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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I had my prostate removed in 11/22/2023 the ejaculation is gone but the organism is still there and highly enjoyable

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Excellent breakdown. Thank you. I am 74 years of age and just recently had a penile implant (AMS 700). I do have BPH (102cc). However, I must be missing something cause the urination regiment is tolerable. There is no pain. And only once a month I get trickle like symptoms. The implant allows me erections. I cannot tolerate Fanastiside. Took me only two tablets to figure that out.

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@ndclayt41

I had my prostate removed in 11/22/2023 the ejaculation is gone but the organism is still there and highly enjoyable

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My point: even though you have been diagnosed BPH. Don't be so quick to poke around down there. What my wife fears is one day I might not be able to urinate at all. I simply reply: that will be a clear indication that I need to poke around down there
😜.

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@keithmr, given that the The Optilume® drug-coated balloon (DCB) is a relatively new procedure, it is helpful to hear from others who have had it done. You and other may also appreciate the experiences shared by @rjw4usmc and @davyde in this related discussion:

- Optilume Balloon Treatment for Prostatic Strictures
https://connect.mayoclinic.org/discussion/optilume-balloon-treatment-for-prostatic-strictures/

@dstephens20 and @scurry were also looking into Optilume.

Keith, what is the one tip you would offer to other men considering this treatment for benign prostatic hyperplasia (BPH)? What do you wish you had known?

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I haven't had a procedure yet. I just don't think MIST should really include removal of tissue. There must be many men that don't need the longer healing process and in hospital stay and that goes along when there is a simple procedure truly minimally invasive and performed with local anesthics. Why obliterate just separate.

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Everyone has their own situation to assess, and I am definitely in favor of starting with least invasive option(s). In my case, however, I have had two laser PVP procedures, one Rezum procedure, and tissue has grown back after each one. I am now getting ready to have my fourth BPH surgery. I recognize my case is probably rather unusual, and for this reason I am seeking my further care/surgery at Mayo. The good news is that there is an increasing array of less invasive options available now for BPH treatment. This can make it challenging in selecting the best one for any given person. I feel the key here is to have a skilled urologist who is able to help evaluate the full range of options (including pros/cons, risks/benefits) to select the one that best fits the individual's condition. If I had not been through what I already have I would definitely consider the MIST procedure.

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