Procedure Information
Posted , 15 users are following.
Good Morning All
I have not seen much on any of the procedure for BPH on the site. For a while we were seeing a lot.
Over the last year we have seen many new ones and you still have some of the old stand buy hanging on. These are mostly done by doctors that are set in there way and do not want to learn anything new.
A man has the right to have the best treatment he feel he need that will fix his problem but there have been men on the site that had to have more then one because the first one did not do the job.
When a men is looking for a procedure he needs to find a doctor that care enough to listen about his concerns. Being we are all different we all have different concerns. I think it also has to do with age.
BPH can hit a man of any age from 30 to 70. I have dealt with it at 55. I have a brother that is 77 and has had no problem.
When picking a procedure a man in his 30's will have different concerns then a man in his 70's most of the time. Are you looking to just pee better do you have concerns about your sex life and are you willing to give up your ejaculation.
All this has to be taking into any decision on what procedure you pick. A good doctor will tell you to start looking at less evasive procedure these are the ones that will cause less side effects.
Procedures that cause the less amount of side effects are Urolift.....MidLift.....PAE.....Rezum. These procedures do that by not cutting away at the prostate.
Procedures that cause more side effects are any Turps done with a Loop or a Laser. You also have Holep and then you go into Simple Robotic Prostatectomy and a Prostatectomy which remove the prostate when you have cancer. There are also some others that are new that I will not go into but they cause the same side effects has a Turp. These procedures are just a Turp done in different ways.
When picking a doctor you need to look at all the procedures that he does If there is something that you want and he does not do you need to move on and not be talked into something you are not ready for. Just get all the information you can. Another thing talk with any of the patients that have had the procedure and see how they came out.
I'm only going to say a few things on the Rezum procedure because that is the last procedure that the site has been talking about.
A lot of the men have had a long healing time and the procedure was very painful. I get video's and information on procedure every week this week it was on the Rezum
The steam is giving in a injection at 70 Celsius which is 158 Fahrenheit. The doctor that was talking about this said that it cooks the prostate tissue. Did you also know that at 131 Fahrenheit causes second degree burns and at 162 Fahrenheit the human tissue is destroyed so they are just under that.
The reason I'm telling you guys this is because maybe this is why it is so painful and the pain will continue for months sometime. Cooking the tissue. You guy's must know that if you have ever had a burn you know it hurts like you know what. In any of the booklets on Rezum it tell you nothing about this.
I think this is enough for now. Just be aware of what you pick because you are the one that will have to deal with the side effects not the doctor he just moves on.
With Christmas in the next 2 week I wish you all a happy holiday and try on that day not to think of your problems. Just for that day enjoy your family
Merry Christmas & Happy New Years...........................................Ken
1 like, 48 replies
Boethius kenneth1955
Posted
Ken, Thank you for starting this new thread and your well-written post, it is a good general overview that would certainly have been helpful for me when I started getting myself educated on BPH and treatment options. I agree with many of your comments and will just add my a perspective on Rezum and your comments on pain. I had Rezum under general anesthesia and except for burning & discomfort associated with the foley catheter I really didn't experience much pain at all. I also had a smaller prostate size and fewer injections than most so that may explain less pain. I am now five months out and doing much better. The positives are that I sleep through the night 75% of the time if I am careful about fluid intake in the evening. I no longer have the urgency, burning and dribbling and can go longer between voids. I am no longer taking tamsulosin and cialis . I do still have a fairly weak stream and wish it was better than it is, still takes me a longer time than it should to void, think I likely have bladder damage from letting the BPH go too long before seeing a urologist and deciding to do Rezum.This site has been great and so helpful. Each one of our experiences is different but we can all learn from each other. Thanks again Ken and everyone for sharing your perspective and experience with the various BPH treatments as the science and procedures continue to advance.
kenneth1955 Boethius
Posted
Good morning Boethius
It's no problem I try to give men all the information that I can find. With the Rezum I have never heard any of that. I watch a video and this is what they said. I have never seen it in any of the booklets talk about these things
How hot the steam is and what it does. I still can't get it through my head when this doctor told everyone the the steam cooks the prostate Tissue. Any procedure you should be out after you find out what the doctor is going to do.
When I had my Urolift I also had a general. So I felt nothing. That is true each man is different so we never know what will work.
Glad your off all the meds and I hope you see more improvement as time goes by.
All the best...Ken
Outtatoone kenneth1955
Posted
Good points. I have posted my experience on Rezum from 3 years ago. The Rezum is temporary but has still been well worth the cost, time and pain. I had posted my original experience because I felt like there was lots of negative perceptions and doubts. Anyway, if anyone wants to learn more, please see these two post.
My original story:
https://patient.info/forums/discuss/rezum-treatment-details-553352
The story I am on now:
https://patient.info/forums/discuss/rezum-treatment-details-part-2-722110?page=0&order=Oldest
2019Guy kenneth1955
Posted
Marty and Ken - your exchange is interesting and, equally importantly, polite. Which is often a rare commodity here on the interwebs!
Marty, I'd never heard of Aquablation before and I'm glad you brought it to our attention. I suppose I could say that I wish I'd known of it before I had the Urolift in October, but when I read the FAQs on their website get the impression that it works best for prostates that are far larger than mine. I also looked at the video; at one point a disclaimer comes on "not for sale in the US". Hmm.
Ken, I've of course read and commented on your fine posts on the other Urolift thread. I'm so glad it worked well for you. Unfortunately it doesn't seem to be doing that for me, although I am continuing to be patient. Next week it will have been 2 months and I would estimate my improvement at maybe 10%.
If by the first of the year that hasn't ticked up I guess I'll know. Will be having a chat with my uro in a couple of weeks and trust that he'll enlighten me. My situation is a bit more complicated as I'm also blessed with PCa, though thankfully only 2 low-volume cores Gleason 6. So no treatment in my immediate future.
But of course the urinary situation is a huge drag. I'll bring up both PAE and Aquablation with him.
Thanks, guys. Very informative stuff!
David
Marty02 2019Guy
Posted
David,
Finding a Urologist who truly knows PAE and Aquablation was difficult for me. Especially with PAE, since that is an Interventional Radiology procedure that cuts into the bread and butter of a urology practice. Aquablation requires a AquaBeam robot that many hospitals still don’t have. I was told all kinds of crap about PAE and Aquablation by doctors that just was not true.
I had my PAE done five years ago and then had my Aquablation done November 5, 2019. My prostate size was about 60.
It appears thus far that I stopped the majority of blood in urine after 4 days and I was fully recovered after my 15th day. I was able to function sans Foley the day after surgery with just some tolerable burning when I peed which stopped by day 4. I now completely empty. No RE thus far. I have only some occasional annoying sensation in my urethra after urinating that will go away in time, I am told.
I know that the four other patients my surgeon did prior to me are experiencing similar results. This is all anecdotal to you and you should keep it in context. Do your homework! I did not have PC. Good luck!
Marty
richp21 2019Guy
Posted
Don't surprised if your uro doc does not recommend PAE. PAE's are performed by interventional radiologists (IRs), My excellent uro doc (life saver when i had a kidney stone) was woefully uniformed about PAEs ... he mentioned potential problems that may have been true 10 yrs ago, but not a concern these days.
Rich
richp21 Marty02
Posted
Not sure if PAE would be a suitable option due to the PCa.
2019Guy Marty02
Posted
Thanks, Marty. It's great to hear how well things are turning out for you. And ditto for the other guys you mention. I will indeed be researching further!
d
2019Guy richp21
Posted
Thank you for chiming in, rich. My impression - although I've only been seeing my current uro for a little while - is that he's likely up on all the newest gadgets, etc. He's fairly young and did a fellowship at City of Hope, a top research hospital here in southern California. He also seems very open to passing me on to other docs if the situation warrants, and will tell me straight up whatever my PCa sitch might preclude.
Regardless, I'm figuring that the hospital system I'm enrolled in likely doesn't have the very latest stuff. And then there's the thing I read on the Aquaetc's website about the non-US sale.
I'll post an update after I speak to him in another 10 days and appreciate your input!
Marty02 2019Guy
Posted
Just to make sure you are looking at the right website, the mfr of the Aquabeam robot is Procept - Robotics. Google Procept. It is for sale throughout the world.
Ive never seen this procedure mentioned with PCa. Let us know what you find out.
2019Guy Marty02
Posted
Thanks, Marty. And yes, it was the Procept-Biorobotics site I visited. When you go to the FAQs and expand "How does Aquablation therapy work?", there's a video. At the very beginning a graphic comes on at the bottom "Not available for sale in United States". Maybe that was on there before the FDA approved it and they simply haven't removed it.
More questions to ask!
russ_777 kenneth1955
Posted
"The steam is giving in a injection at 70 Celsius which is 158 Fahrenheit. The doctor that was talking about this said that it cooks the prostate tissue. Did you also know that at 131 Fahrenheit causes second degree burns and at 162 Fahrenheit the human tissue is destroyed so they are just under that."
Steam, by definition, has a temperature > 100 degrees Celsius at any pressure > 14.7 PSIG. The tissue is heated to 70* C from the heat released when the steam changes state back to liquid water, not by the temperature of the steam. I think you're being overly dramatic and misleading by saying tissue is cooked and comparing to 2nd degree burns. That is the point -- to kill the tissue. If it's very painful it's because the patient opted to do it without anesthesia or opted to remain awake but was not given a prostate nerve block injection on each side of his prostate prior to the injections.
kenneth1955 russ_777
Posted
Hello Russ
I'm sorry that you feel that I am being over dramatic but I am just telling you what the video that I watch said.
The video was on Med Tube. The Doctors name was Ulrich Witzsch It was a SMIT 2019 The video was on Rezum and they did talk about 70 C when I look it up it did tell me that it was 158 F and the doctor did say that the prostate tissue is cooked.
This is all I have to say on this subject. Have a great day.....Ken
russ_777 kenneth1955
Posted
I understand you're repeating what you heard or saw. Sometimes context is needed. The theory of operation of Rezum is that the heat released by the steam changing state to water is what causes cellular necrosis. Perhaps it's a technical point, but goes to understanding of the process. You are correct that the tissue does get heated to a temp of 70 C, just not how it happens.
kenneth1955 russ_777
Posted
No problem Russ
I just wish more doctor would take the time to explain the procedure to the patients. Not 5 minutes and you out. I know not all are like that but they are in the symptom
Have a great day...Ken
kenneth1955 russ_777
Posted
This is about Aquablation
This was a question that I sent to Neil Barber August of 2018.
I ask him if the area around the seminal canals can be avoided to help with the ejaculation. Less of a chance of retro
This is what he wrote me. I'm afraid the planning is in real time when you are asleep You can't identify the prostatic or common ejaculatory ducts. But you could plan to be conservative at the bladder neck and where the ducts emerge in the hope of higher rates. If you want a procedure that 100 % preserves all sexual function. Then the Urolift is the only option with good data behind it.
I did make a mistake. When I watch the video. It does look like they remove the hole prostate. That is not true it only removes half of the prostate. Sorry.
After reading his reply on the second email. This is what he said .Aquablation like all procedure remove roughly half of the prostate to make a wide tunnel. The bladder neck is important in maintaining normal ejaculation should semen be delivered in the prostatic urethra ( There is always a chance that will be cut )
So having a good doctor to do any procedure is the key.
God Bless to all.....Ken
Dogcajunatyahoo kenneth1955
Posted
Ken, where is aquablation done in the US. What dr. has done this procedure - if done on you? 69yr old with BPH n 200ml P size.
Marty02 Dogcajunatyahoo
Posted
Some, but not all doctors, are listed on the Procept website.
Regarding size, this is from the Procept website (preauth letter template): “Men with prostate size >50 g [prespecified analysis] had statistically superior improvements in IPSS after Aquablation therapy compared to TURP [p<0.02]. With larger prostates comes increased variability for TURP, which allow the robotics to demonstrate superior efficacy against TURP. There is no contraindication for Aquablation therapy in prostates > 80g.”
The above is based on a study that included prostates 80cc to 150cc.
Basically, whether or not to do aquablation on your 200cc prostate is something the urologist has to decide, but your prostate size is not contraindicated by any of the studies that I am aware of.
Chris Diblasio, Bethpage, New York did my Aquablation on my 60cc prostate.
kenneth1955 Dogcajunatyahoo
Posted
Good morning
Aquablation I did not have
I know there are doctor in New York and Georgia that do the surgery
Good luck....Ken