Optilume balloon therapy for BPH

Posted by keithmr @keithmr, Feb 16, 2024

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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@keithmr

Absolutely fine! Recovery was easy after the procedure. I'm still astounded with the fact that there was no sensation at all at anytime that the procedure left behind. Urination, flow and shut off working great. No sexual side effects. In fact after getting of Tamsulosin which was a horrible drug me I am now happily able to have an orgasm easier and no longer retrograde. Nearly 8 months and not a regret. I'd urge you not to off having something done. What none of these procedures do will stop all your symptoms of lower urinary tract. It will open the flow immediately. What you need to talk with your urologist about is how to deal with symptoms after procedure that were caused by the enlarged prostate. Perhaps still have urgency at times. May have to retrain your bladder to hold more urine again which is from bladder spasms. I've had to retrain for a fuller bladder which takes time. Looking back I'd have started Kegel exercises well before the procedure, so start squeezing those pelvic floor muscles and come of your procedure ready take charge of your sexual satisfaction and relief of LUTS.
I had my procedure at Samaritan Health Hospital in Corvallis, OR. Dr Robert Laciak.
One more thing. If you've not had a systoscopy yet there is a anxiety that comes along with a scope inserted thru your urethra to the bladder. The thing I had to take charge of for myself after the first one was to make sure the medical assistant, lijely female, knows to to fully coat your urethra with the lidocaine when instilled thru tip of the penis. Once the syringe is emptied hang on the tip of your penis so the gel does not just run back out onto your draping then milk the gel back thru the urethra along the taint so it actually numbs well into the full length of the urethra. Lidocaine not only numbs but slightly dilates the urethra so the further it's in greatly minimizes any discomfort. It a very fast insertion of tge scope and really was more a surprise sensation than any pain. Take a deep breath and just relax and its quite begin. My experience tells me docs a med assistants aren't communicating well enough to thoroughly coat the urethra with lidocaine. So advocate for yourself for not unpleasant experience. I had no injury feeling after cystoscopy but was well ready for it which helped tremendously. If you've used or are going to use a catheter for testing of complete bladder emptying in Dr's office they don't always numb so ask for it for that to if need be. Remember deep breath and it's in and you can relax and watch the the monitor and learn as you Dr looks everything over and then make a decision that works for you.
To reiterate why I chose OptilumeBPH :
Truly non invasive procedure with no removal of tissue and faster healing.
I need to be able to self care after as I live alone with no at hone support.
Immediate relief to urine flow.
Wanted to reclaim my sexual health!
Great success.
Any other questions or comments I'll keep a closer watch on this site if I can answer anything else.
Good luck, you're going be so much better very soon.
Keith

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Thank you so much @keithmr, very detailed information.
It actually sounds like you are a medical professional - I guess they also can get BPH.
You mention that you have no longer retrograde, but for how long after the procedure did you have that, - assuming it was caused by the Optilume procedure?
And for how many days did you need a chather?
I'm asking because there are other patients, who had really bad experiences with Optilume, and I really want to be careful.
My guess is that a lot has to do with how careful and trained the physician are?
Thanks again
Soren

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I believe that Optilume is a bad procedure. I had it done in August of 2024, and it has been a total nightmare for me. Six months or horrible pain, bleeding, and leaking. Additionally, it did not stop my BPH, and I am still on Flowmax, or I cannot pee. After six and a half months of almost constant pain, serious bleeding, and leaking, I was finally able toy done two days ago, something they could not do for six months because the Optilume damaged my prostate so badly have a cysoscopy, and we found that it did nothing to open up the BPH. I would not recommend this procedure to anyone. If you do it, do not plan on returning to work or anything for six months and expect it to be difficult to even sit in a chair.

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Any new updates for anyone who's had Optilume for BPH? I am at the stage where I will definitely get a procedure done and I am leaning towards Optilume. One of my questions was about commercial insurance coverage for the procedure here in the U.S. It looks like Medicare covers it but some commercial plans don't. The other thing I worry about is any pain during the procedure. Even cystoscopies hurt for me so I am wondering if they can just knock me out with general anesthesia. I am also looking at iTind but it looks like that is not covered by most insurance and also not sure about its long term durability. My prostate is small and the narrowing is at the top of the prostate near the bladder opening due to the growth of the prostate in that area.

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I would want to have at least several reviews by patients over the first year and why can't you talk to the doctor's patients about their experiences? How many such procedures has he done? They couldn't all be totally successful and wouldn't you like to hear from them too? Secondly, what does a team of doctors at an institution like Mayo think in general about the procedure compared to all your options for your particular case? Lastly, if you only have problems at night waking up several times to urinate and you have an acceptable urine stream during the day, you might consider stopping the medication and if you can tolerate waking 3 times a night maybe that's an acceptable quality of living instead of taking the surgery risks.

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@keithmr

Odd to me. The paclitaxel keeps the split lobes of tge prostate from growing back together. My urine was clear of blood and clots completely at week four and I considered myself healed at week six. I do know that the factory rep must accompany the durgwon oh the first ten procedures the dr performs... Maybe the placement of tge balloon catheter was not quite correct or moved at time of inflation wit about 90fr or 1 1/4 inch. If it's not placed a secured while inflating it could cause a tear in tge bladder neck.. I'd be surprised if you've not had a systoscopy by now to find out what happened.

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how large was your prostate prior to getting your Optilume procedure. Ive had a rezum 6 years ago and my prostate has grown back. My concern is that my prostate keeps growing and since this procedure does not decrease the size of the prostate, that continued growth would reduce the results.

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