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Tulsa Pro Experience, Mayo Clinic MN – July 2024

Posted by jcf58 @jcf58, Jul 19, 2024

Gleason 7 (4+3). I was treated Wednesday July 17, 2024. I checked in at 7am, entered the MRI/Tulsa suite at 8:15, and woke up in the recovery room around 11:30am. Approximately 30% of my prostate was ablated. I woke up with no pain and catheter in. The first 5-6 hours of the catheter were a little tough as I felt an urgent need to pee, but you can’t because you have the catheter in. Was fine after that. I did take Oxybutynin for bladder spasms at night. At 12:30pm, I walked out of the hospital and 2 blocks to my car to be driven home to Minneapolis.
Over the course of the next 40 hours, I just needed to regularly empty the catheter bag and continued to have no pain. Didn’t even take a Tylenol. The morning after TULSA I took my normal 2 mile walk. Catheter was removed at 7:45 Friday morning and I was good to go home. Catheter removal was not bad and they had to ensure I could pee on my own before release. Urine stream is about half of normal but will improve as inflammation of urethra declines. No medication needed at this point.
I did a ton of research before deciding on TULSA Pro. I talked to 7 different doctors. 4 current and 3 retired (1 had RP and another had radiation). The technology and low risk of side effects made this an easy choice for me. I was also fortunate to have the cancer contained in a fairly small lesion.
I couldn’t be more pleased with the procedure and my care at Mayo.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

datatech | @datatech | Mar 20 4:44pm
In reply to @jcf58 "It was a couple months for me. But I always had full control which is better..." + (show)
@jcf58

It was a couple months for me. But I always had full control which is better than some of the other procedures out there! Be patient. You likely still have swelling and some ablated tissue keeping stream restricted. Good news for me is I only have to get up once per night now vs twice before procedure.

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Thank you, it is good to know your experience is similar as mine. My biggest indicator of improvement is the first morning 'pee'. At first very, it was very weak but now has improved. I have also noticed the stream is now better when sitting on the toilet that what it was right after the procedure. I am making improvements and healing so I am happy. I just need to be patient. 🙂

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jcf58 | @jcf58 | Mar 20 8:22am

It was a couple months for me. But I always had full control which is better than some of the other procedures out there! Be patient. You likely still have swelling and some ablated tissue keeping stream restricted. Good news for me is I only have to get up once per night now vs twice before procedure.

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1 reply
datatech | @datatech | Mar 20 6:12am
In reply to @bobbygene "I almost feel guilty for the ease of recovery from my TULSA procedure. I didn't need..." + (show)
@bobbygene

I almost feel guilty for the ease of recovery from my TULSA procedure. I didn't need any meds for pain or spasms. I took the antibiotic and Flomax. Stopped Flomax after 3 months and didn't see any difference in stream. My stream is back to pre TULSA and I seldom have to get up at night. The Dr. asked if I wanted Viagra and I took his offer. He wrote it to an online pharmacy called Cost Plus. 12 tablets were only $5 plus postage. It works well and the cost is great. My GF thinks I'm a stud.(:

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How long for your urine stream to return to normal? I am probably impatient, well, actually I am impatient about it. Prior to TULSA I almost never woke at night to urinate, now, I am up maybe twice a night. Of course I am not completely healed but still, I want this over with. 🙂

I am off Flomax in another week or so, I really don't like the stuff as it makes me slightly sleepy during the day. Not so bad that I can't function but if I sit down, I will want to sleep.

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bobbygene | @bobbygene | Mar 19 1:05pm

I almost feel guilty for the ease of recovery from my TULSA procedure. I didn't need any meds for pain or spasms. I took the antibiotic and Flomax. Stopped Flomax after 3 months and didn't see any difference in stream. My stream is back to pre TULSA and I seldom have to get up at night. The Dr. asked if I wanted Viagra and I took his offer. He wrote it to an online pharmacy called Cost Plus. 12 tablets were only $5 plus postage. It works well and the cost is great. My GF thinks I'm a stud.(:

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1 reply
datatech | @datatech | Mar 19 9:04am
In reply to @jeffmarc "Strange that you had sensations of a need to urinate when you have a catheter in...." + (show)
@jeffmarc

Strange that you had sensations of a need to urinate when you have a catheter in. With a catheter, you don’t need to urinate. It’s constantly emptying your bladder, I sure don’t remember feeling any urge to pee with a catheter in.

Can you do this after the catheter was removed?

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Lucky you! 🙂 The differences I suppose between our bodies. From what I have read, this is a common event with Foley placement and some will have it and some will not. I had a full gland ablation, so I expect there is the possibility the bladder neck/urinary sphincter region is irritated, if not possibly injured a bit from the procedure.

The urethra of course is slightly injured from the 'sunburn' it gets from the ultrasound waves, if there are two sweeps performed the injury is greater as well as a greater potential for strictures. Most of my ablation was done in one sweep, there were two small sections were the doctor decided to do a second sweep. Approximately 2 percent of TULSA patients have some level of stricture and I am hoping I am in the 98 percent group of those who do not. 🙂

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datatech | @datatech | Mar 19 8:52am

The first 24 hours are a learning curve for your mind and your bladder. After the first day the urge to urinate was less frequent and mostly related to if the balloon were pulled taunt against the bladder neck, but that was seldom. Re-adjusting the way the catheter and penis were positioned in my boxer briefs, and sometimes just slightly advancing the catheter relieved those urges.

As for spasms, those occurred a few times and only during a bowel movement. Too many related pelvic floor muscle groups, and abdominal pressure on the bladder I suppose. As I was on Augmentin to prevent a urinary infection my BM's were mostly diarrhea but even then, sometimes you 'squeeze' with that.

Over a 14 day period I took Pyridium maybe 4 times, and Oxybutyn maybe 4 times. Basically, very little medication for discomfort, which suited me as I am not a pill taker. I am still on Flomax and will be for maybe another week and a half. The urine stream is improving, and on the 24th I go to my local urologist for a bladder scan to ensure I am completely voiding. This will be two weeks after the catheter removal. Barring no other complications, I get a PSA in June and a MRI around September. As long as my urine stream continues to improve, there should be no reasons for me to return to my local urologist.

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jcf58 | @jcf58 | Mar 18 12:06pm
In reply to @jeffmarc "Strange that you had sensations of a need to urinate when you have a catheter in...." + (show)
@jeffmarc

Strange that you had sensations of a need to urinate when you have a catheter in. With a catheter, you don’t need to urinate. It’s constantly emptying your bladder, I sure don’t remember feeling any urge to pee with a catheter in.

Can you do this after the catheter was removed?

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I had the same urge during the first 24 hours. That was the most uncomfortable time with the catheter for me.

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jeff Marchi | @jeffmarc | Mar 18 11:24am

Strange that you had sensations of a need to urinate when you have a catheter in. With a catheter, you don’t need to urinate. It’s constantly emptying your bladder, I sure don’t remember feeling any urge to pee with a catheter in.

Can you do this after the catheter was removed?

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2 replies
datatech | @datatech | Mar 17 9:34pm
In reply to @jcf58 "Sounds like it everything is working out great! I still don’t understand how the procedure was..." + (show)
@jcf58

Sounds like it everything is working out great! I still don’t understand how the procedure was painless for you and me 😉. They killed a bunch of internal tissue and yet no pain. Remarkable.

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Yes, it is remarkable that there is zero pain; my doctor told me up front that it is unlikely there will be pain and if there is it would be more of a discomfort. After the procedure I told him that were it not for the catheter I would not have known anything had been done. I had none of the pubic or scrotum swelling that some people say they have experienced.

I took Pyridium(sp) for several days until my bladder became use to the catheter and that was only to stop the sensation of needing to urinate. I took Oyxbutyn(sp) a few times for minor bladder spasms. I started Augmentin the day before the procedure and Medrol the day before the procedure. Took Flomax about a week prior and still take Flomax. I will take Flomax for about a month and then it is finished...no more meds for me.

Every patient has a body that will respond to TULSA in its own particular way. However, I am thoroughly convinced the skill level of the doctors and MRI tech make all the difference in the after procedure results. Mine were top notch, I have no complaints.

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jcf58 | @jcf58 | Mar 17 7:06pm
In reply to @datatech "I had the full gland TULSA PRO ablation done end of February at Texas Prostate in..." + (show)
@datatech

I had the full gland TULSA PRO ablation done end of February at Texas Prostate in Dallas, Texas by Dr. James Cochran. All went very well, in at 7 a.m. and was prepped, the procedure started around 8 a.m. and I was awake at 11:15 a.m., out of the facility about an hour or so later. The entire staff were great and excellent to me, before and after the procedure. All very professional. I had zero pain from the procedure as far as the prostate goes. There is of course some discomfort from the catheter at the bladder neck, but medication took care of that. I left with a %100 silicone catheter, a leg bag and a night bag.

I wore the catheter for 12 days, had it removed at my home urologist where the URO RN did a 'fill and pull' where they fill the bladder and then you urinate in a small container. You need to pass at least 2/3 of what they put in. She put in 270ml and I passed 300ml so the catheter did not have to go back in.

The urine stream is still very weak, more so in the morning after waking up. Later in the day the stream improves to about 30 percent of what it should be. It will be this way for probably 8 or so weeks, maybe longer. Passing very little blood in urine, no pain during urination, no incontinence and no ED.

About the second week after the ablation I began to feel 'engorgement' in my penis, soon there after I began having mild erections during my sleep. Erections are now about at 90 percent of what they were. I am 69 so I am happy with that; I do expect that as I heal the erection percent will go higher.

I will get a PSA at 3 months and a MRI at 6 months. With a full gland ablation the PSA should be low, but what the doctor has mentioned to me that what ever it is, it needs to stay roughly the same from there on out. I did have a PSMA prior to the procedure and there were zero uptake, not even in the prostate were there uptake. Biopsy did show cancer but it was quite mild, and Gleason 3+3, 6. After the second tumor appeared I pulled myself from active surveillance and scheduled myself for TULSA PRO. I used AS as a window to decide what to do, that second tumor came along and I already knew what I wanted for treatment, I immediately made an appointment for the ablation.

All in all, at this point I am very, very pleased with the TULSA procedure and equally pleased with Texas Prostate, Dr. Cochran and his staff. I could not have asked for better care. I will post the results of my PSA and MRI when they are available.

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Sounds like it everything is working out great! I still don’t understand how the procedure was painless for you and me 😉. They killed a bunch of internal tissue and yet no pain. Remarkable.

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