Retry Urolift?

Has anyone had Urolift repeated and was it successful?

Had a Urolift done in March (2018), some initial success but it didn't last. I'm catheterizing less and peeing better when I take Rapaflow now, but if I stop it only takes a few days for the prostate to shut down the flow. No noticeable side effects.

My prostate size is about 49. I had high retention, unknown to me, and have been catheterizing for over a year and a half.

I had another cystoscopy and my Urologist thinks adding more pins might help. 

He said his success rate is about 75% when he repeats it. I had 6 pins placed initially which is all the insurance allowed, but he thinks adding a few more might do the trick (my insurance allows repeats).

I asked him about Rezum and he doesn't recommend it. He tried doing it for a while and didn't like the results. He mentioned he had talked to a Urologist recently that does them and he doesn't have the first follow up until four months.

I follow this forum regularly and have looked into the different procedures. I chose Urolift initially because it's covered by my insurance and seemed like the least invasive and least side effects. Not interested in a TURP or anything that causes RE. FLA too costly and seems not always successful. My prostate is about 49 so don't think PAE is a good option and not done anywhere near me. Seems like HOLEP needs someone with a lot of experience.

I asked him about aquablation, he said a hospital he works with is trying to get one and I might be a good candidate, but of course there is still no insurance code for them yet.

We also have a gentlemen's disagreement on catheterizing. He thinks I should try to do it as little as I can (maybe once a day or so), I'm still doing it 3 x day when I take Rapaflow, 3 or 4 the days I don't. I want to keep the bladder emptied regularly so hopefully it may keep healing. He thinks it's healed as much as it's going to and I shouldn't have it interfere with my life so much.

A brief summary of my Urolift experience below for anyone interested:

- 6 pins placed, very uncomfortable to say the least with the rigid scope/placement tool. Feels like a prostate biopsy needle for anyone who's had one, but through the urethra (ouch!) 

- Filled me up with about 600 ml at the end of the procedure and I peed most of it out, the Urologist was very happy and so was I.

- Stopped catheterizing and continued taking Rapaflow, had a lot of urgency and pushed out a lot of clots for the first week.

- Stopped taking the Rapaflow after a week at the Urologist recommendation and by the time I saw him for the two week follow-up was retaining 300 ml. Very discouraging.

- Started taking Afaluzin for less side effects and continued with the no catheterizing. Didn't seem to work as good as the Rapaflow and when I went in a month later retaining about 300 ml still and had a UTI for the first time.

- Started catheterizing again, hard starting again after a 6 week break.

- Tried various things with taking days off with the Rapaflow because of the RE and other side effects and am now taking it a few days on few days off, day on day off, more or less depending what's going on at work and in life. I can pee better and catheterize less when I do the Rapaflow now but still not emptying and I don't like the side effects. If I did the Urolift again and could get to only catheterizing once or twice a day (or less) without any medications I would consider it a success at this point, but of course would like not to do either.

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