Hello, I had PAE on July 11. My urologist told me it did not work. I am not so sure. Still want to wait some time longer. However, it might be true that with my big median lobe PAE was not for me. What could be the best surgery in my situation? Did somebody with a big median lobe had improvements with TRUP or UROLIFT? Anything else for my specific situation? Thank you.
Hi, FLA is brilliant, no pain, no side affects , excellent results.
There was a person named Stan from Austria on this site about a year ago. He also had a small prostate but large ball valve type median lobe. PAE did not work for him, then he tried Focal Laser Ablation, (FLA), with Dr K in Houston about a year ago. It worked well for him, and he posted here for a few months after the FLA, but I have not seen any posts from him for about 8 months. I suspect he is out enjoying life.
FLA has not been covered by insurance in the past, so most people were paying $21,000 out of pocket. If that is too expensive you can try Rezum if you want a minimally invasive procedure with low side effects. It has almost no incontinence or ED. RE is about 10%.
Fla with Dr. K. Worked for me after 2 try’s. Didn’t feel like it wotked 2nd time around either. Had to still take Flomax. But after a year from 2nd fla i slowly stoped Flomax. Now i pee pretty dam good. Good flow. Hardly any night time visits to bathroom. I can hold my pee without much worry. No more Gatorade bottles in car..No dribles. Not much bladder pain any more.
Only problem is sometimes hard to start. I do get some of the above problems every now and then but over all its great. Didn’t think it worked after both times with fla. But after a year on second time it seems so far that its working pretty dam good.
Jim
Fla with Dr. K. Worked for me after 2 try’s. Didn’t feel like it wotked 2nd time around either. Had to still take Flomax. But after a year from 2nd fla i slowly stoped Flomax. Now i pee pretty dam good. Good flow. Hardly any night time visits to bathroom. I can hold my pee without much worry. No more Gatorade bottles in car..No dribles. Not much bladder pain any more.
Only problem is sometimes hard to start. I do get some of the above problems every now and then but over all its great. Didn’t think it worked after both times with fla. But after a year on second time it seems so far that its working pretty dam good.
Jim
Fla with Dr. K. Worked for me after 2 try’s. Didn’t feel like it wotked 2nd time around either. Had to still take Flomax. But after a year from 2nd fla i slowly stoped Flomax. Now i pee pretty dam good. Good flow. Hardly any night time visits to bathroom. I can hold my pee without much worry. No more Gatorade bottles in car..No dribles. Not much bladder pain any more.
Only problem is sometimes hard to start. I do get some of the above problems every now and then but over all its great. Didn’t think it worked after both times with fla. But after a year on second time it seems so far that its working pretty dam good.
Jim
PAE shrinks the protate but may not address median lobe issues. Most reported PAE failures here involve median lobe - that was my issue. TURP will solve this issue because the median lobe will be cut away. FLA works but is not covered by insurance and you will have to pay about $25k and fly to Houston. If you have the time and money that is a good option. My TURP was completely covered by my insurance, operation was 2 miles from my house, and I was home after 4.5 hours. Each procedure has to be considered from may aspects - insurance, cost, convenience, time, and potential side effects. Everyone is in a different circumstance so there is really no best answer for everyone. HoLEP is very effective, but again may not be covered by your insurance and is only performed in a few locations.
Hi, in my case my median lobe had almost completely blocked my flow which left me in agony and misery and the potential side affects of all the surgical options out there frightened me and prolonged use of drugs would simply cause more and more damage to my bladder and kidneys, FLA solved all my issues instantly the median lobe was no longer an issue at all! and best of all no side affects!
For me the money while difficult to hand over was a concern but the relief was worth it and life is great when I think back to the misery I am now FREE! FLA is so simple and least invasive, its done in an mri machine with a 1mm laser which is so accurate they can get as close as 1 mm to a nerve without harming it, they simply delete the overgrown median lobe tissue without harming the bladder neck or valve so that there is no harm to anything important, you remain conscious and go home the same day.
Did the doctor charge you for the second time too? What was the time span between the tries? How much time passed after the second try?
Thank you, Jim.
Thank you, Tom.
When did you have TURP?
How fast you have recovered?
My situation is probably different. I am 79 years old and the first time I was told I needed a surgery was 20 + years ago.
I waited and waited and waited until in June I was diagnosed with stage 4 CDK.
So my waiting ended, and they put in indwelling catheter.
In addition my bladder is stretched and I have many problems with linings of my bladder.
My urologist told me that there is about 60% chances that TRUP will work for me mostly due to my bladder.
I wonder if the same applies to FLA or with FLA my chances will be better
Thank you, Brian.
How much time past since your FLA?
Alex,
Had my TURP (bipolar TURP) in April. Had Foley catheter in for 3 days post op, which was the only irritation. Recovery was very fast. I am a regular exerciser and did not do my normal exercise routine for a week, then gradually got back into it. Once the Foley was out I basically felt fine. My flow gradually increased for the next few weeks - urologist said there would be some prostate tissue swelling. Now, after five months, my bladder continues to calm down - less frequency and urgency than before. This would also be the case with any procedure - takes time for the bladder to heal from retention issues. I am wondering if your kidney issues are related to the prostate retention issues you have experienced. I am speculating, but I would expect some improvement in kidney function once your urine is flowing naturally again. The TURP and recovery was much easier than I was expecting. I am 73.
Tom
It was a total of 2 years. It took a year the second time around. It has only been about 2 months since i quit flomax. Not really sure how or why it cleared up and took so long. Very happy i know longer have to take meds. He charged me 10 g for second time around. Going to call Dr. K soon to let him know that it worked.
I also had a small prostate. There has been a few guys in here that had small prostates like mine that it didnt work also. i spent probably 35 grad total. Pretty much wiped me out, but i do feel it was worth it.
i am 62 so i will be working will into my retirement if i get one.
Hi Alex,
1 year and nine months have past, my relief from an overgrown median lobe blocking my flow at the bladder neck was instant from FLA in Houston and has remained very good all this time .
You are right, Tom. My CDK is directly related to my urine going back to my kidney. I was told about this a long time ago, but ignored it. After I was fit with an indwelling catheter my kidney improved a bit from stage 4 to stage 3.
Thank you for sharing your story about TRUP!
Hi, Jim,
have your doctor ever explained to you why your first FLA did not work? I mean they saw 3D MRI of your prostate and knewwhere is the problem. So how they could have missed on removing the problematic part?
Thank you!
I have a 28g prostate and median lobe. Tried Urolift which has left me in constant pain and only improved things for about 4 months. Now on a waiting list for a TURP to sort out the blockage.
Hi all,
I had a partial success with PAE then (at least so far) great success with FLA. It did cost $21k and I did fly to Houston. So you might ask why did I fly from Australia to Houston AND pay $21K? To avoid the many known risks associated with TURP.
We should also, to give a more complete view, share that these other big differences between TURP and FLA . TURP is known to cause retrograde ejaculation in > 90% of patients and also causes inability to gain an erection and incontinence in a percentage of patients as well. TURP also requires general anesthesia with it’s known risks and causes substantially more bleeding. (FLA typically causes less than 2 tablespoons of bleeding and very few side effects. TURP is usually successful in improving flow and Urologists on average are comfortable with it as it is what they know.)
So another way to think about it might be are you willing to accept the risk of anesthesia, bleeding, retro, possible incontinence and possible ED to save 21K? Every man is different, has his own unique circumstances and and has to make his own decision.
Also FLA is a much more modern procedure with much less clinical data. We really do not know how long it helps or if other complications may arise later. It seems to help many men in the short term with many fewer side effects.
Also have heard that some insurance is starting to pay at least a part of the costs for FLA so perhaps worth looking into with your doctor.
Good luck with your decision and your outcome!
Joe
thank you, Andrew, for sharing your story.
It is interesting that even such small prostate could cause problems. My prostate is bigger. Not sure anybody ever measured the size. but I was told it is about 70 grams. The doctor who did PAE told me after the surgery that he believed my prostate would have been bigger. He had never seen my prostate before the surgery.
I had no scans before PAE because I have CDK and they did not want to use contrast that is not good for my kidneys. So my IR told me that he would stop the surgery if my arteries are bad, but they were OK.