good choice (as opposed to tamsulosin).

I found the non sexual side effects of 5mg Daily Cialis similar to Tamsulosin (lightheadness, blurred vision, etc) . Also found that unlike Tamsulosin, daily Cialis gave me significant heart burn easily resolved with OTC Prilosec. Overall I preferred daily Cialis to Tamsulosin(Flomax).

Jim

Rich pardon my error. I was speaking off the comments of Uncklefester and his single rasied eyebrow emoji in the message he sent. I have never experienced the side effect that Jimjames speaks of but I am not frequent user of cialis.. 

I will tell you something, I was told by a fairly famous doctor at Cleveland Clinic in Ohio that the reality of drugs is that there is really no such thing as "side effects". This is actually a marketing ploy by the pharmaceutical companys.

The effect of the drug are the effects of the drug. The Pharma Companies decide to list the ones that are not specific to the treatment that they are selling them for as "side effects". He told me drop the word side. Stop saying that. The effects of the product are the effects of the product. Weather all of these effects apply to each user or not is another story but they are all still the effects of the drug. This doctor was the only one I have ever had explain it that way. I ask him why I have never heard that and he said there is just to much money in the pharma side of the business for Doctors to fight the marketing but that Doctors know this more than anyone.

John

The only side effect I get from cialis is erectios and mild heart burn.

Things are going to get much better.

I am 1 month and 2weeks into it

And it was the best thing I ever done.

I don't get up at night and really don't think

About the restroom.. my sex life is great

Absolutely no side effects...

Dr K is revolutionizing men's prostate health. Buy far the best procedure out there.

Victor,  

That is SO amazing! I am at 3 1/2 weeks and my stream is getting better all the time. So much so at times, I wonder who the hell I am!!! Everything works as advertised with no side effects. Still healing though. I was supposed to symptomatically be at pre procedure right now but I couldn't have been worse having gone into AUR twice in a week and told to wear a foley for 11 days prior and 8 days post procedure. This is nothing short of amazing!

How long did it take before you were peeing this well? What week was it where you saw the biggest improvements?

Ross

Hi John,

   Not sure why that makes a difference. My understanding has always been that the side effects are those effects that might be or are definitely troublesome, and are different from the effcets intended to treat the condition. Maybe I'm missing something here (won't be the first time!).

Hi Rich,

Side effects typically are undesirable, but in the case of 5 mg Daily Cialis for BPH, the side effect of enhanced erections may be desirable or undesirable depending on the person. Of course if you take the same drug for ED, then enhanced erections become the intended effect ("to treat the condition", and not the side effect. 

More typical side effects below from the Cialis website, although based on what I've read and my own experience, I think the percentages are quite conservative. I don't see "hearburn" listed yet it seems like a significant amount of people here reported having hearburn when taking it, including myself. Of course, we all react to drugs differently.

In ED (2.5 and 5 mg): headache (3% and 6% vs 5%), dyspepsia (4% and 5% vs 2%), nasal congestion (2% and 2% vs 0%), flushing (1% and 3% vs 1%), and pain in extremity (1% and 2% vs 0%). Back pain (3% and 3% vs 1%) and myalgia (2% and 2% vs 1%) were also reported, sometimes with delayed onset.

In BPH and ED/BPH (5 mg): headache (4.1% vs 2.3%), dyspepsia (2.4% vs 0.2%), nasopharyngitis (2.1% vs 1.6%). Back pain (2.4% vs 1.4%) was also reported, sometimes with delayed onset.

Jim

 

Thanks Jim. I did forget about that aspect with Cialis. Doesn't look promising for me as I had the nasal "side effects" with Levitra, and with tamsulosin. Seems like those two areas in my body are connected .. both are smooth muscles.

Rich

Rich,

I found both the side effects and the intended effects (alleviation of bph symptons) of Cialis similar to those I had with tamsulosin. The only real difference being sexual where Tamsulsolin resulted in retro ejaculation and Cialis in enhanced erections. But that's just me. It might be worth a try to see if you get the same nasal side effects with Cialis altough seems likely.

Jim

Hi Jim,

   That's my thought also. Waiting to see if the PAE results (at 2.5 months post-procedure right now) will allow me to get off all meds. If not, I will consider trying cialis.

Rich

Hi Rich, I had PAE with Dr Bagla in VA in 2013. I was able to get off of the meds fairly quickly; around a month or two but alas was back on them within a couple of years. PAE certainly gave me some relief for a while but it was unfortunately short lived. I hope you have a better and more robust outcome than I did. 

I discovered from a recent MRI that the PAE had not had any impact on my median lobe and that tissue was continuing to grow and protrude into my bladder neck. This is why I chose MRI guided FLA, I needed a targeted procedure to specifically treat my problem tissue. PAE does work for many men but it isn't targeted and for me, that was the problem. 

I hope it works for you.

Ross

Thanks Ross. Got my fingers crosseds also.

Hi Rich I used Viagara & Levitra prior to having BPH problems. They both gave me a head ache, runny/stuffed up nose, flushing and a general exhausted feeling. I don't have these problems with Cialis. Maybe because its low dose IDK

Hi Unc,

    Well that's very encouraging news. Thank you. Have you taken tamsulosin, and if so did you have nasal side effects?

Rich

Hi Rich I took tamsulosin for about a year. I had some issues with stuffy nose. It did make my blood pressure kind of low so I was dizzy. My uro gave me sample of 5 mg cialis. Check your uro for some samples. On tamsulosin I peed fine during the day but had trouble at night. Cialis my day time stream isn't quite as good but night time stream is bettrr. BTW on both these meds my flow rate is about 20 ml / sec. So I'm happy with that. I had hoped to have FLA done this summer but an unexpected home project came up that will gobble $40k. I'll have to deal with taking drugs for the time being. Still trying to put together money for FLA.

Have your reports been about the 5 mg cialis? Did you try the 2.5 mg?

Good luck with the $$$ accumulation!

 

Hi Victor, how is your progress with FLA ? Hank

How are you doing Hank?

Well I am post 5 months after FLA with Dr. K and I am loving my results and performance. No side effects at all !

I am 52 and I urinate like an 18 year old.

I never think about the restroom any more,I can go on long trips and my kiddos have to go to the restroom before me.. 

I just want to say that Dr. K is amazing 

He is a very good friend and he has a beautiful family. We play gulf and Chess

Often. His mission is to really help people and he takes pride and responsibility, and he goes that extra mile for his  patients and this world needs more Doctors like him. I think that FLA 

is the Gold Standard for BPH. And I am greatful I live in Houston where his work is performed and having this great Doctor as one of my best friends..

If anybody has BPH or any prostate problems you won't be disappointed with Dr. K

Thanks so much Victor for the update and congratulations for the great outcome. I am making a tally for FLA results, not just for myself but also for others. You are the quiet one and also the last one. Hank

Hi Rich this post post is a little late. I didn't try the 2.5 mg dose. Insurance is paying for cialis

Yes I know just have been very busy with work . But I am here for my  fellow Conrads who want to talk about this great procedure FLA...

Hank how many FLA procedure have been done for BPH so far ? And has there been anything negative comments? I talk to Dr. K all the time 

And I know he is a very busy man..

Everyone I talked with that had the FLA 

Has had great results..is there anybody that it didn't work on..?  Let me know thanks and I am glad you are doing great!

Ok Victor. Since you are such a nice guy you can be the first to know preliminary results of my research. On this forum, there are 10 participants, including yourself. There is one that can be called a failure. Two can be called having limited success. The other seven can be considered having broad success. Other than going through recovery period that varied among them, none had any bad side effects from FLA. That means no one is worse off now than before FLA, which I think is very important. Thanks again. Hank

They're all a bit poorer though. 

Didn't all the men that had limited results also have other issues going in?

My notes are consistent with Hanks, although I think there could be some variance in how you interpret "limited success". That variance could cut both ways. 

This figure is also consistent with the 70% success rate, as reported on this forum, that Dr. K. projected to one of his patients who seemed to have typical BPH symptons. (Could have been 80%, I don't have the post handy.) This success rate -- be it 70 or 80% -- is really no different from what is reported from other prostate reduction procedures, which doesn't surprise me because the success of all of these procedures are in part determined not just by how well the obstruction is removed, but by the underlying condition of the bladder going into the procedure.

The good news beyond the very limited numbers (10 people) are that so far, no retro. The bad is that it costs 20-30K and that the durability factor is unknown since the procedure is so new. 

Hopefully, we will be getting more data soon from the trial participants.

Jim

@unckle: Didn't all the men that had limited results also have other issues going in?

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

I think a decent percent of all bph patients have "other issues" going in, and that to a large degree accounts for procedural failures not just for FLA, but for other prostate reduction procedures as well. As I mentioned in my previous post to Hank, the figures Hank stated, which are the same ones I noted, are consistent with most other prostate reduction procedures. In the end, it's not just the procedure itself, but it's the underlying conditions that are going to determine success rates.

Jim

Good points, unkcle. Hank

" ..success of all of these procedures are in part determined not just by how well the obstruction is removed, but by the underlying condition of the bladder going into the procedure... "

How true Jim. I wish more people would be aware of this fact. It's why I always asked someone with a failed procedure what their bladder status coming in. 

Hank

And that's where urodynamic testing comes in, which unfortunately isn't used pre-op in many cases. In the case of FLA, a 3T MRI is not a substitute for urodynamics. The former shows the obstruction, but the latter shows how the obstruction effects the voiding process. This isn't to say that we can't get success with compromised bladders, but the point is that even the very best prostate reduction surgery or procedure is still limited by the condition of the bladder, as well as nerve function. 

Jim

Hank, I read your post to Victor on the preliminary results of your research and i am wondering if you know the answer to this question. 

I’d like to know whether or not the “failure” is doing better than he was prior to the FLA procedure.  Better can mean either urinating better or urinating the same on less medication.

I am curious about the term failure and that degree. 

Thanks again for the effort your are putting into this.

Hi J,

Let me jump in on this because my analysis is similar to Hanks. I think "failure" can be looked at several ways. First, in terms of the expectation of the patient (Victor) and second, in terms of the expectation of the reader (that could be you, Hank, myself, etc.). Lastly, failure could be quantified as they do in study/trial reports, but that is difficult to do here without the data. 

So, in terms of Victor's expectation, it was apparent to me that the FLA did not meet Victor's expectation, or even come close. So that's a "failure" to use this overly simplified approach. In terms of what would be my expectation, I'd also say it was a failure. And obviously Hank concurs, because that's how he categorized it. 

Jim

J,

Just want to emphasize, that I'm not talking about a "technical failure", because I don't know if the procedure was performed as it should have been and have no reason to believe that it wasn't. What I'm talking about is a clinical failure, in terms of sympton relief. It's very common, both with prostate reduction surgery, as well as other surgeries, that the operation is a technical success but a clinical failure. This has to do with many things, but in the case of BPH/LUTS, the reason often is the underlying condition of the bladder and sometimes the nerves controlling the voiding function. A complete urodynamic suite of tests can go a long way in helping to predict the clinical failure part. 

Jim

Hi John, I know someone will bring up this question of what constitutes a failure. To be subjective, 😀 I am sending out questionnaire to all FLA participants, and their responses will determine the actual answer. In the meantime,  this is what I think a failure is, and my opinions don't count, after a procedure:

1. No or minimal improvements. Or

2. Still needs another procedure soon.

Other than that, verything depends on before and after symptoms. About meds, they will play a role too. If a person is able to stop all medications, depending on the remaining symptoms, it could be considered a success. 

I am not trying to undermine FLA here. No one should expect FLA or any other procedures to have a perfect records. 

Hank

What were symptoms that led to having FLA?

How long since had FLA?

Prostate size?

Lobes?

Age?

 

Good suggestions. Hank

Hold on a minute maybe there is a misunderstanding about Victors 

Out look on the FLA procedure.

The procedure was a great success 

And I am very pleased with the out come. I struggled with BPH for three years and waking up 6 or 7 times a night. Always looking for a restroom 

All the time. Dr. K gave me my life back

I can now do things like a long motorcycle ride, wait in line at Disney world with out the need of having to urinate. I have great sex with out the need for Viagra. I don't need to take 

Flowmax anymore. I would say that I am definitely a success  From the FLA procedure..   I am sorry for anybody who hasn't had the same results.

Sorry Victor, I got your name mixed up with the fellow that recently posted that his FLA was not a success. Glad yours went well!

Jim

First I agree with all you say on the bladder issue. I also have noticed that the young guys do even better with the FLA. I think this could be two things. 1) and most important, the younger men have not put off and waited as long as us older ones. We were first in denial and second scared as we could only find the TURP. I waited 9 years to do something. I think this weakens the bladder. 2) I think the age really effects the mechanics of the bladder. I know a lot of men older than me who do not have BPH and they all say that the urine stream is naturally affected with the aging process. In their words you are not going to escape peeing like an old man even if you have NO BPH. 

Now for my confusion. I know of most of the men who have had FLA and I only know of one that is disappointed with the outcome and he has told me that it is still an improvement. JimJames, you also know him. He has had a rough go of it with the kidney damage that was done before his Urologist told him he could not help him and he needed to just go do something. Anything. His urologist support him fully through 2 PAE procedures and then FLA but his urologist told him Urology had nothing to offer him and he could lose his kidney. He still has retention but he will tell you that he is glad he did the FLA and it did bring him some symptomatic relief. 

As far as Victor , he is younger and I think he has even a better outcome than I have though make no mistake I am happy and satisfied completely. The thing I am questioning that Hank will find out is did some of the patients get no help or even worse is the condition worse after FLA.  I now know a few men who did the PAE without success and went on to FLA and now claim success. 

Hanks work will determine a lot. I think he should ask AGE and PROSTATE GLAND SIZE  at the time of the procedure. Also maybe large median lobe or not as PAE does not usually help with a large median lobe. Few procedures do but FLA can absolutely target that problem.

Hank and I were referencing another fellow -- not the one you are talking about -- who recently posted that his FLA went South. Maybe Hank has his name and a reference to the post. 

As to "Hanks work", it's certainly a start, but good luck getting complete clinical data, because in many cases it even isn't available to the patients themselves in cases of incomplete pre-operative testing. 

But again, this really isn't about FLA as much as prostate reduction surgeries in general. They all tend to work most of the time but not all the time, and the reason in most cases isn't if the procedure went well or not, but the underlying condition of the bladder and nerves controlling voiding. 

Jim

 

And you feel you have one man who is in this category? 

Thanks for uncovering that because I have not found that person as of yet. Outside of the man I mentioned to JimJames and he is a very special case. He is the first to tell you that. But he also says he achieved relief and is glad he did the procedure.

I think the work you are doing on this will really help us all. I thank you again for all your efforts.

Hank,

Sorry if you have addressed this but did you have FLA done?  If so, how are you?

I also think the PAE comparison is not a good one. PAE is not a prostate reduction surgery, it's a shrinkage process. You would have to compare FLA against actual prostate reduction surgeries like TURP, Button TURP, GL and now the newer Aquablation. Except you really can't  because FLA still doesn't have the numbers either in patient sampling size or durability, as any of the other procedures mentioned, even Aquablation, which is just getting out of trials. 

And again, I'm not against FLA, just trying to keep things honest here. I really like the fact that so far no reported cases of retro but at 20-30K out of pocket for many, it's important that everyone has realistic expectations. 

I believe Dr. K. himself stated that 70% (maybe he said 80%) is a realistic expectation for success. That sounds about right at the moment. 

Jim

I will try and dig up the name of the fellow if Hank can't. As to the person you mentioned as a "special case", I think his case is typical of maybe 20-30% of the bph population, and that's probably why his results weren't as good as some of the others. 

Jim

Sorry John & Jim,

Due to the promise of confidentiality, I cannot reveal any personal information without permission of the participants. Hank

I am an interested suffer, haven't had any procedure yet. Hank

I mean sufferer. Hank

OK. I found the post. It was by Jim81578. I have copied the post below. I have also copied Motoman's response which also describes his current status:

Jim81578 said:

Ok been about 4 months now. At about 3 month was peeing good. No bladder pain and no more night to the toilet. Heres were it gets a little tricky. At first I cut my 8mg of flowmax in half. No problems. About 2 weeks after that I cut off flowmax. After about a week things went down hill. Called doc k he said two soon so got back on pills for about. Then I stayed on flow max and cut off fenisteride after 3 weeks everything went down hill bad. It was like before I had Fla. Called doc k said maybe I was to aggressive. So right now it's been about 2 weeks or so back on all pills and is starting to get better.

Going to go see a new urologist in about 2 weeks for his opinion. After that I'm going to try to dwindle down on meds a little slower this time and if that doesn't work. I'm going back for a redo. Dr K says he will give me a substantial discount. Says he can get a little closer to the urethra. I will need to get another 3tmri to see what the prostate looks like. Really want off the meds. My times above may not be exact just close as time seems to fly by. It will be 4 months on September 1st. That's my story for now.

Motorman then said to Jim:

Jim 

I am having a similar experience. I had great results from about month 1 until month 3 or 4. Then things started to slow a little. More hesitancy, start, stop, weaker stream, etc. I am now up 2 times, sometimes 3 times per night, where before the procedure and after, it was only one time per night.

Dr thought it might be. UTI, so took a month of antibiotics, which didn't do anything. I am also back on Terazosin daily, which is an alpha blocker I was on before the procedure. But a much smaller dose than before the procedure. 

This seems to be helping a bit, and I am still better than before the procedure overall, just not where it was a few months ago.

I had a small prostate at 45 grams, but I wonder if it is growing rapidly? DR K doesn't think so, and thinks it could be prostatitis which doesn't look to be easily solvable. I was so happy to be off the meds, so it is kind of a let down at this point, but the good news is I know I was able get good relief for a while. Maybe during the healing process something closed in on the urethra? 

I will probably go see a urologist soon to look inside and see if there is any blockage if I don't see any improvement.

??? 

I have the exact same figures you do and it all comes from public postings on this forum. 

Jim

Why don't you ask all of us for permission? Most of us are open about the results, or you wouldn't have been able to find us anyway. I doubt the people on this forum are the only people that Dr K has treated for BPH. That is an assumption people are making, but not everyone comes on a forum and talks about their peeing issues. It's probably less than half. 

I am curious how where you put me. I have been open about having some issues lately, after having great results for the first 4-5 months. I don't know whether it is inflammation, infection, blockage of some sort, or what. I am working with Dr K on this. But I am still much better than before the procedure, just not as good as the first 4-5 months. I am back on a smaller dosage of medication, but can live with the results I have. So as I told Hank in the PM, I am happy I had it done.

Well I am sure it is all in the hands of the beholder as success to me was symptomatic relief WITHOUT any sexual side effects. So far, I know of no one who has done FLA and has had any sexual side effects. Now if sexual side effect are not a concern of a patient, then TURP may really be best. Or green light or any of the others.

I know the difference I wanted which I feel I found was a Doctor whose first priority was "to do no harm" and then second achieve results. I could not find the first in a Urological procedure. They all not only admitted the percentage of possible sexual side effect, they expected me to just accept that it would probably happen. Especially retro ejaculation. This was not for me. And each of us are entitled to research and make their own decisions based on the criteria they set for their procedure.  It is like the doctor mentioned in a recent post who told the patient on this site that he cannot tell him the size of his prostate until after the Urolift procedure is done. I am standing up and walking out on the deal. 

Again, I think there would be a lot better results if men do not wait too long to do the procedure.

I know that is hard to do but getting somewhat better I hope. We were in a time period where there was a "catch 22" situation on a procedure selections for BPH. It was TURP or suffer and TURP stands for sexual side effect in my book.

I know you invented the CIC method for a stop cap and a wait and see approach but there are not a lot of men that I know who would go through that process even though it worked wonderful well for you. I might would do it today at this age but not eight or nine years ago.  

Dr. K is also working on his study information and I know he would really appreciate independent results gathered that is outside of his study. He is not trying to push men the FLA direction. In fact, the turns away almost as many as he does and is quick to do so if he does not see evidence he can help them. Best part is his philosophy first, do no harm. That is the way the profession should still be practiced. 

I did acquire some more information under the promise of confidentiality. I just don't want to cause confusion and unduly pressure on the responders by getting involved now. You guys can beat me up later. 😀 Hank

Without mentioning names of course, could you mention the some of the reasons that people wanted to remain confidential about their FLA results?

Jim

And another update from me:

Dr K suggested it might be inflammation or prostatitis. He said I should try Aleve twice a day. So I started that yesterday, we will see if things improve. I went to my Urologist today, haven't been in to see him in a year. They did a Bladder scan and said 12 ml left after peeing, so I am emptying very well. Also no sign of any infection or UTI in my urine. If things don't improve I may go back to him in a couple months to scope me to see if there is any blockage from the healing process. Or perhaps another MRI to see if something has changed since the procedure.

I would never do so as I feel what you or doing is in the name of truth and research for yourself and for other. I am fine with that. Remember, I have made my bed and I am very pleased with it. Sometimes Others in the same situation feel like why bother with patient info or anyone else. They feel they paid their money and got the procedure and are happy. So have a good life and bye bye is their attitude. Most of the men in the so called K club do not feel that way. If we can help other with our story then good. But each of you have to write your own story. 

You are doing a good thing to help with this but it is the next phase and was not around we all got our feet wet. 

That's why I'm trying to be careful in addition to giving my own take/interpretation -- to quote both you and others who have had FLA in full. I believe a full reading of everyone who has posted about their experiences gives the most complete picture as different people are looking for different things. 

As to Alleve, be careful because it can be a two edged sword. Yes, Alleve can help with inflammation, but it can also increase retention. Maybe try combining Alleve with something like Flomax to counter that affect?

Jim

I did not know Aleve could cause retention. I'm only going to do it for a week or two. I am taking Terazosin 2 mg daily, down from 10 mg prior to the procedure. I was off it for the 6 months after the procedure.

John,

You said before you didn't know who the person was who had a failed result other than the fellow that both you and I know. I posted you his name and what he said, earlier. Did you get it? His name is: Jim81578

Jim

If you see your voids decrease it's probably the Alleve, everything else being equal. The risk of retention is greater with all the NSAIDs, including Alleve. Doesn't mean you shouldn't take it, just good to know what to watch for. 

Jim

No one asked for confidentiality yet I offered and intend to keep it. Hank

Got it, thanks. 

I am going bass fishing in the morning a 5 a.m. so I am about to check out and i will be tied up all day tomorrow.  I have a 150 acre Oklahoma lake full of 10 to 15 pound black bass. Duty calls. 

I will check back in sometime Friday. Keep up the good fight my friend. 

Good night. 

Are you still riding that bike like a mad man? You were a hard core biker!!  The only man I know with the nerve to get on the bike 3 weeks after FLA?

10.4 that fine with me. I will be out for a day. Good luck with your work. 

Hank, thanks for doing this research. I just responded to your PM.

Ross

Well not according to what a doctor and what this person told me he is far from typical of any group. He had a severer kidney condition that most doctors said was too far gone and may not be able to save. I think with FLA and your help he did save his kidney but though he says he is much better and able to play competitive soccer, he is not where he would like to be. I don't believe any procedure would have done him good or as much as what was accomplished. So though he is not complete he is happier.  

you may be correct but reduction by laser of 20-30 percent or shrinkage of 20-30 percent is still reduction. Shrinkage is very random and uncontrolled and for that reason alone not real compatible. You can see the atrophy in the post procedure MRI's

I had a different read on it. Kidney issues are not that uncommon with BPH. I had hydronephrosis (water refluxed into the kidneys) myself  which quickly resolved with CIC, as it usually does. Unfortunately, some doctors use hydronephrosis to scare people into surgeries when CIC can do the same thing. Not saying CIC is for everyone, but it should be an OPTION given to everyone. 

Jim

You can call it controlled shrinkage if you want, but I would call it precision laser cutting based on what you have said Dr. K's laser works. So for that reason you really can't compare it to PAE which as we both know can be random and uncontrolled. So again, comparing FLA to TURP or GL is more apples to apples. 

John,

I agree 100%.  The verbiage and application with sentence structure can affect any question that is asked.  The questionnaire that I saw had lots of voids for the questioning as well as non-consistent answers going from Yes / No to giving a score from 1 - 10 that were asked. If you are going to use the information just as information that is different than putting raw scores to some and not to others and then deriving a conclusion.  I truly think, that if you want to run a semi-scientific study, the questionnaire I saw leaves too many unanswered questions.  Look, the people on this Forum, most likely are suffering from a combination of Bladder Function and Prostate Growth causing various problems, mostly based on the title of these forums, BPH is deemed as the final result.  We also have many people that have had all kinds of different procedures and with different results and multiple procedures and multiple problems.  If you deny all of that information, what kind of a study are you doing.  You could come up with all kinds of answers.  I know JimJames sounds like he has all kinds of statistics experience, a good organizer, with lots of information gathering experience.  Jim might be a good one to put this together, naturally with lots of input from others.  Jim was a cather and has not had any of these procedures, I don't think?  .So, because we are not babies, we are pretty much all here for the same purpose, that if a study is going to be done and may affect whether people go and get one procedure vs another, all the cards need to be laid on the table.  Let's put together a meaningful questionnaire, by calling in some feedback from some of our doctors that are on the site as well as many of our highly informed patient researchers.  I would like to see it reviewed at least by a person that is experienced in questionnaires word studies and understands that how a question is worded can affect the answers.  If this questionnaire, even though it is non scientific, if your not careful, many people are going to get the wrong idea.  Hank's stats have not even been compiled yet and look at the conclusions that are coming out with already.  People on this forum are here looking for Help as much as Information.  We have to be careful what gets published, even within our own semi-private group.  . 

The Forum chit Chat that we do is different, highly helpful and informative and right now is the best source in the world for patient responses for BPH issues, but when any form of a study is done we have to be careful.  You can tag disclaimers on it all you want, but someone may take this and he may make a wrong decision.  This forum is a clearing house for prostate information.  We have Uro's involved and IR's, most importantly, patients of these procedures.  Most of what we discuss is contradictory to what our URO's, most males 1st source for their prostate issues, have told us and that is why we are searching for other answers.  As much as I would like to see an In-Scientific Study about the Patients and their Procedures vs Some Degree of a Success or Failure Rate, we do need to be careful.  I think if people put down their actual test information, Urodynamics, UrethroCystoscopy, Transrectal Ultrasonography, Tests, Prostate Size,  my prostate size showed entirely different size readings than what Ultrasounds and CT Scans came up with (87cc and 108cc) vs My 3TMRI studies (179cc), read by 2 different sources, still came up with a size within 1.0cc of each other.  The 3TMRI is the most precise way to measure, based on the ( L x W x H x 0.52)?.  Unless you took the data from the 3TMRI and made a Digital Model to get the most accurate.  Normal and Healthy Male Prostate (20 - 25grams and 4 x 2 x 3cm)  Prostate condition, determined professionally again. If you want to through in your International Prostate Symptom Score as well. 

Lets do not do this hap hazard and scare some people into bad decisions. 

This is all screwed up, but at least you get my point.

Mike 

Things that you may want to add to your Study.  I forgot to add the (SHIM) Sexual Health Inventory for Men test, with the (IPSS) International Prostate Syptom Score.  These Q&A Tests are available on the internet.  I know that Dr K had his patients fill them out for their records.  Of course, here we go with how much INFO is TOO MUCH INFO?

Mike   

Hi Mike,

I agree with almost all you said. A discussion group like this will not provide the same data a controlled study will, no matter how hard you try. Just too many variables and as I mentioned before, unlike with a study, the variables are often unknown to the questionnaire participants due either to incomplete pre-operative data caused by less than stellar dotoring and/or simply not keeping track of that data. On the other hand, I still find discussion groups like this invaluable for their anecdotal accounts but you have to be very careful how everything is interpreted.

What I would like to see on this forum, would be an expanded patient profile section where each person would have a page or so to give us as much information as they can in one place. Again, this is not a substitute for a study but it would certainly put people's comments into a better perspective. Right now, I think you have less than 50 words for your profile. Pretty much useless.

Jim

Thanks Ross. Hank

I agree with what you are saying.. 

there are many factors...

I did not want to wait to long before I took action because I new that my blatter would  become weak. 

A good profile would be useful but would not reflect and changes in status.  

We need an update mechanism.

We could also use a forum wisdom page reflecting advice to sufferers, things we've observed that you probably should ask your doctor about ie "PAE seems to be more effective with smaller prostates'  

Victor, i sent you a PM. Hank

I agree with you, except for your 1st assumption.  We have to be careful, because I believe Ross had a relatively small prostate, is a young person in his 50's, had a PAE done through Dr Bagla, still had problems and it did not work.  He went with Dr K performed and FLA for BPH on him and he is now in his 20's, peeing circles around everyone and his sex highly improved.  Myself, I was going to have Dr Bagla do a PAE on me.  My prostate was 179cc, large.  When I contacted him, he said that they had good results with large prostates and in this case Size did Not Matter and he would welcome me as his patient.  Their patient studies showed that It was not that big of and issue.  Previously in his study, I think 60cc was the largest and then they followed that study up with prostates over 60cc and that is where his size deduction go applied. 

Mike

I did promise confidentiality, because some of the information I asked for were not posted publicly. Hank

User profiles are not static and can be updated any time the user wants. At least that's how it works on all the sites I've been on. 

Jim

Hi Mike, since you guys were so nice to me before, if you don't want me to post my FLA review, just get 2 more (total 3) FLA members to PM me. Hank

Hi Moto, since you guys were so nice to me before, if you don't want me to post my FLA review, just get 2 more (total 3) FLA members to PM me. Hank

Hi John, since you guys were so nice to me before, if you don't want me to post my FLA review, just get 2 more (total 3) FLA members to PM me. Hank

Yeah John, riding as much as I can. Gotta do it while I am young enough to be able to. Summer in North Idaho was outstanding for it.

What? I am confused? I am ok with you posting the info I think it is good stuff. 

John, reading back a few posts, there were some FLA members questioning my qualifications (which I have none 😀 and my methodology, so on. I thought perhaps your club members, for some reason, would want me to stop poking around.  I would gladly comply if three of you want it that way. Hank

Strange?  I question anyone questioning your qualifications. Correct me if I am wrong but you are doing this to help you decide what you want to do? Correct? Well that is qualifications enough in my opinion. Oh, yes, I know you were going to share it but that was not the motivation for doing this, it was for your decision making process I thought? We typically call that research and since it is your body and your decision, I wonder why anyone else would think you are not qualified to do just that. 

First I think the treatment results speak for themselves with FLA. If you do the research and do not feel this is truly  the best choice for you then you should not do it but you and you alone have to determine that. I did do the same thing for my decision.  Second, I cannot and will not tell you or anyone to do this procedure or anything other procedure. I did my research and based on me wanting a solution with my on personal criteria, I made a choice I spent a lot of money doing it. I traveled  to 7 different cities and visited 9 doctors to choose what BPH procedure I thought made the most sense. I am very pleased with the direction I went. But that should have nothing to do with you. If my decision would have been a bad one I would want you to know that also.  Third, I can't remember if you have spoken with Dr. K or not but if you are serious about this research and possibly a procedure you really should speak with him about both. It does not commit you to anything and it does not cost you any money to do so. 

Since you now feel uncomfortable with the collection and sharing of the information, I think you should only share it with the people who directly ask you to share with them the result of your questioning matrix.    i.e. ME.

I am interested and would love for you to share it with me when you have it. I don't know about anyone else and they can speak for themselves. Unlike some other people on this site, I know the truth about this procedure. Not only because of my experience but because I have been involved with many of the others who have done this and we have shared our experiences and our results very candidly. 

SIDE NOTE:  I just got home from bass fishing for the last 14 hours. A very full and successful day of top water bass fishing and I never got off the boat. This is something I could do a lot of and did a lot of competitively when I was young and did not have the urination problems that I later had with BPH. No problems today it was magnificent but I don't need to go into that with fish stories. Just to say, I am back in the game and I am very pleased.

I hope the same (getting back in the game) for you and all the BPH suffers no matter which way they go with a treatment. And, as I told you before, I am here to help you or anyone if I can. Just as I have tried to with many other guys. It is the least I can do out of gratefulness and thanks for what I feel is a blessing I recieved.  I have nothing to gain or sell in anyway in this effort. 

Have a great weekend Hank, I leave in the morning to play in a 3 day golf tournament which is the sacred  Red River Ryder Cup Match Tournament between Oklahoma and Texas. It has been going on for 18 fierce years. And now, I can play in it once again!!   I feel honored to be invited. 

 

Thanks John. Have fun ! Hank

I wanted to throw my two cents into this discussion. I am on my 4th month from my FLA with Dr.K. I am 66 years young and I was a wreck before the procedure. Taking Rapaflo and Finesteride to just barely get me by each day. I am off all medications and I will say I am basically 98% happy with the results. Somebody said earlier in the discussions that a younger person will probably have better results than an older person, I would say this is right. Before the procedure I had to give up coffee, alcohol and spicy foods. After the procedure I can now have alcohol and spicy foods in moderation. Coffee is still a problem. For some of you that are having some of the reoccurring issues I would look at your lifestyle choices. Also someone said earlier that they thought their bladder might be a little compromised due to retention over the last ten years. I would say this is probably a pretty good guess. Doing the kegel exercises daily will make a big difference  .Before I did this procedure I asked the Dr. the odds of going off meds and emptying my bladder, he said 70%. I have reached those goals and know I will never be perfect. I was hoping for a 50% improvement and got a 80% improvement. I am very happy with this percentage and  hope it lasts for many years. 

 

I sent you a PM. Hank

I sent you a PM. Hank