Tulsa Pro Experience, Mayo Clinic MN – July 2024

Yes, these remaining few weeks are really beginning to weigh on me. I'm having this strong need to get this behind me, along with the worry............what if things have gone on too long. I was extremely diligent about all of this and my first MRI in 2022, the radiologist missed my lesion on his read. I've been walking around with this cancer for 2 years longer than I should have. This really bothers me. I try to tell myself........well, two years ago you probably couldn't have had TULSA-PRO either. I always trusted the words of doctors. It destroyed my confidence in them. I never even thought two years ago about a second opinion. I will now seek one for anything of major consequence with my health going forward.

I had same concern. I figured since Mayo wasn’t concerned, I shouldn’t be. Ironically my PSA actually went down a bit in the 2+ months I was waiting 😉

I had my procedure on October 9, stayed on campus until I was released on Oct 12. I have now returned to a small town in Colorado. I've never been under general anesthesia so I don't know how long it takes for the body to rid itself of whatever chemicals they used. I'm still feeling off the mark and my stomach is queasy. They also gave me prednisone and flomax which I've never taken before either. One thing I've noticed which is alarming me and if it's not better tomorrow I will be contacting Mayo. I was wondering, after your procedure did you notice any fluid retention below the surface, above your penis, on your pubic mound? I believe I'm experiencing a pretty significant accumulation of something there which was not there prior to the procedure. Maybe this is just part of the healing process, but it has me a bit worried, since medical care where I now am is limited. It's not causing any discomfort that I can tell, but it strikes me as odd, since they didn't mention it to me at Mayo as part of any normal healing process. They ablated 60 cc of my 100 cc prostate, so I expect my body has some work to do to get rid of the dead cells. I was just wondering what was your experience. Thanks much!

It may be hard to compare our experiences. I had 30% of a 45cc prostate ablated, or 13.5cc. You had 60cc ablated, a much greater volume.

I have had General Anesthesia a number of times and never had much of a reaction. I actually felt like I could have driven home after the procedure.

Also, likely because of the small volume ablated, I did not get Flo-max or prednisone. I did call Mayo about a week after as my urine stream was only about 1/3rd of normal. They assured me that was OK, and the fact that I was continent put me ahead of the curve.

I would call on the fluid retention (maybe medication related or trauma from the ablation).

Doctor told me it would take about a year for the body to absorb and eliminate the ablated tissue. I did notice some tissue come out when urinating a week or 2 after the procedure.

Best of luck.

Thanks. I'm hoping all I'm experiencing is just part of my body's reaction to the procedure. It was delivered a pretty significant blow. I sent Dr. Woodrum a message via the portal. If I don't have an answer by mid morning, or if things get worse I will most definitely call the office.
Appreciate your quick response very much!

I am having the TULSA procedure this month in California, but I was assuming that Medicare was not yet covering the cost. Are you aware of what codes were used or other details of you circumstance which may have allowed you to qualify? Thanks in advance.

I will try to find my Medicare record for the codes. Others on this site have said it needs to be performed at a hospital to be paid by Medicare. I had mine done at Mayo's hospital in Rochester, MN. I didn't check with Medicare as I was going forward regardless. Profound Medical has reimbursement guidelines on their website that may help:
For additional assistance, please contact Profound Medical’s TULSA-PRO® reimbursement specialists at:
Phone (Toll-Free): 855-285-5724
Fax (Toll-Free): 833-557-0896
Email: Support@PROFOUNDReimbursement.com

Mine was billed under code C9734.

I got this from Google: Medicare will start reimbursing the TULSA-PRO procedure on January 1, 2025. The Centers for Medicare & Medicaid Services (CMS) has established three Common Procedural Terminology (CPT) codes for the procedure, depending on how many physicians are involved:
5x006: TULSA Device Management
5x007: TULSA Treatment, used when two physicians are involved
5x008: TULSA Complete Procedure, used when one physician is involved

**Until the new codes take effect, hospitals performing the procedure on Medicare patients should use the C9734 code.**

Profound has more info at this link:
https://profoundmedical.com/wp-content/uploads/2024/09/109923E_TULSA-PRO-Coding-and-Billing-Guide_2024.pdf

My TULSA procedure was done on 9-11. After having my catheter removed one week post procedure, I was having a tough time eliminating urine. I don't live in the immediate area of the Jacksonville clinic, so they taught me CIC (Clean Intermittent Catheterization), gave me a bunch of catheters and send me on my way. I didn't get clear instructions regarding when to use them, so I just assumed they wanted me to use them as needed to clear my bladder. I mostly used them at night to measure how much was left after I urinated before bed. (My CIC teacher told it should be less than 100 ml) That accumulation you've noticed on the pubic mound could be a side effect of those drugs you mentioned. I was not subscribed any drugs and did not have any retention in that region. And hardly any bladder retention a few days after catheter removal. I was told to expect some sluffing off of dead tissue starting about 5-7 weeks post procedure. I would see this as smallish solid pieces in my urine. I did see a small clump of tissue in my urine last night before bed. I have masturbated a couple times to "clear out the pipes". Ejaculate is bloody as expected. Getting less so.

thank you! Mayo got back to me. Told me this adema is not uncommon and as long as I was in no pain or had no fever it was a normal response in some cases. I had 60cc of a 100cc prostate ablated including the lesion, so my prostate took a big hit. They also gave me 14 days of prednisone and 1 month of flomax to help with swelling and urination. So far my stream is adequate to keep my bladder happy. The swelling is diminishing gradually so I'm feeling assured things are progressing as planned. Thanks for the 5-7 weeks sluffing information. So far my urine has shown no signs of that process. I had my procedure on Oct 9, so it's still very early in my case. How long did you wait before clearing out the pipes?