Hi all, Just a quick update seven months after FLA treatment by Doctor Karamanian for severe BPH. Short version I could not be happier. No longer think about it much. Flow is, literally, like being a young man again. All the plumbing does what it is supposed to do with no side effects. Sleeping through the night, making it through 18 holes of golf, making it through meetings, etc. Just that now really appreciate it. :) It was expensive, but worth every penny, and yes with 12 laser passes for my very large prostate (vs 6 normally) it took a few extra weeks to fully heal... but knowing what I know now about this and the other alternate procedures for BPH I would highly recommend Dr. K and nurse Donnie. From his willingness in the beginning to read my 3T MRI and give me an hour of free caring consultation - even though I live overseas, to the excellent staff and facilities and follow up care to the great results over time I am thrilled. This was the best outcome I could have hoped for. Good luck everyone. Joe
To Joe (34587), thanks for the update but what is "FLA" ? So many different procedures to keep track of acronyms are hard to guess. and if you can where are you? USA, state? or Great Britain or other? This forum is all over the world. Thanks and glad it worked for you.
I'm with John...I Googled "FLA UROLOGY PROCEDURE" and could find nothing. More details please? Glad it worked for you whatever it is...but I am curious what it is!
Patrick
Thanks Joe - and congrats! Did you have an enlarged median lobe?
Congratulations Joe - glad it worked out for you. I had my FLA in Dec 2017 and am also doing well, though mine was for both prostate cancer and urinary issues (flow problems).
As for John and others, FLA is: Focal Laser Ablation
Dr K as he is often called is Ara Karamanian. If you do a web search on him you can find his website. There are a few other practitioners of FLA, but since insurance tends to be little or nothing for this procedure, the number doing the procedure is small.
FLA - focal laser ablation done by a radiologist instead of an urologist. Dr K is in Houston and highly recommendable. I met him as well.
Hi Patrick,
I had this procedure done almost 3 years ago. by Dr Karamanian.
FLA stands for "focal laser ablation" and is not performed by a urologist but by an interventional radiologist.
Hope that helps
A PAE (prostate artery embolization) is done by an interventional radiologist. Focal Laser Ablation was originally done (and still is) to treat select areas of prostate cancer (it is focal and not general) and done by a laser that ablates tissue. Later it was used to reduce prostate size and helps or almost cures BPH issues. It is very precise and uses very expensive imaging equipment and is NOT covered by any insurance, to it's all out of pocket, unfortunately. Dr. K receives rave reviews here but the cure rate is not 100% - nothing is.
I agree with you , it has been 3 months since I had FLA with Dr K , I'm doing great , Do you remember how long did it take to you to reach the top of your recovery ? I do not know if I am already at the top or still going , as you mentioned it is worth every penny , I still email Dr K and get email back or phone call same day , hope more Doctors could be in touch with patients as Dr K does .
I was noticing improvement for 9+ months, most in the first 6 then continual slower changes. I believe some of it was due to the bladder problems I had (and still have) due to urinary retention over 15+ years. While most of us are told we have 'BPH', and that may be ONE of the issues, I (and others) have additional complications that all impact our urinary health.
Tim,
I also have bladder issues and currently self-cath 6x/day as I am unable to void without a catheter. Curious if you were able to void naturally before your FLA procedure and did you travel to Houston to have it done by Dr. K? I am researching options while using CIC to hopefully rehab my bladder and am interested in your history prior to your FLA procedure.
Thanks and good luck going forward!
Hi Patrick,
Interestingly, I'm in an almost identical situation to yours. Have been CIC'ing since Summer '14 and am at about 6 times a day. Waiting to see more clinical results for FLA for BPH. I did already try PAE in Fall of 15; however, largely due to enlarged median lobe, it didn't help.
Best of luck!
I was not doing CIC prior to the FLA, though I may not have been far from needing to. The urologist I was seeing at the time wasn't very helpful. He wanted to do one of the standard procedures, of which I was not interested.
While we can have common symptoms, the causes can be so different for each of us. I've read some who have excellent results to many different procedures and some do not. So many variables - makes the decision that much more challenging.
I did go to Houston (I live in Atlanta) - had the FLA for PCa and urinary flow issues, flew back after 3 days with a Foley. Procedure was painless (they gave me Versed, so I don't remember most of it). Only suggestion I make to people is do not be in a hurry to get rid of the Foley. If you take it out and cannot urinate, consider having one re-inserted until you can. Amount of time it can take to heal varies for all of us, the amount of tissue ablated, it's location, size of our prostate - lots of things.
Thank you Tim I was self cath 3-4 times a day as I could void a little in between , as Tim said do not rush in retrieve the Foley , as longer is in as better it is , I removed it a seventh day and had to put it back two weeks later .
One of the benefits of CIC is using the technique post-procedure to avoid the Foley which I wore 7 weeks prior to starting CIC. I was SO happy to lose that Foley and have become habituated to the CIC routine which buys me time for bladder rehab while exploring options. Some here have rehabbed their bladder with CIC, avoided any surgical intrusive procedure, and were able to lose the catheter, much to the surprise of their urologists, who of course recommend whatever procedure they specialize in.
Bottom line, good advice to take your time and explore all options before rushing into a procedure with minimal chance of success and living with irreversible side effects.
Hello Arlington and thanks for your response. WOW, CIC since 2014...you are a warrior! I'm assuming you found a uro who supports your CIC regimen without pushing you into a surgical procedure...well done! I'm learning how important it is to be your own #1 health advocate and make your decisions based on thorough research rather than depending on decisions made by self-interested physicians. Good luck to you going forward and let us know if you find a good option to stop CIC.
Patrick
I initially went in to acute urinary retention due to an antihistamine cocktail prescribed to me for hives and I have never been able to come out of retention.
Yeah, my uro still pushes his TURO, but in a nice way. He said CIC'ing is a viable alternative for those who prefer it to a procedure. Unfortunately, at my last appt. about a year ago, he suggested that I stop Rapaflo since I was cc'ing anyway. When I did so, things closed up to the point where I was no longer able to insert the catheter and it took me about a month to resolve. The worst result of that was that I am no longer able to pass through the best and most discreet catheters (by far) that I had found; the Coloplast Speedicath male compact. If I can get back to a point where I could use those, it would be significantly better.
So what are you using now if not the SpeediCath? I agree about the compact and would use it 100% of the time if it was covered by Medicare but have been advised that a history of UTIs is required for Medicare to cover them. As such, I use the SpeediCath standard FR14 as my "go-to" cath which Medicare covers.
Apparently BPH caused my urinary retention which was not discovered until I had a bicycle fall and ended up in the ER where a CT scan showed a "massively distended bladder" and 5300 mls of bloody urine was drained with a Foley. Up until then, I was urinating regularly and had no idea of my urinary retention. ER staff could not believe I was not in excruciating pain with my bladder condition. I was not. I left the ER with the Foley and was referred to a uro where I failed a urodynamics test and began CIC after wearing the Foley for 7 weeks. My uro agrees that a procedure will not help until I regain bladder function and says "no use in expanding the pipe until,the pump is working...". Apparently I have nerve damage from my bladder being stretched for so many years. I had no symptoms other than a decreased flow which I attributed to my age of 70.
Have never heard of Rapoflow, but declined my uro's suggestion of taking Flomax after my PCP prescribed it and it put me in AFib which I had been diagnosed with and had a cardioversion to return me to NSR until I began taking Flomax. Is Rapoflow an alpha blocker like Flomax?
Ahh, these golden years!
I had my FLA for PCa and BPH with Dr.K in early Sept/19. My results are great, all my BPH symptoms are gone, IPSS went from 25 to 1, my average urine flow last time I measured in early Dec/19, taken from 10 measurements is 16ml/sec. I used to take Alfuzosin, I stopped using it some 7 weeks ago. I had ~60cc prostate and median lobe, had some minor complications post FLA, due to 15 ablations (5for PCa, 10 for BPH) my prostate was swollen, after I removed the Foley had poor flow, started self catheterizaton and got UTI, ended up in ER and got another Foley for two weeks, as soon as I removed the Foley, the flow was great and all symptoms of BPH were history. Dr.K and Donnie, his nurse are a great team, couldn't be happier with this outcome.
Yes Rapaflow is a selective alpha-blocker in the same family as Flomax and the generics. First time I took one, I almost fainted while jogging. I read a study on the NIH website claiming that approx 50% of men are helped by taking alpha-blockers. I was in the other 50%. I tried all 4 that were available at the time, but had no benefit and a few side effects. Other than lower my BP, I could not breathe well when lying down, which affected my sleep.