I am thinking of focal laser ablation in Delray Beach, FL. I have a very large prostate (250grams). I did my first interview with the medical coordinator I believe. She said that I would be in the MRI for about 1.5 hours. I just read on this forum somewhere where someone with a prostate size of about 176gr was in the machine for over 3 hours! If that is the case will I be in for the whole day in an uncomfortable position? Any help would be appreciated.
Hi Gary, interesting that she said only 1.5 hours in mri, my prostate was only about 55grams and I was in mri for approx 3-4hours but I had a large median lobe and needed fFLA on tissue along the prostate urethra as well, what helped me cope being in that position for so long and with bad shoulders is although you are not asleep you are given a sedative which leaves you feeling very relaxed and you can ask to be given more to help you sleep or to move your arms I guess as long as you tell them before you move. I had Dr Karamanian in Houston who is excellent, I flew from New Zealand to have him do it, all went extremely well and so glad I used him to do it, all the best, kind regards Brian.
Why did you ever allow it to become so big? I would have thought that you must have had unbearable symptoms by now. Is FLA really the best option for one of that size?
The surgeon who did my second laser procedure (135 grms) told me that the biggest he had treated was 300grms. My father in laws prostate was over 200 grms in the mid 1990’s before all the new procedures became available. His health was not good enough to go through a TURP and they first tried a stent before fitting him with a permanent catheter. It would have been very different for him now. His was diagnosed when he had a fall in the street and started to pass blood. When they put a catheter in they got over 2 litres out.
There is a good write up on prostate treatments and the FLA procedure on the Sperling prostate center.
Please get an opinion for PAE. With this size, they are going to try and ablate and ablate...and my doc has seen complications that a few have mentioned here from fla. but those websites make it seems like there are none. With the prostrate being that big, you will need a pae or removal. My doc did my pae and have been great ever since. 45 min, nothing put through my rectum or penis and results are great!
Checked out that website and it is so phony! It promises perfection and no risk. Beware of this laser websites of false marketing
How big was your prostate?
Hey Gary hood luck with the procedure. Mine was only 45 gms, and I was in the MRI for about 1.5 hours. But Im not sure the size really relates to how long the procedure is going to take. They are not trying to make the prostate smaller, just clear the urethra obstructions.
And yes it is VERY uncomfortable while inside the tube. They put a wedge shaped block under your mid section to jack up your butt so they have better access. I have lower back problems, and could barely get out of bed the next day. But your are semi sedated during the procedure so you don't really notice it during the procedure.
I am just curious if your insurance is going to cover it, and if not what your total cost is going to be? My insurance told me they would cover it, and then would not after I had it done. I am still in grievance procedures with them.
I had mine done 6 months ago.You are welcome to private message me if you have any questions.
Thanks and good luck Joe
Personally, I would not let the amount of time you may spend in the MRI influence my decision as 1) you will be sedated to some degree and 2) it is one and done. However...
I would suggest talking to other practitioners of FLA and ask how much tissue they would ablate, which can influence recovery time and possible complications.
As someone else suggested, I would also investigate PAE, which is more likely to be covered by insurance and is less invasive. With a gland that large you may want to see if PAE can reduce it first and if you are still having issues you could then pursue other treatments.
Good luck
Presumably the cost of the procedure must depend on how long you are in the scanner for. Does that not make it difficult to judge how much to quote you and to schedule other patients on the same day.
Almost 200 grams. Look in to research and publications on FLA and BPH and there is a reason you will not find anything
To my knowledge all of the FLA practitioners quote a flat/fixed fee.
I live close to Delray Beach, Fl so I will talk to Sperling on Monday and try to get better answers.
I knew my prostate was big, but I did not know how big until recently. My urinary symptoms were manageable until very recently. Why did the fla not take the first time with you? You had to go back. Did the charge you double?
Sam, I researched the pae procedure and I found out that the amount of radiation that you are exposed to is astronomical. For example you are exposed to an average of 265 rem. A 1,000 rem dose is lethal. I am 68, so if I live another 20 years it gives that amount of radiation time to do damage.
"Look in to research and publications on FLA and BPH and there is a reason you will not find anything." Please elaborate on this for me. I agree that there is much less info on BPH and FLA than for cancer. But why?
Joe, I don't think my insurance will cover it, but I will check. My doctor feels that the "open" procedure is the best route for me. I will ask him if I TURP may work. Which facility did you go to? Florida?
I forgot to mention I have a large median lobe pushing my bladder. As I write this I have a foley catheter in me as I have for about 2.5 weeks now.
Hey Gary I went to Houston for mine. And Tim is correct most thst are doing the FLA and the PAE quote. Fixed price. Did the place you talked with not tell you a price??
It seems most insurance companies will not cover it. Mine paid $3,200 oit of a $21,000 charge . And thst is AFTER they gave me a pre approval in writing.
I agree with some of the other guys research PAE before you do anything radical. It really does seem to be a good option for really large prostates, plus insurance does cover it mostly. And if it does not work you can still always do something else Later.
joe
I'm curious Gary, What doctor are you seeing? What is your quote cost?
Why do you think PAE would be so much radiation? I'm thinking its probably less radiation than FLA