Kyle13: Here was my description: Prostate, Index Lesion x 5 Left ant TZ mid, needle core biopsy:
Adenocarcinoma, GRADE GROUP 3, Gleason grade 4+3 (score 7) (estimated 70 % grade 4)
4 of 5 needle cores are positive
70 % tissue involvement.

All 12 of the other cores were negative.

I had 30% my prostate ablated. I started sex 1 week after and have had no issues. I told my doctor that I actually think it’s better than before, but I think it’s just that I’m so happy that things didn’t change.😉

I had TULSA on 26 Feb. As to the physician to use, there are about 24 centers in the U.S. that provide TULSA and they are about equally divided between the east and west sides of the Mississippi River. If you go to tulsaprocedure.com (an off-shoot of profoundmedical.com) and select Find A Center you will get a list of Centers and Physicians that provide TULSA.

As for your ASAP, did you have the gene/DNA study such as Prolaris or Decipher? If not, you should if it is applicable. ASAP is tricky so be careful and don't wait too long thinking you will outlast it. My opinion is you should do a PSA at least every 6 months and a MRI once a year. If the doctors talk you into another biopsy then be certain it is a Transperineal Biopsy which can sample the entire prostate, a 30 core saturation biopsy is definitive of what is in your prostate. Doctors may fight you on some stuff but remember, it is your cancer and not theirs. If you have a doctor that is disagreeable then find another doctor. Remember, it is not your doctors job to save insurance money.

As far as sexual function. Depends. People generally come out of TULSA with the same level of ED or Continence as they went in. The one notable exception is if they ablated the ejaculatory ducts then you will have dry orgasms. I struggled with that for a short while (mentally) and decided that age 69 I really did not need to leave a 'calling card' anymore, so to speak, and living free of prostate cancer for the remaining 10 to 20 years of my life was more important.