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Optilume balloon therapy for BPH
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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Thanks a lot @rfherald very important information. I think I will contact Dr. Capeluto. My prostate is about size 65g - so maybe?
Its a good sign that the doctor is not just trying hoping the best, but tells you no.
I could recommend all trying to find the best BPH treatment to go to ChatGPT and ask. It is actually amazing the amount of information this AI can collect in no time. You get a good overview of all there is on the internet.
You can find a list of providers at the Laborie website
https://www.laborie.com/find-a-provider/
my prostate is about 100 ml i did the PAE and had no success. i was very hopeful. however it didn't produce fruit for me. the good news is , it didn't have any adverse affects nor any known negative long term issues. its been about a years since i got the PAE.
Aquablation can work on very large prostates. One provider mentioned 30-40% reduction in the prostate
regardless of the starting size.
I went in with a prostate size of 200 and at the 3 month follow up the nurse said they removed 3/4th of the prostate. I had a PSA of 21 before the HoLEP procedure and my first test after the procedure my PSA was .56. I had complete blockage in December 2023 and had a Foley catheter for 13 months.
Good luck to you whatever your choice. I had holep 8 months ago and have had a dismal recovery. Incontinence mostly that will not resolve. I did not feel comfortable about my doctor but the facility/hospital is highly rated. My gut feel about the doctor turned out to be correct. He is not good at his job. After the fact I would choose a procedure that will not significantly alter your urinary tract or a procedure that can be done again if not successful the first time or another procedure could be attempted. When they push instruments through your sphincter bad things can happen, Unfortunately I found out. I have a new doctor that I have confidence in so hopefully things will get better. Good Luck. I was told I am young and healthy and should not have any problems with a holep procedure, WRONG.
I had Optilume for BPH on 11/18 so I'm a week out - no pain but bleeding with clots, sometimes large, is the big issue. I am reading about similar experiences on other sites. It's alarming not being able to urinate and having to strain to push the clot out sometimes and am hoping I don't have to go to the ER. I would hate to have a catheter go back in because I really hated that. I am wondering how others did with blood clots and their experiences at the ER, if any. Also wondering if anyone was prescribed Finasteride pre-op for post-op to control bleeding