Posted , 12 users are following.
A simple question really. I'm told and I read that the TURP procedure more than likely will cause RE. How do you judge that likelihood?
Is the procedure pot luck? Is it due to the shape and size of an individuals Prostate? Does it depend on the blockage? Is it down to the skill and experience of the surgeon?
The latter is surely an issue?
1 like, 91 replies
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j12080 charles40613
Posted
Here is a few comment for an average person.
This is a situation where these Doctors are selling you a solution typically to urination issues. You cannot just accept their percentages or the word.
First, why would a man not first know all he can about his prostate gland components and what they do and how they work? It is not that hard to find out or to understand. Second, why would a man let anyone do anything to his prostate if he did not understand completely ALL the things they are going to do and specifically how they will actually do those things inside his body? Then just apply some common sense and logic and you will be fairly correct in what your outcome will be.
It is easy to understand retrograde ejaculation and dry ejaculation (which are different) from a particular procedure when you understand how they preform the procedure inside you body.
It is not rocket science when realizing that the scraping of the urethra by the blades used in a TURP cut across the outer opening of the ejaculatory glands as they are pulled down in the procedure. With NO visual contact with the area during the actual movement of the blade, it is hard not to cause RE during a TURP.
Please just try to research exactly how the procedures are done by these so called professionals before you select a treatment. They are not going to give you the details. Much like a mechanic does not give you the detail of how and what he does when he replace the front end of you automobile. But let's be real, this is your prostate.
jimjames j12080
Posted
Hi John,
Up until recently, the big attraction for me with FLA has been no sexual side effects. But recently, one of the FLA patients posted erectile dysfunction after FLA that took Viagra to correct.
So let me ask you, or anyone else concerned about sexual side effects, this question. If you had to make a choice between a procedure that had a 10% incidence of retro ejaculation or a procedure that had an 8% chance of erectile dysfunction, which procedure would you pick?
Rezum is the procedure running at around 10% of retro ejaculation and FLA is the procedure running around 8% of erectile dysfunction (1 out of 12 reported cases).
You might say, "but we only have 12 cases", and that's really another big point. We only have 12 reported cases so who knows what the real risks and benefits are. So, until more FLA data comes available, including Dr. K's trial data, it's very hard to come to hard conclusions.
Jim
jimjames
Posted
I forgot to answer my own question. I'm no fan of retro, but faced with the choice above, I'd pick the procedure (Rezum) with a 10% chance of retro versus an 8% chance of erectile dysfunction.
Jim
j12080 jimjames
Posted
j12080 jimjames
Posted
Ok. Sounds like you have made a decision then. If that your deduction then we all get our choice. I will point out that there are many more men on just this site than 12 that have had FLA so not sure of you percentages.
ED has many causes. This person's privacy needs to remain respected. In FLA, to cause ED there would have to be contact with the Peripheral zone nerve bundle. Dont know this case detail but that is not a usual occurance in FLA treatment due to location in the gland of the nerve bundle.
Good luck with the Resume procedure and please keep us updated. By the way , 1 divided by 20 is only 5% occurance percentage regardless of the actual ED cause. I can name 20. Not trying to change your mind, just being more factual.
kenneth1955 j12080
Posted
John Is Dr K first name Ara I don't want to write the wrong one. I have a few question Thanks Ken
j12080 kenneth1955
Posted
Yes sir. Dr. Ara Karamanian in Houston TX.
at the prostate laser center on Fannin
jimjames j12080
Posted
@J12080:Good luck with the Resume procedure and please keep us updated.
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I was only posing a hypothetical for both others and myself. I'm currently very happy with self cathing and am not planning Rezum, or any other procedure.
J120: there are many more men on just this site than 12 that have had FLA so not sure of you percentages.... 1 divided by 20 is only 5% occurance percentage regardless of the actual ED cause. I can name 20.
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I remember around 12 when I was counting and analyzing, but you could be correct. Could you please list the 20 names so others and myself can follow their stories. You wouldn't be breaching any confidentiality since they have already posted about their procedure here.
But even if we accept your figure of 20 cases and therefore 5% retro. I would still take a procedure with a 10% chance of retro (rezum) over one with a 5% chance of erectile dysfunction (FLA). I have a hunch I'm far from alone here.
J12080: ED has many causes... Dont know this case detail
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The person clearly stated no erectile dysfunction prior to FLA and erectile dysfunction right after FLA.
I don't think you can have it both ways. For some time now you've been using the anecdotal data of a small group of patients here to show that FLA works. You can't then say -- well, wait, in this case, maybe there are other reasons! Anecdotal data is anecdotal data, for better or worse.
Which brings me to the bigger issue which is the limitation of anecdotal data, or even observational studies for that matter like the one Dr. K. is now doing.
There's a reason the better studies are double blinded. It helps prevent both operator bias as well as the placebo effect. That's why, for example, sham procedures are often performed (take the iTind Trial) because the placebo effect is magnified even more when someone has a surgery versus taking a pill.
And then there is confirmation basis, which is very strong. I plan on doing a separate thread on this in the the future, but basically confirmation bias is when people tend to believe in what they believe, regardless of new facts being presented. And the more someone is invested in something, the more confirmation bias they have. It's an interesting phenomenon and I recommend anyone interested to google it and learn more.
So again, if you're going to accept the good reports on FLA, then you have to accept the bad. Or, if you're a skeptic of anecdotal and observational data like myself, then you will caution people to wait for more data, preferably double blind, peer reviewed studies before diving in.
That doesn't mean people should dive in, but just that they should be aware of what they're diving into and the lack of study data in the swimming pool.
Jim
jimjames
Posted
Typo in fourth paragraph:
I wrote: "But even if we accept your figure of 20 cases and therefore 5% retro" Meant to write
"5% erectile dysfunction".
j12080 kenneth1955
Posted
Ken, I went ahead and PMed you the information and the short answer is YES. As you can see got moderated once again trying to send you all information. But, he is very accessible for any conversation if you wish to call him and Donnie is the same way.
Additionally, I don't know when or why i would speak to him again in the near future.
If you feel compelled, would you please ask him to explain how or why someone got ED from an FLA procedure it would sure serve a purpose for me as I do not want guys not getting the facts that are looking into any of the treatment options.
We don't want one way or another misinformation being interrupted that would not be good for men in the sensitive process of decision making.
If I was contacting him I would reference the situation myself and ask about it as I am positive he will have no issue in discussing this and giving a general information without breaching any confidence of any individual. I assume the reference made was to one of his patient and if so, I am positive he is aware of it and would gladly address in the proper contents. He is a wonderful person who really cares about this.
Good luck and watch for your PM. I hope this helps you..
jimjames j12080
Posted
j120: I assume the reference made was to one of his patient
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John and Ken,
Yes, it was one of Dr. K's patients. He stated in this forum that he had no erectile issues before FLA but he could not get an erection without Viagra after FLA.
Jim
jimjames
Posted
"Jay111" is the person who ended up with erection problems after FLA.
Jim
j12080 jimjames
Posted
Had to finish watching the playoff of the golf tournament.
Ok, sorry I did not know you were being hypothetical. I thought you... oh well it doesn't matter.
Jim If you feel Rezum is the answer then that is what you can tell men. I had my procedure and it was great for me.
Many men also did the same thing and are off living life and happy. Peter in Hong Kong Ross in NY and Victor. They are not posting because of this type of controversy of this type. They don't want the issues and they paid their money so good bye. I will get you the names. I will also start a new thread for these and others FLA patient to report so we can try to know there longer term results.
With regard to the gentleman and the ED you claim is from FLA. IF it is the person I believe it is he has discuss a nature treatment that I did look into and... well I will let you read it if the moderator will allow the site. It's a bleach that he is taking.
This can also cause or worsen any nerve damage. i.e. ED
https://respectfulinsolence.com/2016/10/31/bleaching-away-what-ails-you-miracle-mineral-solution-and-jim-humbles-genesis-ii-church/
I am happy for you that you like Rezum as we all need a future procedure in the wings when the BPH returns, cause it will return. The prostate keeps growing.
Names for you, i will get them just give me some time here is off the top of my head:
john, ross, mike Victor, richard, brian, Michael, jeff, joe, joe's brother, Peter, Tim, jim, martin victor, I got more but will have to find them as there are other sites that are not on Patient.info
j12080 jimjames
Posted
j12080 jimjames
Posted
I believe you are speaking of the man below and he is down under. I believe he was on the MMS regimen before he did the FLA but I would think you would place your usual FDA approval to this homeopathic chemical treatment. Some due claim this has an association with ED and I am not one to judge but I do know that the ED condition would be unlikely to be caused by a procedure that never enters the peripheral zone of the gland. I will find out more about this and let you know.
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Jay to JimJames
JimJames,
Well, you seem to live here on this prostate forum, and I do not. This particular thread seems to be about Focused [Focal] Laser Ablation. This is a surgery that I have had, and you have not.
I attempted to describe, in detail, my experience with the FLA and my opinions related to this surgery. I would still like to know what the flow rates are for the successful 'others' [even just ONE OTHER] that has had this surgery. As you have not had this surgery, you cannot help me in this regard. All you are doing [seemingly] is attempting to undermine the potential for others [that HAVE had the FLA experience], to give me this kind of information by making it 'okay' not to help me in this way... because after all, this information is not important. [At least not to YOU.]
The JerseyUro did not seem to have a problem with my expression about 'flow,' and he definitely demonstrated agreement with my point of view. You may not like him, but he seems to be on the front lines of prostate problems, just as Dr. K is on the front lines as well. You are NOT on the front lines of prostate surgery, but you ARE on the front lines of this forum, and that is all.
Whether I worded it correctly or not, I KNOW that I got my point across, and that's the important thing. Flow rate is a very important statistic, no more, and no less important than the PVR or the IPSS in general. But for me, with the problems that I have had it is 'THEE' most important thing, but that's just me. Every surgery that is done on the prostate [for BPH] attempts to increase flow as its primary goal, with quite often some horrible side effects BECAUSE of the surgery. But, if one cannot urinate, that person will die, and this definitely has to do with the ability to FLOW, or not to FLOW. I am doing everything in my power to avoid serious side effects with surgery. Still, to live, one needs to be able to urinate. Sex life is supposedly secondary to 'continuing to live,' at least that's the theory in general. For me though, life without sexual expression is not really worth living. But again, not everyone would agree with me on this either.
Cheers
jimjames j12080
Posted
Yes, same fellow, but I think it's a slippery slope trying to dissect/analyze (perhaps discredit) his negative side effects from FLA, because if you do that then we have to question the positive anecdotal stories as well. All I know is that he states no ED before FLA and ED right after FLA. The ED comes from a numbed penis head, and while I'm no neurologist, sounds like nerve damage. Given the heat and vaporization involved with FLA, doesn't sound like a stretch that a nerve could have been damage.
Not sure what the "MMS" regimen is, but you state he was on the regimen before FLA, and before FLA he didn't have a numbed penis head. So, the reasonable assumption is that FLA caused he numbed penis.
I certainly hope that his experience was an outlier experiece, but until we get some more and better data, all we have are he anecdotal stories, the good and the bad. And if we accept the good accounts, I think we are compelled to accept the bad unless there is hard evidence showing otherwise.
Jim
jay111 jimjames
Posted
It's not that I cannot get an erection post FLA, I have great difficulty maintaining an erection after the FLA because of the numb meatus... using viagra eliminates this problem. 1 bad case out of 20 is still great odds for any surgical procedure. If you read my entire post about my problem [link below in next post from someone else], it is explained there in great detail. In addition to BPH pre-surgery, I also had a very bad case of prostatitis.
Dr. K did mention that my problem could have been caused by the lidocaine which is used during the procedure.
I cannot say anything bad about Dr. K... he really is one of the most caring and empathic doctors/humans on the planet.... I know he gave his best and does so for every patient.
jimjames jay111
Posted
Thanks for the clarification. Did Dr. K. give you any type of explanation? It sounded like a nerve might have been damaged during the procedure but I'm not a doctor. John (J12080) suggested it may have been from supplements you were taking but that didn't sound right to me for a number of reasons, including the timing.
Jim
j12080 jimjames
Posted
Agree Jim just find it wrong on your part to access bogus percentage number which only apply to the small limited universe that you have knowledge of FLA procedures and use that to warn men of your incorrect analysis. In the first place you are wrong in the second very limited in only using patient.info.
j12080 jay111
Posted
kenneth1955 jimjames
Posted
Jim & John...Please let's not fight about this. Let's just agree that we need more DATA. We are here to help our fellow men. I hope one day it will all work out for everyone...We have to stand together Take care and God bless all of us..Ken
jimjames j12080
Posted
No more bogus than your claims about how great FLA is. We're using the same "small limited universe" which has been my point all along. It's just that you want to use the small universe of successes to promote your point of view but you don't want to validate the small universe of failures. You can't have it both ways. I'm not "warning" anyone, just trying to point out that we only have very limited data on outcomes. Something you have always failed to mention.
Jim