Planning for iTind for BPH
Posted , 15 users are following.
PAE (Prostate Arterial Embolization) last year did not work for me, so I am looking at the next "least invasive" option, which I have concluded is iTind.
My urologist does not perform this procedure, but a colleague in his practice does, so I met with him a couple of days ago for a consult.
He requires another cystoscopy first. He says that the most important factor for success is choosing the right patient, and the main criteria is size and position of the median lobe. The cystoscopy is scheduled for late July, 2022. Hopefully I will be OK'd and the procedure can be scheduled within the month after that.
In discussion, he admitted that he had only performed the procedure 4 times, but then claimed that was more than any other urologist in Arizona. He insisted that the procedure is very simple for a urologist to perform. The most important part is making sure the device is fully retracted before pulling it out. I would hope so!
Anyway, he said he has more procedures scheduled and will have had more experience before it is my turn.
As a side note, he said he was not surprised that PAE did not work for me, as a 40 cc prostate is too small. I knew it was marginal going in.
If iTind does not work, or I am not a candidate, then I guess Urolift is the next "least invasive" option. I just like the idea of reshaping the prostate rather than cutting or blasting it away.
0 likes, 31 replies
daryl54162
Edited
Extraction!
The iTind device was removed today, under Nitrous Oxide (they gave me the option, which I gladly accepted).
"Breathe deep!" and the world gradually receded until I was only aware of some tugging going on down there. No pain.
And then it was done. A few minutes to fully wake up, and I was out the door.
Since coming home I have only urinated one time. It seemed like mostly blood, which I was told to expect. I was afraid it would sting a lot after all the recent trauma to my urinary tract, but it was not bad at all. Flow rate seemed about the same as before I started the treatment last week; I was also told that should steadily improve over the next 2-3 months as swelling goes down and clots are cleared.
And that constant, constipated pressure feeling in my perineum is gone. That's a relief! And I can already tell that urgency is reduced.
I'll update when anything changes.
timmy09480 daryl54162
Edited
Hi Daryl, thanks for posting your experience with the itind procedure and post recovery. I am scheduled for the same procedure in about a month so any other progress reports would be highly valued or tips that you could recommend. Thanks Timmy
daryl54162
Posted
5 Days after removal:
I still don't notice any improvement in flow, compared to before the device was inserted. Kind of disappointing, but they do say that it should continue to improve for 2 - 3 months.
I ejected lots of blood and clots, some small and some large, the first couple of days; seemed like more blood than urine at first. All clear now.
An unexpected effect for the first 2-3 days after removal was pain during erection. Quite sharp, near the base of the glans. I think there were some tears or scratches in the urethra from the insertion and extraction processes that had healed in a flaccid state, and the stretching was tearing them again. The problem has faded now, and no longer prevents me from exercising the option.
I see the urologist for the last time in 2 days (one week after removal), and I think he is planning to take a look inside, so I'll see what he says about all this.
daryl54162
Posted
Week after removal -- Condition: Still about the same as before the procedure began. The pain-on-erection problem is gone. No blood, clots or other symptoms.
I saw the urologist's PA yesterday. He was encouraging, said that I should give it more time to allow swelling and inflammation to continue decreasing. He did not do a cysto -- there was no need at this time, and "Let's not irritate things any more than they already are."
I go back in 4 weeks.
I'll report back here if there are any changes.
daryl54162
Posted
25 days after removal: I don't notice any significant improvement.
There was one interesting event, though:
About a week ago I went for a 4 mile hike in the desert. When I came back, the first time I urinated the stream was almost pure black, like dried blood, and fairly strong. It startled and scared me at first, but the next stream a couple of hours later was totally normal and I concluded that the exertion of the hike had broken loose some dried blood. I was hopeful that this would be a big turning point and that flow would be better, but it didn't really seem to make any difference.
I go back to see the urologist next week for a one month follow-up.
I was told that improvement would continue for about 2 months, but at this point I am not optimistic.
starling13154 daryl54162
Edited
Hi Daryl, I am following your itind journey. I'm thinking of having it done so your insight and comments are very important. How are you now have you recovered and have you found the procedure beneficial at this point?
daryl54162 starling13154
Edited
I have not noticed any significant improvement.
However, it might be important to state that I have never been to the state where I have needed drugs (i.e. Flomax, etc.) even before the iTind. I have always been able to start a stream, though the flow rate varies a lot from day to day; sometimes a trickle, sometimes pretty good. I can empty most of my bladder, though the last portion requires several pushes ("dots and dashes"). My main complaints besides off-and-on low flow are frequency and urgency, which didn't improve. So it's possible that for someone with more blockage, the treatment may open them up enough to be where I'm at now, which would probably delight someone who has been self-catheterizing or is on multiple drugs.
I may have been expecting too much.
tll68856 daryl54162
Posted
Thank you for your update. Please continue posting any updates or improvements. You've done such a comprehensive series of updates that it's extremely valuable.
compiler daryl54162
Posted
Your symptoms are less severe based on your reporting. Your prostate probably is not large and no median lobe. So the iTind is suitable for your case.
tll68856 compiler
Edited
but I think that Daryl said that he doesn't see tons of improvement and that he may have been expecting too much from the itind procedure.
I was considering the procedure as well because the information on it reads that it really works and that there's absolutely no adverse side effects.
compiler tll68856
Edited
You need to have your prostate anatomy carefully evaluated and ask your doctor whether he has performed the same prostate anatomy but success.
tll68856 compiler
Posted
Can I urologist tell if say one is eligible for an ITIND procedure by just looking at an MRI or does one need to do a cystoscopy to be sure that that the patient's anatomy is good for an Itind procedure?
tll68856 daryl54162
Posted
Hi Daryl, your progress with the itind procedure going now? Have you noticed any other changes or improvements?
timmy09480 daryl54162
Posted
Hi Daryl, how is the itind procedure turning out now? Any changes or better results?
Really interested to hear where you're at now since the procedure.
daryl54162
Posted
I am the original poster.
2 months out, and I don't feel any improvement. Some days the flow is OK, other days just a trickle.
Nothing much different than before the procedure, but that means no adverse side effects either. So if your insurance covers it and you are willing to put up with a week of discomfort, I would say give it a try. The statistics show that most people get significant improvement. I am one of the unlucky ones, I guess.