MRI 15 months after failed FLA/biopsy info

Posted , 16 users are following.

Good morning guys, hope everybody is well. I just wanted to give a quick rundown of my 3 T MRI results from a couple of weeks ago. DR K was kind enough to order it for me, so hopefully we could all learn why it did not work for me. I was also lucky to be living in Chattanooga Tn right now, and was able to,schedule with the famous DR Busch. trust me on this he is a lot like DR K and I would not hesitate to travel many miles just to have him do any future imaging done for anything, but especially the prostate. He actually sits down with you immediatly following the procedure and goes over it with you. And a more pleasant and interesting person to talk with can not be found. He spent at least 45 minutes with me discussing the results. He is also considering FLA at some point, and really believes it is the future.

BUT anyway the bottom line on my case was that it appears DR K removed a LOT of tissue from my prostate, but it also appears that the remaining tissue never collapsed in and reformed like would be expected. The reason is an unknown, possibly because i have a "hard" gland, or possibly because it was only 43 gms. It is no 42 gms so DR Busch thinks I got zero reduction in size, even though a large amount of tissue was removed.

DR Busch also thought my large median lobe was still a major issue. He also said he would be interested in a follow up MRI in one year to see if anything changes.

So in a nutshell it did not work for me, and we may never know the reason but it still seems to be the most promising treatment. And I am certainly not sorry that I tried it.

On another note about Dr Busch is of the opinion one should never get a prostate biopsy before having a 3 T MRI done first. He is so meticulous about how he looks at and measures every single image. There is no doubt if you have anything suspicious going on he will see it, and if you need a biopsy he can focus on the EXACT spot that needs to be checked. I cant stress this enough, even if you can not travel to Chattanooga to meet with him in person, pay him to review your scans before you decide on anything. It will be the best money you will ever spend.

Good luck guys.

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  • Posted

    Hi Joe,

    Sounds a lot like what happened to me. My prostate was about the same size. Described as very hard by Dr K . It worked great for about 8 months, the gradually went back to old results prior to procedure. It is not quite as bad as prior to procedure, but almost.

    I had a follow up MRI a year ago, my procedure was done 2 years ago. I also had Dr Busch and Dr K review the 2nd MRI. I concur about Dr Busch. I think it costs something like $600 to have him review the MRI.

    Anyway, they both concluded that lots of prostate removed, but it looked like the space then was filled in by fluid sacs, or cysts, they both described them as looking like a bunch of grapes in the cavity created by the FLA. Maybe that is similar to you?

    I am hoping they learned something from this, and a return visit to fix things could work in the future. In the meantime, I am also following the results of aquablation.

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    • Posted

      Good morning Moto sorry to hear you are in the not so good results group also. DR Busch did not mention cysts or fluid sacks, but I have not gotten a copy of the official reading, and I dont know if DR K has had a chance to look over the films. But it does appear just from mine and your experience that a small hard prostate might not be the best candidates for FLA soley for BPH.

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  • Posted

    Joe,

    Good to hear from you and thanks for the follow-up. My FLA was shortly after yours (Dec 2017). After recovering from the fistula, my urinary symptoms improved then slowly started to degrade. It is possible that having the catheter in for an additional 3 weeks helped keep the urethra open, but once removed the prostatic urethra slowly narrowed. Over the subsequent 6 months (June - Dec 2018), my symptoms slowly improved. While they are much better now than during the past 10+ years, like you and Motoman, my gland has not reduced in size appreciably (29 to 25 cc). I'm hoping that over time, I will continue to see slow improvement, but as we all know - no one still knows very much about using FLA for this purpose. The MRI I had in October 2018, showed the void from the ablation, but nothing within the void that was mentioned by Drs Busch or Karamanian.

    Since there is currently no sign of the PCa lesion, I still consider it a big win and like you continue to wait/watch and keep up with new treatments in this field.

    Good luck and please keep us apprised of your progress.

    -Tim

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  • Posted

    Thank you Tim really glad to hear there is no sign of the pca lesion. DR Busch also seems to think when it comes to pca there is nothing to compare to FLA?

    My brother had his in DEC 2017 also and his results have not been impressive either. His prostate did seem to shrink but DR Busch and DR k are puzzled as to why he did not get relief. He is currently trying antibiotics as DR Busch said he had an area that appeared to be prostatitis.

    Guess we will all just keep fighting the fight.

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  • Posted

    Thanks Joe for sharing. How much did it cost for the 3T MRI with Dr Busch ? And $600 just for the review, as Moto mentioned ? Did your insurance cover any of it ? My uro refused me MRI, saying that it's for cancer detection only.

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    • Posted

      Hank,

      You should be able to find a 3T MRI for $500-1000 if you shop around, and tell them you are paying for it all. I had to pay for mine twice, and that is the range I found, and Dr K confirmed that.

      I am not sure of the price of Dr Busch review, it was $300-600. He didn't charge me, as there were a few snafu's along the way between he and the nurse/secretary.

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    • Posted

      For point of reference:

      My insurance company (BCBS) pays the TN facility at total of $750 for the MRI and consult from Dr Busch. It pays 100% since I have PCa, no co-pay. That has been the amount paid last 3 years.

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    • Posted

      Hank,

      I don't know if a prescription is needed for an MRI. Dr K did contact the MRI place on my behalf both times. The first time, he got the insurance company to agree to pay, but it was actually just applied to my large deductible. The second time, I didn't even bother with insurance, as that was a higher price, and I knew I wouldn't be meeting my deductible anyway.

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    • Posted

      Good morning Hank. my insurance did cover it, and it was quickly approved. However since it was after the first of the year, my deductible and max out of pocket had reset. So including the MRI and the consult with Dr Busch my cost was $555. I think Donnie at DR Ks office told me if insurance didnt cover it, it would be around $1200.

      Hope this helps

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  • Posted

    For those who had FLA with less than desired results, did you have a Foley catheter placed for a week or so after the FLA procedure? I believe I recall that in earlier FLA procedures, no Foley catheter was used, but experience has shown that using a Foley catheter for a week is useful in helping an open path form through the prostate. I have a good friend who is scheduled to have a FLA with Dr. K and he was told that he will have a Foley for a week post op.

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    • Posted

      Yes, I had a foley for 7 days post, removed it - could not urinate and did CIC for 3 weeks, then developed a fistula. Foley went back in for 3 weeks.

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    • Posted

      Yes, I had a foley in one week after the procedure. I had my procedure two years ago this week.

      After removal, I could urinate a bit, but sometimes difficult. I did CIC maybe once each day for the first week after removal of the foley, then was able to go on my own.

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    • Posted

      Yes Sir one week with foley for myself as well. Was not as uncomfortable as I had expected, and at least I could sleep thru the night without having to get up to pee lol.

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