Post Greenlight Surgery for BPH

I will take your advice and follow it, thank you very much.

OK they are taking out my catheter tomorrow and I am buying some Male depend diapers now, just in case.

If you don't want to were the diapers try the male pads.  I use them the first day after I have the catheter out when I had my urolift.  You will be ok  Ken

Just purchased Depend brand underwear for men , 12 pieces just in case. MARK

Mark, Hopefully you won't need any of this, but if you develop incontinence you might find a condom catheter -- sometimes called  a "stadium" catheter -- preferable to Male Depends. 

Jim

Yes it's good to me ready for anything  Take it easy  Ken

Mark, a word of encouragement, after my focal ablation I used small face towel between my legs each night after the catheter came out. As it turned out I did not need it but I wanted to be sure and I did not want to wear the depends to sleep in. You will do very well it's just going to take a few weeks to heal up. I did not feel better for 3 weeks of course until I felt better I did not really know what feeling better was like then all of a sudden it happened in one day like someone flipped a switch. Keep trying you're going to be great

Thanks, Mark

Ok the logic  is sound, I will be calm.Thanks, Mark

Mark  Not all of us on here have a negative comment.  There have been many good results with many of the procedures.  Keep talking with your doctor and tell him what is going on.  We have to stay in touch with the men on here because that is the way we learn what is going on  Also all men heal in different way...Take care  Ken 

OK Thanks

Over a year ago, they attempted urodynamic study, but they could not get the catheter to go in, so they cancelled it. I had urinary retention of 400ml in my bladder at all times. But another urologist who I consulted said my retention was 900ml and told me it was dangerous and to do the procedure immediately. He is 80 years old and was like saying do not leave my car without doing a procedure. But he preferred the microwave TUMT he said greenlight was barbaric. The day of the greenlight they did general anesthic and I thought that meant they might do TURP. but the reason they choose general anesthetic was because I used to have sleep apnea.  The surgery was OK, they injected VERSED at 8.30 am and I was in the recovery room at about 10am, with the bag. Over the first few days while at home, my bag had blood, but not much and I had constant burning. Bag will be removed Monday or Tuesday. I let the leg bag stay on and do not change to 2000ml , so I wake up several times during the night to change the bag, maybe 2 or 3 times and the bag usually has 500ml of urine in it. Clear.

Mark, forgive me if I have told you this but it may help your recovery and it was a God sent product to me. I just had FLA and it was wonderful but the doctor gave me a drug for bladder spasms and burning or stinging urination and it stops urgnecy feelings. It is called URIBEL and it will make your urine a pretty blue color but it goes back to clear when you stop taking it. But this product really works vey well in you condition. I had it during the Foley and afterward. Good luck. 

Hi J120,

Congratulations on your continued recovery!  

Earlier, you mentioned a Prednisone pack post FLA. Was this taken at the same time you were on URIBEL. Can you differentiate what benefits came from each?

Also, the symptons you mention -- bladder spasms, stinging urination, urgency -- would you say they were a temporary byproduct of FLA or of the catherization?

I ask because all those symptons are typical of self catherization (CIC) during the first couple of weeks. Not in most cases, but in my case they significant. It occured to me that a drug like URIBEL might have made a significant difference to me during that time.

Jim

Hi Mark,Thanks for your reply. I sure you get well soon.

frank.

Earlier, you mentioned a Prednisone pack post FLA. Was this taken at the same time you were on URIBEL. Can you differentiate what benefits came from each?

ANSWER Yes Uribel was taken both before prednisone during and after. The Prednisone pack was only 6 days and it was to help eliminate the intial swelling that happens from the procedure as that is when it is swollen the most. I did not take the prednisone right away it was the second week I took it for swelling The uribel was also to help with the swelling but it was mostly to stop the side effect of the Cath and it sure did. I started taking it the day before the procedure and my pee turned blue but felt nothing from the drug. I know it helped me a great deal because with a new 16f foley in me I went out to eat post op from the recovery room to a nice sea food reasturant with my DAD and Wife right away on the way to the hotel. Then the next day we went to a memorial sevice and tour of NASA in Houston cause John Glenn had passed away. We stayed all day for the whole tour and I had no issue with the Catheter. Then when I went home 3 days later, I drove 6 hours to get home and I had the Catheter in the whole time with Blue Pee from the Uribel. No issues with the Cath. It was  removed by me the next day and I did not have any stinging, I did have some urgency feelings but never Bladder Spasms or any real stinging. I know this was because of the Uribel As I did not do the pregnisone until I took out the Cath after 5 days post op. Dr. K said I should have started my prednisone sooner but I really was against it and do not like the steriods as they can effect the immune system. He ask me to reconsider and I did. Once again, he was correct. He is a smart, concerned doctor.  I kept taking during perdinsone per his instructions.  Another thing I think that really helped was that Dr. K wanted to use a silicone soft catheter for comfort reasons. He said to me, "that is what I would want used on me" and he said the same about the conscious sedation drugs that they used. Some doctor only give you a pain shot and a valium for this procedure. They had me on something like you use in a colonoscopy procedure. I felt nor remember nothing. I Signed the paper work and then my family went to get sea food for lunch. Seriously it was that good. 

Also, the symptons you mention -- bladder spasms, stinging urination, urgency -- would you say they were a temporary byproduct of FLA or of the catherization?  

ANSWER I am sure the stinging urination would be from both, but the URIBEL killed most of that as it was minor. The urgency was the same that I had with BPH before the procedure so it was not casuse by the FLA or the Cath. With a cath you dont get much urgnecy as you just have pee free flowing all the time into the bag. You actually feel nothing.

I already had that urgency before the procedure. All urgency went totally away on January 6th which was 20 days Post op. Now I have none and if I feel like I need to go I hold it and the urgency goes away very quickly. Like I did 20 years ago. I don't run and pee now. Both Dr K and Walser told me it would be about a month and it would all happen quickly and it did over night. On the 5th of January I slept all night and my volume went up 500% from peeing 3 or4 times a night just 100 to 150 prior to the fifth. Prior to the procedrue I would go 8 times a night.  The next night , January 6th, I did not get up at all and pee 600cc the next morning at 6 am. It was really like hitting a light switch the amount of change and Dr. K said that was very typical of the FLA treatment. They have done many of these for PCa. 

Yes, I believe you are right on that URIBEL would help you I think it was a life saver for me and I am not a pill person.

Hi Jim, I need your answer to this problem? I have been getting headaches,a lot . It's not hypertensen,can you get headache from CIC?

Lately i get the urge to pee less than 3 hours ,sometimes 2 hours. Dr tells me not to cic more tha 6 times a day. At this rate i be doing 8 times a day.

I don't drink liquids that much,maybe drinking more liquids be an answer,

My more concern are these headachs. Tylenol doesn't help that much? Do you think it could be CIC?

Thanks a lot JIm

frank, 

Thanks. Sounds like URIBEL or similar should be prescribed for the first week or two for anyone just beginning CIC. Your doctor should be commended for doing so many things right beyond the actual procedure. Sadly, the amount of dedication and follow-up by Dr. K. that you describe is rare in my experience with many, many doctors over the years.

You should also be thanked and commended for the pioneering spirit you've shown by being one of the first to try this direction, and also for chronicling it so well. Hopefully, it will give others more confidence to try it.

 

Today, fortunately, things have worked out well for me through CIC, but if I ever needed surgery in the future, Dr. K. would be on my short list to call.

Jim

Frank,

No I don't think the headaches are from CIC. \

You've asked this question before about your urgency and cath frequency. I suggested you experiment by cathing 7 times a day and keep a void log.

BTW when I first started cathing they only wanted me to cath twice a day even though my cath voids were often over 1000ml!!!  I did some research and decided I would cath 6x/day to lower my void volumes. The doctors aren't always right and sometimes you have to make your own decisions as long as they are based on sound reasoning. I can't see any downside -- such difference in trauma or UTIs -- between cathing 6 or 7 times a day. Do you???

Jim

Jim

What is FLA stand for?

Focal Laser Ablation preformed by an iterventional Radiologist with real time  3TMRI of the procedrue so they acutally see what they are ablating as they do it and it is highly acurate up to one mm. 

And they dont go through the urethra. It is done with a hair size laser into the prostate to laser the tissue causing the problem while not getting near any of the important things in the gland. Sure gave me back my life. if you need more information I will personal message it to you. 

John

I would like that information, incase they have to do Greenlight again. Does it avoid retrograde ejaculation than?

JimJame yes you are correct the urologist are very much trying to first keep FLA quite and not tell their patients about it especially if the patient has BPH. They tell them that this is really just for prostate cancer. Second the urological industry is trying desperately to find a competing procedure they can push but you understand it better than most. The key is the fact that with the MRI you have real time “eyes on” by the Doctor. Dr. K. has a lot of “eyes on” experience not only as an Interventional Radiologist but he has always specialized in the prostate from his fellowship to his directors position in Houston. 

Yes I am now completely sleeping through the night I am getting up once a night but it is my own fault. I do not wake up needing to urinate. I some nights wake up and wonder about it and can’t go back to sleep so I get up to go watch the stream. Dr. K. laughs at me and says I will stop that when I get tired of my new toy. Wow does it flow right now! I am not having retention now but I will get retention checked after I find a new Urologist. My last one will not be my doctor if I had FLA. I know I do not have retention now as I can first tell from the feeling and the huge flow during urination. But I will check it when I check my PSA in a few months.

Ok, prior to FLA treatment. My PSA was 5.7.  My size was 125. My density was .030 which was good. I had one suspisious location that was under active surveillance for the last 18 months. It was remove also during the Ablation. I had nocturia and was up 6 to 10 times a night. I would have to walk around to urinate. I had incontinency sometimes 2 to 3 times a day as I could not make it to the mens room. BPH controlled my life. I had to carry a bottle in my truck to pee in. I have had to pull over and pee on the side of a road. I could not go anywhere without peeing first before I leave and then learning where the bathroom was the minute I get there so I am ready. I had no sexual issues but that was what I did not want more than anything. FLA gave me my life back with NO sexual side effects. I am only 27 days out of the procedure and ALL my symptoms are much better or completely removed from my life. I now go in the daytime 4 to 5 hours between urination and I do not have incontinency any more. Jim, I would pay five times what I paid if I knew this would be my results. Yes, this was my first and only procedure and it was FLA. I researched every procedure for 20 straight months. I will send you a history of that next as you seem like you would be interested and I can tell you would understand my procedure of research and the logic I used. Research is the key. Why would a person just take the word of a urologist???

One other thing to note, Dr. K is about to begin a clinical trial the is will partially fund for 7 to 10 men on BPH. He will pay for a percentage of the cost to lower it price for them. I could not do it for several reasons and I past and wanted to go before that. IF anyone has interest they should call him and discuss it with him directly. Several men on this site have called him for advice and information and have all commented on the level of attention, interest and support he gives them. I believe at least two people have contacted him and signed up from this web site. He wants and will publish the results. This is to change the situation you were speaking to earlier of acceptance, this will really help. Bottom line is this will also be very long lasting solution as the tissue is removed and will not grow back where it was ablated. 

John 

Absolutely I am now 27 days post op and have had sex twice this week and there was acutally a lot more ejaculate than before FLA. I had no blood in it either which was unexpected. Sorry I sent you someone elses answer to a quesion they ask 3 minutes ago as i just hit the wrong button. I will get you the info soon. 

John said: "Why would a person just take the word of a urologist???"

-----------

I guess that's why we both currently don't have a urologist

Dr. K's partially funded study sounds interesting. Do you know if there will be a placebo arm? Also, did Dr. K. do the procedure on you himself, or was it his associate, or both? I read in one of your previous posts that he may have had scheduling conflicts when you wanted it. 

Sure, love to look at your notes as I am keeping a list on everything new. Right now I really can't justify any procedure since my bladder, while not as productive as yours (my best voids are 350-400ml), is so nearly normal that to monkey around with things, even in very non-invasive way, really doesn't make sense.  Yet, who knows what the future brings. 

Jim

  

yes, I got both guys thank goodness!! He had several procedures set for the week I wanted to do it and I could not change. If I did not do it at that time  I would miss the window that I had agreed with at work. I had already used all vacation time for the year traveling around doing research and they gave me extra time off of 2 weeks with pay only to get it done as BPH was seriously effecting my job really bad. I can't take off now for the first six months of 2017 and I am retiring in July, so it does not matter. It was my fault as I just waited to long to pull the trigger. Yes, I guess I could self cath but I just could not imagine that at work. So he agreed to set up all the procedure and helped on the strategy of the laser and computer. Walser did the laser work which is in the room next door and is all computer driven after being programed buy them. Dr. K did all the post op and the intiial testing with me. It worked perfect as Walser is really heavy involved in administration work at the University Medical Branch and he does not have time to follow up with patients which I did not want to be a problem. So he promised me he would handle. His case that was scheduled at the same time as me was a serious prostate cancer case. He did not tell me that but the nurse they each used told me.  

I dont know about the placebo and I have not got any real details of the trial but I know it is so he can publish results and it is register, certified and set up so it will really help with the information getting out about this fantastic treatment. It would have been nice to save a bunch on the procedure but I think I got a bargin without any of that discount stuff due to the results I got. yes it is a lot of money but I am so pleased and will now have a fantastic retirement ahead of me and that is what I wanted so I did not want or care about a discount savings. We put it on credit cards and I am going to pull my IRA or proftit sharing and pay it off in July when I go. It will be like buying my self a nice retirement gift!!!

I agree that if you are doing well right now you should keep the course and don't change any thing now. But you may wish to call Dr. K and disucuss everything with him. You really can ask him anything. He does not try to sell you but he will really get invovled in teaching you all he can so you can to make the right decision when you need to. And he will charge you nothing. I had spent hours talking to him several times. I then went to see him with my wife as I visited 7 doctors. He stayed after work to diagram my MRI and to show us all the equipment and components of the procedure. He explained the cost and why it cost what it did. He spent close to 3 hours with us that afternoon until 6:30. I did not sign up with him for anything  then and in fact I went to Florida then Tennessee to meet with other Doctors after I spent all that time learning from him. He was perfectly ok with that and I told him that was my plan before hand. I continued to gather research on many treatments to compare. Nothing made as much common sense in my research as FLA. I could tell he was the best. So I went back to him by phone again asking more questions. He had no idea in December when I called him that I was going to say NOW. Let's Go NOW. He really did me a favor. It is up to you but if it was me I would call and feel it all out like I did the first time. You will be a little shocked. We are both older guys and we have good guts. I never met one like this guy. He is the real deal. He is also Armenian and most of those people are very fine people. Ask him about the study and he will talk your head off. 

Good luck Buddy keep me in the loop on what is happening to you. It is interesting how you have managed this so well. 

John

John,

I probably would have called him 2 or 3 years ago, at least for a chat. However, still not sure I would have gone ahead until more results came in, as not as much a pioneer as you are. But today is a different story. My IPSS score is 7 (mild) but my "real world" IPSS (factoring in age, and tangential factors) would be 1 or 2. That means very little if any reward for whatever risk of rocking the boat which for whatever reason is sailing pretty well these days. If things change I have his name.

Jim

Good morning John.  You had a very good doctor and he did what he said he was going to do.  Doing the MRI before and explaining it to you is about the best you can do for a man.  He also told you that he would avoid all the good part so you would keep all your sexaul function.  Most men avoid surgery if they have to get rid of anything.  Not saying that sometimes it is ok but there are the times that all change and some men just can't live with it.  I feel FLA is a step in the right direction and would be great for cancer and BPH because it can get ride of the tumor and the tissue that is causeing the problem.  If a man does not do reseach we would never know.  I hope that the FDA will start aproving this procedure and they could help alot of men.  I have a friend that is only 51 now that had his prostate removed because of cancer Now he wished he would have waited.  All he wants to do is die.  Sex is a problem and is no ejoyment for him at all.  I try to help him and I talk to his wife to.   They are both good people and I'm glad they my friends   She is also depressed because she talk him into it because the doctor told them all would be ok   .  Take care my friend  Ken 

Ken that brief story so sad. My heart hurts for this young man who obviously was sold a bill of goods by some Urologist wanting to make another car payment.

In talking to Karaman ian over time, I have realized that his helping men exactly like the young man that you discribed is his passion and what he lives for. He has told me many time that it is not the number of procedures he does that fullfills him, it is the quality of life he restores. There are many disciplines of mediciine he could have pursued and they would be much more lucrutive than Prostate Laser work, primarily cancer wrok.

Why because Yes you are right, men will first know nothing of FLA unless the work hard to find it. Then, there doctors and others will discount it, lie about it, and do anyting they can to stop the truth. 

I remain shock at why a man, especially a younger man would listen to anyone without research? Why would you not learn everything about your conditions and the Anatomy it involves? You go to a doctor and he sells you the newest thing is has learned and tells you it is Great! Yes it is time consuming and sometimes expensive to do the amount of research I did for 20 months. But, just like your friend found out, these are life changing events. And when they damage you the doctor says, "sorry this happens sometimes". How horrible this young man is tourtured and I know he worries about this marriage relationship. I ask every what possible effect, barring a stupid mistake by him, could the procedure have on EACH one of the components of my gland. I made a speard sheet compared all of these treatments because there are not any do overs in most mistakes.  

 I am not wanting to push men toward FLA even though I know it is absolutely hands down the best for low to intermediate PCa with Gleason 7 or lower and it also gave me better result than I imainged it could for BPH. I want to get men to understand that they need to know the outcome percentages of the process they choose BEFORE they do it. If you choose a treatment and it does not work, they is a reason that was possible and you should have ask the Urologist you have so   much faitth in the direct question. "How will this procedure interact with my ejaculatory ducts during this procedure". > "How about my Cowper's Gland, will it be effected by the laser and if not, how come." It better to know before than to be saying, "well you did not tell me that was possible".

Now I just want to enjoy my results and try to get men to slow down and learn before they tell a doctor YES. I am thinking of posting my story of the jouney of researching that I did on a new post? So men can start seeing the importance of the level of understanding they need to have. you are one of the few people I have heard make comment on this and I Applaude you. 

John

Men have to stick together.  Before my problem I did not know alot about the prostate or strictures until I got sepis. I was sent to my urologist because they could not get a catheter in me  ( That's a horror story )  I have learn alot over the years.  Men never talked about there problem.  You don't meet a friend and say how you doing How's the prostate.  But we should talk with each other about things like that. Sometimes we talk with our wife's. But another man know and may have the same problems.  There are so many procedures out there.  You said that you have a book on FLA.  With ever treatment I look up I print them and I have many folder with all the information I can get.  I'm 61 and I don't have sex alot these day but i'm not giving up anything because of BPH or Cancer. I want to be ready for anything that comes up.  Information is want all men need.  I hope more men start to look things up and not just take the word of the doctor.  Doctor do know alot but we need second opinions to make us pick what is good for us.  Not all treatments work for everyone  Ken   

Hi Jim, What are your thoughts on this question? I could not get catheter in at am? i tryed  magic sure grip, and speedy cath fr 12. I gave up went back to bed,Around 9am  it worked. I still cannot pee without CIC.You said you had the same acute retention,however after so may time of CIC you started to pee again. My thought is, while doing CIC this must open the prostate obstruction eventually,and then one can pee again.

Does this make sense?

Thanks Jim

frank,

Frank,

Our cases are different. In most cases I was always able to void even if it was only a little. As to "CIC..open(ing) the prostate obstruction..." this may be one element of the process but probably the more important element is that CIC decompresses the bladder giving it the potential to heal, regain tone and therefore for the detrussor muscles to get stronger and therefore work better. Given how long you have been in complete retention it's unclear to me if you will be able to eventually natural void with some sort of operation or procedure.

Jim

Hi Jim, Thanks again for JIm for this info.

frank

Hi Jim, You don't think i will be able to NV even with a  procedure? Wow if thats the case why would i want to do have a procedure done? I'm getting urodynamics  test, if this is good then i will try Gl. 

frank,

Frank,

I don't know if you will be able to NV after GL or any other procedure. The results of your urodynamic test hopefully will give you some answers.

Jim