Uro Lift confusion

I also went private for HOLEP, paid for in Britain by AXA-PPP.  It only cost about £3000 including hospital costs (which I figure includes the laser/fibres), surgeon's and anaesthetist's fee, add on the preceding cystocopy that helps plan the op and first consultation and maybe £3650 in British pounds (AXA sent me the bills).  But I was only in for one night; it costs more if you're in for 2 to 5 nights like some men are.  I didn't ask how much Urolift would be, though.  Am sure less, as you leave at once; based on the cost of day surgery (transperineal prostate biopsy) at same private hospital with same surgeon/anaesthetist, adding on £500 for the cost of the tabs/sutures, I would guess £2750; hospital's day charge for biopsy was £1400 I think but insurer disputed and only paid £1200; that's just for bed and nursing for a few hours and use of theatre; on top of that was surgeon's fee, and anaesthetist, add a bit for the urolift kit and that's how I'd guess £2750 if you're out the same day you have it (which I believe is usual if fit and no complications? - that's part of the selling point of 'lift...). 

PAE would be done by an interventional radiologist, not a urologist. That may be one reason why a urologist might not mention or recommend it.

TURP doesn't sound like a picnic but my "lift" was a bit of an experience post op and has had zero effect on anything. I guess I would recommend it.

Lester, can you share a bit more about your Urolift experience?  And what was your situation, pre-op?  And where did you have the Urolift done?  

On the "up" side, if there is one, the Urolift can be reversed, so you can go off and have one of the other options.  From my reading, there are several other non-Urolift options that would be far better than the TURP!  

Cartoonman,

Had a Urolift last November after my urologists sent me information about it and I did some research as well as speaking with an 80 year old that had had it earlier in the year by the same doctor. Had a "lookylou" and I was a candidate. No fun with that for sure. Then the proceedure  and it was no fun with the recovery with nasty bladder spasms due to catether which was in for a week. No improvement of symptoms and could not get off medication (Alfuzosin). Doc said (over 100 performed) that this was the first instance of no allelviation of symtoms and my mild case of Peyronie's disease which I sure as heck didn't have before the proceedure. He wanted to give it another go. Not me and I can't really recommend the Lift but understand many may benefit from it. The 80 year old said he had experienced a 50% improvement. The Alfuzosin I can recommend. Great medication. Now have some Dutasteride to shrink prostate but not sure I want to start it. Also in February something felt like it shifted causing a small amount of discomfort. This went on for a month or so and just before an appointment to go back in (and to maybe schedule another "lookylou" (no thanks) the symptoms disappeared...thank you!  That is all I know.

 

WOW, Lester, and so disappointing to read about, let alone what you actually experienced.  :-(   Never heard of Peyronie's disease until now; possible trauma from botched procedure is what I'm inferring from your report, another UGH!  I wonder that he cathed you after the procedure.  I didn't have one; I jumped off the table and peed immediately.  I was on Alfuzosin and Dutasteride, pre-Urolift, but they little little or nothing for me, except make me feel "off."  And dizzy, which for me was dangerous because I sometimes work on high places!     I quit them after the procedure, and haven't missed them.  Except that, of course, my prostate kept growing, and negated the procedure in a few short months.  :-(    Where are you located?  And (if you are willing) who is the doc?

Doc never admitted the P.D. was from the surgery, only said no report of it happening before. But I guarantee you it was as a result of the surgery. I tried to urinate after the proceedure and was unsuccessful. Maybe too much trama caused swelling. You are very fortunate with that. I have seen that often on this blog; benefits begin to disappear in a few months. On the west coast. Can tell you the doc but don't really want to on the public forum. Any ideas?

Regards

I don't know whether it's an ethical matter, to name names on a medical-issues-related forum.  Stating facts of the case vs. slandering a guy.  But it does concern me that you now have a condition that COULD be linked to the procedure.  The Urolift is USUALLY straight-forward.  It is USUALLY a  fast procedure, 15 or 20 minutes.  But what we don't need, is sloppy work or doctors setting up "Uro Mills," knocking them out and causing collateral damage.  That's my concern.

I've had such good experiences with my guy, Dr. Steve Ganges, in Salt Lake.  He listens, we discuss.  My procedure in December was an immediate success, but it, um, "petered out" a few months later.  Although now he would recommend a TURP (except he knows I'd rather keep on cathing as needed, than risk THAT!), he is willing to try a second Urolift, which I am willing to try, as it is least invasive.  He's done 250+ Urolifts, and only 2 repeats.  I'll let you know how it goes.  

I mention his name because you might want to call him, talk to him, get his take.  I fly to see him from Eastern Pennsylvania...

Why not consider PAE or Rezum rather than repreat the Urolift that didn't last?

Well, Old Buzzard, good question!  (Sorry, I've been focussed on my wife's broken neck (a canyon-fall in Southern Utah) and her surgery yesterday (Here in PA).  

You raise a good question, and I will revisit these options.  My Uro-Doc doesn't like either of them (and it appears he has done some reading about them...) as an answer.  He has done many TURPs, still does them where Urolift won't work.  He admits the problems with TURPs are more than is generally admitted.  It may be that he has better luck with doing them than some of the others do.   I suspect that if he trusted the procedures he would recommend them, even if he wouldn't get any $$$ for it...

Thanks for the reminder, and I will return to have another look.  After we spring Kim from the unit!  :-)

I hope your wife has a speedy recovery. FWIW, there is enough good feedback and experience with Rezum and PAE to override or allay your docs concerns. And I'd certainly try both of them before considering going under then knife.

Thanks for the reminder, Old Buzzard!  Kim had her neck surgery on Thursday, we sprung her (almost getting an "Against Medical Advice" until I suggested I needed to talk to our nurse's supervisor...  :-)     on Friday, and today we went for a two-mile walk in the woods.  Yay, that.   I will now find time to start checking the files here...  Thanks again.

I had the uro-lift procedure  three weeks ago. I had a horrible recovery period going to emergency 4 times due to clotting. One time I did not think I would make. The bleeding cleared up in 4 days but my urinary problem is about the same as before and perhaps a little worse. Now when I get the sudden urge to urinate I often do not get to the bathroom in time.Still getting up four or five times to urinate. Now I'm back on Tamsulosin which helps.

   The lift procedure sounds good but it may be oversold.

Tony   

I am concerned that there may be underqualified providers for this (relatively) new procedure.  Where di you have yours done?  And were there extenuating concerns, pre-op?  Although the benefits of my Uro-lift (12 months ago) didn't last, my recovery was quick (2 days) and then painless.  But it was done by the most experienced doc in the country...

 

So sorry to hear your negative results.  I've put several posts up, if you want to review my experience, and here's a small update.  I went in a few weeks ago and got a flow check (not remembering the procedure name, pee into a funnel on a scale connected to a computer, get profile of flow rate).  Although frequently having a slow stream, can still void, and still happy with the choice.  Remember, everybody's case is different, and outcomes vary, for lots of reasons.  Best wishes for the future!

I am so sorry to hear this. I am 65 year old and going next week to do the Focal Laser Ablation procedure. I could not do a Uro-Lift as my prostate is 125 cc.and classified as too large. Preserving all sexual function, fast effective results, safe, and long term benefits were the criteria I chose to look for.  FLA will work and it will provide longer results as well as reduce the size and PSA score. It is very precise in technique and results. Dr. Karamanian diagramed the ablation area for me and showed exactly what would be removed in the laser ablation. In this diagram, it shows that he does not have to touch the Urethra, or any of the sexual functional areas of the prostate. There is no to little blood especially as compared to other BPH treatments. As tissue is coagulated in the areas of the prostate it will be absorbed by the body and passed off as waste leaving three vacant areas or pockets running along the side of my Urethra that will not regrow tissue next to my urethra.  

FLA is considered a new treatment for BPH but FLA is done very successfully for PCa in low to medium grade cases up to 3+4 Gleason situation. While getting this done, I am also getting an area of the prostate removed that is causing my bladder retention and also a spot that has been on active surveillance in the medial lobe as dark and suspicious. It will be biopsied then removed as it is best gone away. So I feel like I am getting “three birds with one stone” if you know what I mean. They will ablate about 30% of the prostate tissue. Dr. Karamanian is very communicative and diagramed and overlaid on top of my MRI exactly what and where the ablation would happen. He showed me in graphic detail on the image three areas along and beside my urethra that would be removed without touching my urethra and the area that would be taken out that was pushing up into my bladder. 

This doctor also uses a conscious sedation more like a colonostomy procedure instead of a Valium pill which is what Sperling uses. I am not interest in that light of sedation as I want no pain in the procedure.

Yes the procedure will cost me money out of pocket with only some items reimbursed by insurance or medicare but it is worth it to me to go NOW with the treatment I cannot lose time at work any other time of the year.  I have a window before the first of the year with my employment to get this procedure done and back to work. 

As a side note,  I think this Doctor is about to offer significant saving on a trial effort he will be starting for study with 10 patients in January and he told me about it. But, I am not waiting as I don't care about the cost. I want only one think. RESULTS. I got to have some help and I have been given this extra time window opportunity with my job of doing it before the first of the year. So here I go. 

I will let you know how it goes as if you start researching the other options this is something you should know about. I cannot put out as much detail as I like as most of my post have been block by this moderator as you can see in this tread of messages. But I can personal message what anyone wants to know more. I really think this is the answer at least for me.

Sorry to hear about your situation.  One of the things many of us may be curious about is what was the extent of your evaluation for candidacy.  There are a number of conditions that either medically or by the manufacturer, preclude its use.

 In addition to general BPH history, flow rates as well as PVR records should be reviewed and then a Cystoscopy  that verifies prostate size and configuration. As you know the manufacturer specifically excludes this application for certain conditions in these categories As well, the interior of the bladder should be examined. 

Was a NeoTract representative present at the procedure? The reason I ask is that at my procedure the manufacturer rep was right beside the doctor. I remember listening to them and heard them discussing the placement of one of the implants. Others here have said that the rep was there but I don't know if that's always the case.

Hope things get better.

You might be on to something. After the appropirate procedure my  urologist seemed skeptical about my candidacy for the prodecure but gave a reluctant yes.  I thiink I was very marginal. Perhaps I got the green light because he did not want to  be an obstacle to his partner who is pioneering the procedure in this area.

"Perhaps I got the green light because he did not want to  be an obstacle to his partner who is pioneering the procedure in this area."

If true....ouch...that would be would be a significant 'unforced error'.  Was there a Manufacturer rep present?

There was no manufacture rep. present at the evaluation procedure. I certainly like the idea of having such a mechanism available to protect the patient. I want to make it clear that I am not terrrible shape. I did have a rought time after the procedure and now that the blood clotting has disappeared have such sudden urges to urinate that I can not get to the bathroom in time. But in the last several days -now going toward a post procedure month - I feel some improvement. Might be back to where I was before the procedure.   

Well, I hope things smooth out.   I susbscribe to a number of 'news alert' sites including google where you put in a keyword, in this case urolift, and anytime an article appears anywhere with that word in it you get a link to the piece.  Urolift pops up quite frequently here as well as internationally.