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Going for Tulsa Pro
I've posted here a few times over the last year and have read most of the posts from others. I was diagnosed in January 2024 through an ultrasound biopsy (it should have been MRI guided), followed by a PSA test CT scan, MRI, and Decipher test. My cancer is not aggressive, but there are three growths in my prostate. My doctors recommended a full ablation, and I’ve decided to go with the Tulsa Procedure at UCLA with Dr. Steven Raman.
I’ve waited until now because I believe Medicare will begin covering the procedure on the 1st. of 2025. Earlier this year, I switched from a Medicare HMO plan (Blue Shield) to Original Medicare with a supplemental plan, where Medicare covers 80% and the supplemental plan pays the remaining 20%. It’s been incredibly difficult to determine whether Medicare will actually cover the procedure, as I’ve received conflicting information. However, I think they will.
I considered going back to an HMO with United Health Plans, which includes UCLA physicians as in-network, but no one could guarantee that they’d cover the procedure either.
Anyway, I thought I’d document this journey. It begins on January 5th, when I’ll check into an Airbnb hotel near the procedure location. This is two days before the procedure. I’ll have to fast those 2 days and completely empty my stomach (I’ll spare you the details). In the best-case scenario, I’ll wake up with a catheter and a “burned out” prostate. I’ll need to wear the catheter for at least two weeks. Hopefully, they'll get it all 🙂
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Would you please share what you're doing regarding diet and arresting BPH in it tracks? I expect I may need to investigate this approach. Thank you.
Thanks for the reply, that's reasurring. I know all about how Tulsa works, what I didn't mention was that when they were ablating with the bad probe, they weren't getting the correct feedback, so I assume they were ablating without fully knowing how much they were ablating. I did also have concern that about them having to insert the probe twice, so hearing from you has alleviated that fear. I had BPH prior to Tulsa too. I was really hoping that since an enlarged prostate causes BPH, that having some or most of it ablated would relieve the swelling and in turn solve the BPH issue. I asked my doctor about that and he said it might. I've been taking Terazosin for several years for BPH with no side effcts, So I guess I cant expect miracles. Knowing that you had similar symptoms is a relief, thanks for posting! I'll stop worrying about it. I knew the tiny amount of blood coming out wasn't serious, but I was wondering how long it would last. Thanks again 😀
I worked medical devices a lot of my life, and on experimental ones in medical research (never in urology), but taking the probe out and in, is unlikely to have anything to do with an ablative process that is done with an ultrasound beam. The beam is the process. The taking in and out is a mechanical unfortunate event, but unlikely to to have contributed to much of any issues, maybe small or something that quickly healed. Some small tissue scrapping or who knows but probably not a real lot of issue, this is fast regrow tissue so that would be gone now.
I had a ton ablated but it is a ton of tissue in there that will take 6 months to reabsorb. You have a bunch of tissue that takes time to absorb. 6 months come back and ask some of these questions, you will likely be fine till then. I was about the same as you at this stage, so I think no concerns. I wanted off alpha blockers and did get off at two months since I don't like them, but to be honest I could have taken them much longer.
Now the thing is if BPH was active and prostate enlarging prior - that is still in place. I am finding that out. My MRI shows no concerns for cancer but my BPH is still active. So I am changing my diet and stuff to arrest the BPH in its tracks, but you will have to find out if that plays into it at all because it can slow down things again if one doesn't get ahead of it.
Question for the guys who have already had the procedure. On Tuesday I'll be 4 weeks post procedure and 3 weeks post catheter removal. I'm wondering if my recovery to this point is typical. My urine stream is better than right after catheter removal but not as good as pre-procedure. I'm still getting a splash of blood when I first start my stream, but it clears up with a second or two. The last bit of voiding slows to a dribble/drips. I'm taking .4mg flowmax and 1mg Terazosin twice a day. I experimented with 2 does of Flomax a day but it didn't seem to make much of a difference. I feel like I've reached a plateaue. If it is getting better, it's so slow that it's not noticeable. I'm a little paranoid given the fact that they used a malfunctioning Tulsa probe at first then removed it and inserted a functioning one. I'm worried that either they may have ablated an area of my prostate that they didn't intend to ablate and/or caused extra trauma due to having to insert 2 probes. Anyway, very interested in hearing about your recoveries. I realize we are all different but still would like to hear from you. I haven't found much online.
It's been 2 weeks today post procedure and 1 week post catheter removal. No observable tissue and little to no blood in urine. Flow has greatly increased but still less than pre-procedure. My fear was that I would be fully obstructed and end up in the emergency room, but thankfully that never happened. I hope our posts here help alleviate apprehension and fear of future Tulsa Procedure patients. If I had seen these posts before my procedure, I would have been better prepared to anticipate the stages of recovery. The good news is, that less than two weeks out, I was feeling much better, and now I'm 90% back to normal. No pain, 80% flow.
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1 ReactionMy apologies, I just saw your post. I have been approved now for the procedure and met with the doctor Ram Pathak, M.D. I asked if I wanted to schedule how soon they could do the procedure, he said like 3 weeks. They may have more scheduled now that it is a covered procedure. I had to do a ct pelvis scan to rule out calcium deposits, he said if there is any that he cannot do the Tulsa, I just finished the scan and it is clear. I am on a diet, I am overweight, so losing some weight before the procedure so that recovery will be easier, I will be scheduling soon. I really love mayo, there has been no other hospital better. They value you, and value your time, they spend all the time with you that you need and answer all questions so that I understand. Let me know if I can answer any more questions, please contact me.
I had Tulsa at Mayo in July. PSA every 3 months & MRI every 6 months for a 2 year period. Biopsy at 18 months or 2 years. I have not asked what the protocol is after that. I am happy with that schedule as I know if anything crops up they will be on top of it. No side effects and procedure was a breeze.
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1 ReactionI am the 80 year old that had this procedure done in April '24 and a follow up MRI in December at Mayo in JAX. The above post appears to have had similar experience with the cath and lack of many side effects or pain. My priorities might have been different due to being older than most here, but I am very pleased with the results so far. The bedroom and bathroom issues have been minimal and I return this weekend for a follow up next week and will report the results.
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2 ReactionsNote that Tulsa has the ability to do a full ablation of the prostate. We talked about full ablation or just the tumors. I thought we had decided to just do the tumors but we went back and forth, ultimately I think I told the Doctor to do whatever he thought was in my best interest just before going under. I chose Tulsa because of the good odds of not having major life changing side effects. Everyone has to decide on their own, but I'm glad I went with the Tulsa Procedure. All bodily functions I've been able to test are working so far. Still have one to try out but have to wait a few weeks on that. Glad that I don't have urinary or fecal inconvenience issues which is a huge relief. They are very uncommon with Tulsa but not so uncommon with some other procedures. AI answered a lot of my questions along with my own research. Oh, and I just set an appointment for a follow up MRI in 6 weeks.
Thank you for the detailed updates and congrats on getting through what I hope is the worst of it for you. Passing ablated prostate tissue sounds ghastly.
I am trying to evaluate treatments that may be appropriate for me down the road, and one thing that I want to factor into the equation is the fact that any treatment that leaves prostate tissue behind will most likely necessitate the need for ongoing biopsies. Obviously tolerable, but still a consideration in the evaluation process. Good luck as you recuperate and know that you are providing a real and valuable service to others.