Optilume balloon therapy for BPH

Posted by keithmr @keithmr, Feb 16 12:10am

Hi. I'm 67 with BPH and a rather small (30ml) prostate.
I've researched the new Optilume procedure for BPH but not finding others that have had the procedure or have also been looking into it. For myself I had a Cystoscopy and the urologist said ideal for aquablation I agreed to it but have since changed my mind and here's why. Unlike other surgical procedures Optilume for BPH is performed in the Drs office with only local and usually spinal block anesthesia. Optilume for BPH does remove any Prostatic tissue. What it does is a dual balloon catheter is inserted thru the urethral, it small and is inserted thru a 19fr rigid cystoscope along with the camera . The catheter passes into the bladder then is backed out so the smaller of the two balloons is in bladder and will hold the specially sized for each patient second balloon in the prostate. The balloon is then inflated causing a commisoratomy or tear between the two anterior lobes of the prostate then a drug called paclitaxel is placed for about ten minutes on the tear. Paclitaxel prevents the lobes from growing back together again. You will leave the Drs office unassisted with a catheter placed that will be removed usually in 24 hours. It shows durability in 5 year studies. Mostly for me, I have no reason to have my prostate obliterated and even partially removed. I expect to continue to have unaffected sexual function other than being relieved of the side effects of tamsulosin which have hit me hard. Orgasm quality is extremely important and seldom discussed in research. Don't confuse orgasm with ejaculation. It's the orgasm that feels good and why would any patient not preserve that for themselves. Optilume for BPH was approved approximately July of 2023 so hopefully clinics and surgeons will jump on the opportunity to provide a very effective alternative to tissue removal.

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Aquablation is a good option. Very durable and preserves sexual function. Had it four months ago and everything works fine.

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4-5 years is good durability. Other procedures may be more painful but not have the same result. Paclitaxel is chemo. There is suggestion that a small dosage may also help with other procedures such as TURP. Steroid can also stop the growth of scare tissues. Wonder if you can use both to get longer durability?

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But how large was your prostate before the PAE? From the research I've done it only works for those with a small prostate.

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@vernscw

But how large was your prostate before the PAE? From the research I've done it only works for those with a small prostate.

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Don’t have the exact size handy to report here, but my prostate is/was very large, “a 90 on a scale of 1 to 100,” my cardiologist told me. “You have a very generous prostate,” my GP told me back when they gave you the finger during physical exams. So not true. PAE is quite effective on larger prostates. I’m telling you, I can’t recommend it enough. I backed out from it a year ago because the idea of going through my arteries freaked me out, but I finally realized it was better than TURP by far…

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@riverpark

I am 78, very active and healthy. Had years of urgency, weak stream, multi nighttime trips to the toilet, never went anywhere without first concern “where’s the nearest toilet.” Took finesteride but could not tolerate flomax. Turned down TURP offers many times as too risky for my taste. Three months ago had PROSTATE ARTERY EMBOLIZATION. All previous symptoms already gone, pee like I am 19 again. Easy procedure with zero sexual or other side effects. Best thing I ever did. I believe this new procedure done by a radiologist will be the new BPH treatment Gold Standard and put urologists and their scalpels out of business. You definitely should check it out!

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I've been thinking on this procedure for a while. I believe that prostate needs to be of certain volume to qualify and mine is not there. Did you get that from the radiologist that prostate needs to be of certain volume? Thanks in advance for your reply.

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@ralanis

I've been thinking on this procedure for a while. I believe that prostate needs to be of certain volume to qualify and mine is not there. Did you get that from the radiologist that prostate needs to be of certain volume? Thanks in advance for your reply.

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No, sorry. I heard no comments about volume other than my urologist referred me to radiology after I declined TURP, and the radiologist found me to be fully qualified for the procedure after my consultation with him.

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@riverpark

No, sorry. I heard no comments about volume other than my urologist referred me to radiology after I declined TURP, and the radiologist found me to be fully qualified for the procedure after my consultation with him.

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While doing my research into PAE it said that procedure removes between 20 and 40 % of the prostate. My prostate is 139 so it would remove about 47 and leave 92. After the procedure figuring an average of 30% removal I would still have a large prostate. So I am looking in to HoLEP. Glad PAE worked for you. But this is why I thought you must have a smaller prostate.

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You might be right, though I was told I had a quite large one. I’ll dig through my records online and see if I can come up with that number for you. Also the procedure doesn’t exactly “remove” some of the prostate but rather shrinks it over time due to cutting down blood supply to it. I just this morning received my PSA results they wanted 3 months after the PAE procedure. Previous PSA several months ago was 6; yesterday’s was a .4–that’s a point four down from a six. I have had high PSA numbers for many years, endured two biopsies (negative), so this is powerful evidence that the PAE has worked very well for me If I were you, I’d look into it further before you opt for something more invasive. Again, I have no negative side effects from the PAE and better results that I could have hoped for.

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@vernscw

While doing my research into PAE it said that procedure removes between 20 and 40 % of the prostate. My prostate is 139 so it would remove about 47 and leave 92. After the procedure figuring an average of 30% removal I would still have a large prostate. So I am looking in to HoLEP. Glad PAE worked for you. But this is why I thought you must have a smaller prostate.

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You might look into aquablation.

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@billrtx

You might look into aquablation.

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I did look at aquablation and my insurance doesn't cover it. I have Federal BC/BS.

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