Prostate BPH - FLA in Houston UPDATE

the only improvement is bladder seems to be better, less urgency and can wait longer in between trips otherwise flow rate not better and still need flomax. I am doing CIC once in a while and residuals have been 100 or lower which is pretty good for my case.

Hi Mike, reading all your comments it sounds like you are well pleased with your decision to go with FLA, I also had FLA Dec 2017 to correct an enlarged median lobe blocking my flow it was so bad at times I had to wait and hope the flow would start along with horrible pain if I held on too long and even worse pain when the flow would finally start, but after FLA with Dr K I had immediate improvement much better flow with no waiting much better sleep and able to drink more fluid and can hold on longer despite previous bladder damage so by retraining my bladder to hold more fluid longer and kegal exersizes the bladder is slowly waking up and hopefully it will remember how it once used to hold more fluid longer, but my flow is fantastic as I now have to stand further away from the toilet bowl and have flow on demand, my question to you is do you have much better flow than before FLA and what do you think is the reason why you still use cic? kind regards Brian.

Brian I'm happy for you, unfortunately my flow is not as good as you describe, and I still take Flomax. If I stop the flomax I fear the flow won't be acceptable, if I forget for one day I notice the difference the next day, not terrible but definitely noticeable - for the moment I'm not taking chances as I had damaged both bladder and kidneys prior to FLA.

Having said that I am still relatively happy I chose FLA. My bladder seems to be improving like yours. I don't have sexual side effects apart from the Flomax effect. As for CIC, since my last update I've gone to maybe once a week mainly to check I'm not holding much and the results last two times were residuals of 100 and 80 respectively so that for me is pretty encouraging.

I might decide to do another FLA but am taking a break from all that for a while, at least a year. Dr K thinks there is a very good chance he can make it even better next time.

Regards,

Michael

Mike and Brian ,

Glad you both had positive response from the fla. I’m having trouble viewing this on my phone, so can’t review the thread. I believe you both had dr k do the fla - is that correct? If so, did u talk to any of the other drs that do fla prior?

I just started CIC. Was only expecting to do it once a day, but was have so little comenout the rest of the day just started doing it twice a day. But since i started twice a day, very little is coming out otherwise. If I do an fla, will I have to retrain my muscles to start and stop peeing?

Yes Dr K I called Dr Sperling's office but they didn't seem very interested in my case. Of course had I said "where do I sign to spend the 25k?" they'd have taken me.

If very little coming out either you aren't doing it right (hard to imagine what you could be doing wrong) or simply you aren't blocked enough and are peeing normally. Why do you think you need to do CIC ? Have you seen a Urologist?

No you won't have to retrain your muscles.

Mike,

Sorry. To clarify, I have very little coming out when I do not cic. 

I have been going to urologist many years when had prostistus.  That been fine but prostate been growing. It had been getting harder to pee last few months. started meds - wasn’t helping So started cic. Less than 2 weeks ago

In that case I recommend you do CIC 3-4 times a day, first thing in the morning, twice during the day and once before you go to sleep and drink a lot.

Use only the lubricated ones otherwise you'll get UTIs

Hi Mike, have you been able to specifically identify the exact reason why your flow is not good enough?

does your flow improve when you have drank a lot of fluid?kind regards Brian.

Hi Brian,

I would need to do another cystoscopy (or other tests on bladder maybe) to find out if there is any other reason besides large prostate, so I don't know. From time to time flow is better, but I can't say if it's because I drink more or whether the flomax is at optimal levels in my blood. Having said that usually flow rate is "OK" and better than prior to the FLA procedure. I have noticed that occasionally if I am under a lot of stress or emotional I seem to produce a lot of urine and have to go more frequently with flow rate not as good. Coffee or alcohol at those times probably does not help!

Times like that I will do a CIC to get relief. For example I just did a 15 hour plane trip and decided to do CIC before the journey started. I didn't feel I needed to do it again on the plane itself probably I was far more relaxed by then.

 

Hi Mike, so I am assuming you have not had an mpMRI after your FLA to pinpoint your exact cause of slow flow and if not what time frame would you need to have for inflammation to go down since FLA before you have the mpMRI?

No sorry I missed your message Brian. The inflammation goes does after about 3-6 weeks usually I am WAY past that.

Hi Mike, I do feel for you Mike and hope things get gradually better, I know that FLA results get better with time, let me know how things turn out, kind regards Brian.

Thanks Brian, FLA results may get better with time but I'm pretty sure it means months not years. It's now been 1year and 5 months and what I have now is the result.

It's hard to say but my guess is the FLA DID remove a some obstruction but not enough to get a good flow rate. If I take a combo of Flomax and Cialis I am OK. I haven't done CIC now for almost a month and bought a scanner to measure the PVR in bladder and it usually is down to like 125ml. My last PSA test was high so I decided to stop CIC for a while hoping that was the cause for the high reading. I'll take another PSA test in the next week or so.

Hi Mike,

How does CIC raise the PSA score?

Good luck to you!

thanks for good luck wishes - there are some here who say it does not after doing CIC for a long time - but my Urologist's PA said it might be the cause. I have seen where is says "irritation" among other causes like increased sexual activity can elevate PSA levels. So she may be right, I certainly hope that's what it is. Could inserting the catheter irritate the prostate? Introduce germs? Or just the scraping as it goes by the prostate into the bladder?

I see.  So it can "artificially" skew the results.

Thanks Mike.

Mike, forgive my ignorance, I found that although my FLA was excellent I have to keep working at retraining the bladder to be able to hold more which in turn will help it to regain its ability to hold urine longer and its ability to squeeze all the urine out, I wish FLA had been available years ago to prevent this bladder situation and hope it will continue to improve which it appears to be although slowly.so if you can bring yourself to have a second FLA  despite your present views I feel confident its the way to go to save the bladder and kidneys, all the best, kind regards Brian.

Brian, do you still have urinary issues, particularly retention after a successful FLA ? Hank

Hi Hank, the FLA was 100% successful, the issue is the damage from not getting it done sooner, your question-do I still have retention?- the day after FLA the test showed no retention, but 7 months later I still get bladder signals to go too often and before my bladder is full especially in the cold winter months, the good news is thanks to FLA I have very good flow compared to previously which just gets better, also if I now hold on as long as I can I no longer have excruciating pain when finally being able to go, now there is no pain when I finally go, when the warmer months come I will purposely drink more and hold on longer and practice kegal exercises to train my bladder to hold more and longer in the hope the bladder will remember how it used to work many years ago, hope this helps, kind regards Brian.

Hi Brian, you might want to check if you have retention, by sure means of an ultrasound or a self cathing, before you train your bladder to hold more. Going too often is often a sign of retention. If you already have retention, trying to hold more may cause too much urine in the bladder, which might cause kidney problems, like what happened to me before. Hank

Hi Hank, thanks, tell me more if you dont mind thanks.

Hi Brian, I'm pretty sure had I done FLA before two failed PAE's which contributed to bladder damage i would have had better results. I think my bladder is a lot better now, but this could be because I did CIC for over a year. My flow is not spectacular - like you I am able to hold longer, less urgency and pain.

I'm open to doing a second FLA but not in a rush.

I saw you mentioned Kegel exercises, from what I read those exercises are designed to prevent incontinence, so they will not recondition the bladder as far as I know.

Have you measured your post void residual lately? I think mine is around 120 - I have a scanner now at home. If I do what they call "double voiding" meaning pee and then try and pee again a few minutes later, I can get more out and closer to 100 or less.

Do you take any medications to help flow? Did you take them before FLA and not now?

Hi Mike, long before my FLA I had previously used medication at the prompt of a urologist to take muscle relaxing medication to allow me to pee more easily but I hated the risks of such medication and the side affects left me feeling sleepy and disoriented so I ditched them along with natural supplements which did not really work for a median lobe pushing and blocking the bladder valve, I have never needed to take them since FLA, Dr K recommended kegal exercises even though he knew I did not have incontinence, my guess is its training my upper and lower prostate valves to be stronger in preparation for holding a volume they are not used to, take good care Brian.

I think I have the same issue of median lobe pushing and blocking. Dr K said he got some of it but not enough apparently - did he get most of the median lobe out in your case?

Hi Mike, to be completely honest I simply do not know as I really did not fully understand what I was looking at when viewing the mri images of before and after FLA, I recall Dr K showed me wht he did and said he was pleased with the outcome, and as mentioned fantastic results compared with before FLA, I guess each persons median lobe is different from another's and Dr K would have been very careful not to FLA too much tissue in your case so its reasonable to conclude you will have success next time if he is saying you will, sorry not more to you, help kind regards Brian.

Hi Arlington,

So despite everyone here saying CIC does not affect PSA levels, I'm happy to report that after stopping CIC for about a month and abstaining from sex for about a week, my PSA level DROPPPED DRAMATICALLY from 9.9 to 2.4

I don't know if diet ad exercise had anything to do with it, but there you have it - not proof but maybe means something.

Got it...thanks.  And congrats!