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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@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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I am a 76 year old male. I've had 3 PAES. One in 2014 another one in 2017 and another one in 2023. That is how long they lasted. My prostate I went from 160 to 138 On the last PAE. It was done by Dr Bagula in northern Virginia. He is the one that's done the most in the country. The last one didn't Reduce it enough . And I still have problems urinating. He said he would do it again but there was about a 20% chance it may work. He suggested an aquablation,
I had them done then because there was nothing else At that time to have but a turp which I didn't want. So it gave me 10 years to the next best thing came out being the aqua. So I can talk as a person who's been through the trenches From three paees to the aquabilation. The after effects for the PAE were just burning urination for three days and that was it. I had my aqua ablation 10 weeks ago. I'm able to urinate with no problem but I have frequency urgency and burning every time I pee.
Up 4 and five times a night. Two weeks after my Paes I was getting up between one and 2x a night I've had For weak ejaculations Out of 25 orgasms.
My dr keeps telling me it can take up to 6 months for this to go away hopefully it will. I was on Flomax and proscar for two months before the aqua surgery because of difficulty in urination.
That gave me reverse ejaculations. The orgasms were just as strong. I felt like I was ejaculating but I didn't. The drugs had horrible side effects and I was taken off them immediately after the aqua surgery. So I'm glad I did the PAES I wish the last one didn't fail. I hope the aqua problems will cure themselves in the next few months as my doctor said. But the PAE was only a week at the most of burning. So I would take a pae any day Before an aqua. So anyone who has any questions about Paes just let me know

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@jojo99

I am a 76 year old male. I've had 3 PAES. One in 2014 another one in 2017 and another one in 2023. That is how long they lasted. My prostate I went from 160 to 138 On the last PAE. It was done by Dr Bagula in northern Virginia. He is the one that's done the most in the country. The last one didn't Reduce it enough . And I still have problems urinating. He said he would do it again but there was about a 20% chance it may work. He suggested an aquablation,
I had them done then because there was nothing else At that time to have but a turp which I didn't want. So it gave me 10 years to the next best thing came out being the aqua. So I can talk as a person who's been through the trenches From three paees to the aquabilation. The after effects for the PAE were just burning urination for three days and that was it. I had my aqua ablation 10 weeks ago. I'm able to urinate with no problem but I have frequency urgency and burning every time I pee.
Up 4 and five times a night. Two weeks after my Paes I was getting up between one and 2x a night I've had For weak ejaculations Out of 25 orgasms.
My dr keeps telling me it can take up to 6 months for this to go away hopefully it will. I was on Flomax and proscar for two months before the aqua surgery because of difficulty in urination.
That gave me reverse ejaculations. The orgasms were just as strong. I felt like I was ejaculating but I didn't. The drugs had horrible side effects and I was taken off them immediately after the aqua surgery. So I'm glad I did the PAES I wish the last one didn't fail. I hope the aqua problems will cure themselves in the next few months as my doctor said. But the PAE was only a week at the most of burning. So I would take a pae any day Before an aqua. So anyone who has any questions about Paes just let me know

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You certainly know more about PAE than I do. All I know is what I've read. Hope you are feeling better soon.

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In reply to @wellness100 "What is PAE?" + (show)
@wellness100

What is PAE?

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Prostatic Artery Embolization

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Update at six months. Still no problems with having had the OptilumeBPH procedure in May. What I'd like to touch on is the effects of long term medication and delaying the inevitable surgical intervention.
Simply put do not if possible delay surgery in favor of meds. My personal experience has proven that years on tamsulosin, though it did help to pass urine did only lead to furthering the complications Of BPH. In my case I'm still trying to get back to normal bladder activity. Theirs urgency still though different than before and takes a lot of work to retrain your bladder to hold more urine for a longer time and tightening the bladder sphincter to stop dribble.y point is the OptilumeBPH is fantastic and I reccomend it to anyone it's appropriate for but expect as with any procedure that there's more to it than the procedure you choose. Talk to your Dr. about what happens after..

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@jojo99

I am a 76 year old male. I've had 3 PAES. One in 2014 another one in 2017 and another one in 2023. That is how long they lasted. My prostate I went from 160 to 138 On the last PAE. It was done by Dr Bagula in northern Virginia. He is the one that's done the most in the country. The last one didn't Reduce it enough . And I still have problems urinating. He said he would do it again but there was about a 20% chance it may work. He suggested an aquablation,
I had them done then because there was nothing else At that time to have but a turp which I didn't want. So it gave me 10 years to the next best thing came out being the aqua. So I can talk as a person who's been through the trenches From three paees to the aquabilation. The after effects for the PAE were just burning urination for three days and that was it. I had my aqua ablation 10 weeks ago. I'm able to urinate with no problem but I have frequency urgency and burning every time I pee.
Up 4 and five times a night. Two weeks after my Paes I was getting up between one and 2x a night I've had For weak ejaculations Out of 25 orgasms.
My dr keeps telling me it can take up to 6 months for this to go away hopefully it will. I was on Flomax and proscar for two months before the aqua surgery because of difficulty in urination.
That gave me reverse ejaculations. The orgasms were just as strong. I felt like I was ejaculating but I didn't. The drugs had horrible side effects and I was taken off them immediately after the aqua surgery. So I'm glad I did the PAES I wish the last one didn't fail. I hope the aqua problems will cure themselves in the next few months as my doctor said. But the PAE was only a week at the most of burning. So I would take a pae any day Before an aqua. So anyone who has any questions about Paes just let me know

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I had absolutely no pain of any kind with OptilumeBPH. It was as if nothing had been in there at all. Amazing.

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@keithmr

I had absolutely no pain of any kind with OptilumeBPH. It was as if nothing had been in there at all. Amazing.

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I'm deep diving into the OptilumeBPH treatment and I'm sold. Just wish Mayo offered it. Would you be willing to share who did your procedure?

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I had the procedure 13 weeks ago, and it has been a nightmare so far. I still have significant pain, bleeding, and leaking of urine and blood. I had the procedure done to get off Flowmax. I have tried to reduce the Flowmax three times, and if I do, after a couple of days, I can't pee. My surgeon is concerned if we do a camera exam of the area, it will make things worse, so we are just waiting. Any ideas, anyone?

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@av8r6

I'm deep diving into the OptilumeBPH treatment and I'm sold. Just wish Mayo offered it. Would you be willing to share who did your procedure?

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I had it done 13 weeks ago, and it has been bad. I still have bleeding, pain, and leaking of blood and urine. The surgeon does not know what to do and is worried that any internal exam might make it worse, so for now, we are just waiting. I was unable to get off Flowmax, which was what it was done for. So far, it is not working for me at all, and the info from the company about it being minimally invasive has not been correct. I really wish I had not done it and gone with something else.

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@keithmr

Update at six months. Still no problems with having had the OptilumeBPH procedure in May. What I'd like to touch on is the effects of long term medication and delaying the inevitable surgical intervention.
Simply put do not if possible delay surgery in favor of meds. My personal experience has proven that years on tamsulosin, though it did help to pass urine did only lead to furthering the complications Of BPH. In my case I'm still trying to get back to normal bladder activity. Theirs urgency still though different than before and takes a lot of work to retrain your bladder to hold more urine for a longer time and tightening the bladder sphincter to stop dribble.y point is the OptilumeBPH is fantastic and I reccomend it to anyone it's appropriate for but expect as with any procedure that there's more to it than the procedure you choose. Talk to your Dr. about what happens after..

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Hi Keith,
Firstly thanks for you updates and info. I'm looking at Optilume after having 4 TURPS/bladder neck incision and Bulbar stents. My Uro has suggested Optilume and I really would like to find out more as I've sort of run out of options.
I'm a fit 74yo in Australia and it seems to be available here as suggested by my Uro.
Your reports make it sound a viable option. Was your Uro road similar to mine and how are you getting along now ?

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