New Procedure called iTind

Hi Bobby, Thanks for that report. I  have urine retention, no NV. all retention. Did you have some thing like this?

Thanks for your reply.

frank,

Thanks for the update Bobby. I was just thinking about you yesterday wondering how your procedure was holding up. Did you have an enlarged medial lobe? 

Hi Bobby, wanted to check for an update. Are things continuing to go well for you? This seems like this might be a great alternative to the more intrusive procedurex, including Urolift which seems like one of the best choices available now.

I had it done in Madrid, by Dr. Fernando Gomez Sancha. He speaks excellent English. 

I was also referred to Dr. Julian Shah in the U.K. 

I am surprised they are not responding, they were very responsive to me when I was looking a year ago.

Unfortunately, it did not have good long term effect on me. I had to get FLA done recently.

Hi from Italy, new in this forum! Went to the urologist yesterday and he propose to implant  iTind, it was the first time I heard about it, now thinking about it.

He is one of the metodo pioneer, you can find his 2014 study searching for Prof Porpiglia Francesco, he and his equipe did few hundred implantation in Hospital SAN LUIGI GONZAGA, Orbassano Torino ITALY. 

Hey Motoman,

Good to hear that you found an alternative. FLA is one of the newer treatments. When did you have it done, what was the procedure like and how are the results?

My iTind was done late November and results are still holding up pretty good, though stream has weakened a little with an occasional start/stop, especially if I have been holding it in for a while.

No bad side effects, No urgency or hesitancy. Volume is still good, about 200ml as compared to 25ml pre-op. No sense that my bladder isn't empty when I finish. And I can sleep pretty much through the night if i am careful I don't drink after 8 PM.  I will go back in November for followup testing and have official measurements.

Best regards,

BobbyT

Hi Bobby, Thanks for your report on ITIND. Was your prostate very enlarged? I was told Uro Lift would not work for me. I am concerned about knowledge  of ITind? Did you have urine retention also?

Thanks  for your reply Bobby

frank

Hi Frank,

I live near New York City where there are lots of hospitals with top doctors doing research. The FDA is making the manufacturer run clinical trials even though the iTind has been in use for 5 years in Israel and Europe with great success. I was part of the first part of clinical trial as a test subject and I will be monitored for an extended period of time. Initially they were taking subjects who presented with prostates up to 75ml as estimated with a Trans Rectal Ultra Sound which is a painless and harmless test that takes about 4 minutes.  I was diagnosed with a 65ml prostate, had urgency and retention such that I was going almost every hour and could only produce 25ml to 50 ml of urine at a time and my bladder always felt full. It was driving me nuts with no sleep. Now I sleep most;y through the night and can produce up to 300ml at a time, especially upon waking. Huge difference.

I have heard that they have extended the study to men with prostates up to 150ml but have not confirmed this as test subjects have limited access to data since they could be part of the blind or control group.

Logically the size as defined by outer dimensions should not make that much of a difference since the remedy is from the inside. If three longitudinal incisions are created and they are deep enough then pressure is relived and urine will pass more easily. This is akin to fracking in an oil well. The more passages that are created the easier the flow.

I deduce that its the internal pressure or density of the tissue that matters most as well as the shape of the organ and its position relative to the bladder neck.  If the prostate is curved and angled relative to the bladder neck I would imaging that the remedy is more difficult to achieve than if it were more of a straight line. But I am not an expert, I am just trying to visualize the mechanics and fluid dynamics as if I were trying to fix a mechanical device.

The real advantage is that this method is applied under direct visualization through a camera. This way the surgeon can actually see that the device is placed correctly and well anchored so it does move and damage .sensitive nerves or the seminal vesicle ducts. Also, when the device is placed it does not suddenly spring open and cut the tissue so no damage is done right away so it could be removed and replaced if needed. The action of cutting the incision happens slowly and gently over 5 or 6 days by compressing the tissue, restricting blood flow, and killing off the cells immediately touching the wires of the device through ischemia, necrosis and scarring creating three deep channels for the urine to pass.

It was not painful while it was inside of me though it felt weird at times. No bicycle riding or trampoline jumping and sitting for long period was not always comfortable. A nice recliner or laying down was best. The only discomfort was some burning when I urinated as there was a long suture hanging out of my urethra that would act as a retrieval string during removal and it irritated the to of my penis at times but not a big deal. There was urgency, traces of blood at times and some leakage so i used urine pads And I could shower normally. My wife thought it was ironic that I had a string hanging out of me for five days while I bled into a pad in my underwear while she no longer had to deal with that.. 

All of the other methods are implemented with MRI or Ultrasound which I think are less accurate and once they cut, burn, microwave, heat ablate or staple there is no going back. What is done is done. No room for error so if the nick a nerve you can suddenly become incontinent or impotent. That was my calculation - iTind presented me with the least amount of risk. If I had to undergo this every 5 years i would be happy to do so. The worst that seems to happen is that for some men, it is not effective. The prostate somehow exerts enough pressure as to close the incisions firmly enough that urine can not pass through the channels. In those cases they can choose a more aggressive method.

But I am not a doctor so be advised. Just a patient who has done a lot of research and discussed this with about 15 medical professionals to see if I could have been missing something to ask. I basically drove the doctor who did the procedure and his staff nuts with questions. But they were always gracious and kind to me even when they could not tell me so that I would not know if I was getting the real thing or not, but the results speak for themselves.

Google iTind and Medi-tate to find their website.

Best,

BobbyT

Hi Bobby, Thanks for all that info. I just had a ultrasound bladder/kidney study, they said my prostate was 74cc volume. Can you tell me ? are cc the same as ml? If they are then my prostate would be 75 ml also

Is this right? I have been doing cic for 10 months now, i cannot do a natural void I have complete retention?

Thanks Bobby,

frank,

Hi Bobby, I live in USA Illinois. ITind is not FDA approved yet, is it?I believe clinical trials are taken place now, isn't that right?I don't think 74cc prostate is very large. Is this approx 4.9 inch

I'm not sure. Would you know that answer?

Thanks Bobby.

frank,

Hi Bobby I know you were part of a clinical study. I'm curious if you've heard anything about the results if the trial? Also I assume the iTind doesn't reduce the size of the prostate much, correct? So all the procedure does is cut channels in the prostate.

You are correct. I was part of the clinical trial in USA which as far as I know is still going on. I have to go back for my 1 year evaluation in November and perhaps future followups since I am only 62 and plan on being around until i am at least 100. So far so good. *wink*

The FDA is a huge bureaucracy which delays beneficial products from coming onto the market for the sake of implied safety. They probably have killed far more people who were waiting for remedies than they saved from bad products. No drug or medical device maker wants to be sued by hundreds of people so most products are safe. In this case this device have been used in Israel, the EU, Brazil, Hong Kong without much in the way of problems. What is really being tested is duration of efficacy or how long the effects will last. The FDA seems to refuse any evidence accumulated in other countries.

You should contact Medi-Tate and see if you can join the trial. The standard of care for patients in clinical trials is very high. They use the best doctors and select the most appropriate patients so they are very safe. You just have to be willing to trust and accept that you might be in the control group and not receive treatment. That can mess with your head a bit, but I assure that the procedure is not traumatic at all. They plan to get approval for doctors to do the procedure in a typical office setting, not in a full blown OR.

So physics math 101: my understanding is that the volume of an average prostate is about 25 ml or about 3.6 cm in diameter IF IT WERE A SPHERE which it is not. It is a bit oblong. A prostate of 74 ml is about 5.2 cm in diameter.

Now to convert to inches.

25ml = 1.5cubic inches or a sphere with a diameter of 1.42 inches

74ml = 4.5 cubic inches or a sphere with a diameter of  2.05 inches

If you had an MRI or a TRUS, (neither is painful at all), the actual measurements would be on your report which you should be able to get a copy of.

Hope this helps.

BobbyT

 

The iTind USA study is still ongoing as far as I know. What is being tested is the duration of effect. Internationally I understand that men who had it done 5 years ago are still benefiting from it. So far no repeats have been done as far as I know.

None of the procedures make the prostate smaller. They use various methods (cutting, burning [laser, microwave, heating element], freezing, water ablation [like a mini pressure washer], of removing tissue on the inside to allow better flow; aka Rotor Rooter. Urolift uses pins or staples to hold open the urethra sort of like stabilization rods in the ceiling of a mine.  I suppose if a man lives ling enough the prostate will continue to grow and "fill in" what was taken out. It is just that most men are older than 62 and don't get to outlive the effects where as I may live to 90 like my grandmother in which case I may have to have some other procedure.

Only drugs can shrink a prostate but they have a lot of side effects like loss of libido, ED, and retrograde ejaculations. Since I am 62 I would be on drugs for 10, 15, 20 + years and really did not like that as an option.

So I was considering intermittent catheters until I saw the iTind device being offered. I did my research and called doctors in Europe as well as several here in the USA to discuss the risks. The design and mechanism of action is both gentle and elegant. It is placed under direct visualization and checked with a camera. If it is misplaced it can be withdrawn and reinserted until the doctor gets it just right as no "harm" occurs in the first few minutes after placement. It sort of digs in over the 5-7 days it remains inside the prostate. All of the other methods the doctor is sort of working blind and once he makes a cut or removes tissue there is no going back. You are stuck with the results and from what I read each method is a bit of a crap shoot with the downside risks. I was not prepared to be impotent of incontinent at the age of 62. So for me the decision was easy and it has worked well for me.

Naturally everyone else's mileage may vary depending upon his own conditions and tolerance for risk reward. For me, if I had to repeat the procedure every 5 years I would happily do so as it went so easy for me.

Best,

BobbyT

Thanks for the reply Bobby. Did you have ED prior to  having iTind? If so did it help with your ED? I was told my ED is most likely caused by my enlarged prostate. I take daily cialis which helps but I still take fernasteride which beats me up pretty good.

Hi unckle, are you taking anything else for your BPH, other than cialis and finasteride ? Hank

Just fernasteride and cialis. I was taking tamsulosin but stopped that when I got prescription for cialis

I am trying to replace 4mg Doxazosin with 5mg Cialis but other than improvements in erections and RE, the urinary results have been disappointing. And 4mg of Doxazosin is not even a high dose.  Hank

Bobby, Thank you so much for this info. Feel better now knowing my prostate  74cc

and in inches  is 4.5 cubic inches is not  really that large. MY Urologist said i have a very enlarged prostate,this doesn't sound that large.He did put a scare in me.I don't understand this ,maybe you do? In 2016 i had a cystoscopy ,my enlarged prostate was 4 cm long. Now August 2017 i had a ultrasound bladder/kidney study ,my prostate is 74 cc or like you said 4.5 cubic inches. Do you think it's possible for a prostate to grow that much in 1 Year/

i sure appreciate you answer Bobby,

thanks

frank,

Hi Hank, It took a while to regain flow when I switched from tamsulosin to cialis. I know we're all different but I've had good results with cialis.

Hi unckle, how long do you think 'a while' should be? It's been 3 weeks already and I am about to give up. Hank

I think it took me about a week to get back to the way I peed on tamsulosin.  Seems to me 3 weeks is plenty of time if cialis was going to work it would have. 

Thanks unckle. Hank

You're welcome

Hey everyone,

It's been a while since anyone posted here. I hope everyone is doing well.

I'm still interested in having the iTind procedure and I'm wondering how everyone is doing who has already had the iTind. There are physicians in my area in Florida who are now doing the procedure and I just received my second Moderna vaccination, so I am planning on seeing one of the urologists who performs the iTind fairly soon. Any information, advice, precautions, etc. would be appreciated. Thanks, guys. Stay safe.

-Marx

Hey Marx. I have been reading everything i can on the Itind procedure, but I have not found any doctors in my area that do it. I read your post, wondering how did you find the doctors in your area?

Hi Garvan, If you go to the itind website and click on the link for "Contact Us" and fill out the contact form and let them know that you are trying to find a physician in your area that performs the iTind procedure, then hopefully you can get a list for your area.