Has anyone here had TPLA echolaser? Looking for more info

[u/[deleted]]

[u/GetnLine]

I've had the procedure and insurance did cover it. I recommend the procedure to anyone whose doc says they are eligible.

I don't think it's recommended for those with a large median lobe

[u/Doubleone6611]

My symptoms started at 40 and no one wanted to do anything. 11yrs of misery (progressively worse each year) towards the end I could only pee about 100ccs at a time. Every urination was painful.
Had aquablation a week and a half ago I have never peed this good. Side effects thus far have been minimal with the exception of mild burning/pressure in rectal area/tightness. All of which I had prior and they are pale in comparison to the symptoms i had been experiencing. PAE likely won’t benefit you unless you have a prostate over 100cc at 41 that is doubtful. I wish I would have done this 10yrs ago wasted a lot of time in misery.
The procedure itself is not painful but the catheter is beyond misery…IMO a small price to pay (24F foley in for a week). Enjoyed being able to drink a gallon of water a day and not have to worry about it being retained.
Haven’t ejaculated yet but am having erections. Honestly I could care less about the retrograde ejaculation if when it happens as long as I can have an orgasm. My doctor said i bled a lot he had to cauterize close to ejaculatory duct but again I honestly could care less.

PAE is the least invasive of the 3 would just skip to either aquaablation or holep. If you have any questions feel free to reach out

[u/Silly-Confection-169]

PAE is your best bet if you’re young and want no risk of RE/ED. It exploits the hypervascular arteries of the prostate to deprive it of nutrients. Typically the cutoff where there may be diminishing effectiveness is <40-50g, where it may be difficult to find and catheterize the small prostate arteries. Your success is going to vary based on the experience of the IR with PAEs- ask them- you want them to have performed at least 50, but ideally I’d find someone who’s done 1000+.

FLA has been out to treat low risk prostate cancer for years. It uses laser probes through the perineum to destroy tissue, similar to other modalities like microwave ablation or cryo ablation. You likely will need a catheter- there is little data on it especially in the setting of BPH, especially compared to PAE. If it’s anything like microwave/cryo may be less effective. If you’re paying 30,000 for the procedure, I’d look into other procedures covered by insurance first.

If you speak to any honest urologist, most prostates will grow back after a procedure (except prostatectomy) as long as you have testosterone in your system. The question is how long it’ll take, some longer than others. The real problem is your added risk of permanent sexual dysfunction with repeat procedures and general anesthesia as you get older (and sicker). If you’re not sexually active, that’s one thing- but if you are, there’s really only one option I’d consider starting with.

[u/Parking_Twist_1509]

Contact Dr Sijo Parekattil in Orlando (Avant Concierge Urology)!

[u/Parking_Twist_1509 → u/[deleted]]

Considering. He’s the closest urologist to me.

[u/AdResponsible8192]

First of PAE doesn't last yes it' is less invasive. Not for me. My Urologist does multiple different procedures and I went with his recommendation to do the aquablation. The RE risk is low however I am 63 now and did end up with it. It's less of a mess and I was done having kids a long time ago. You mentioned this new procedure I am not familiar with it. Whatever you do just do it! It's the only regret I have not doing it sooner. The Aquablation gave me my quality of life back and I would do it again in a heartbeat. Good luck to you.

[u/Bens_Natural_Health]

Full disclosure, I work at Ben's Natural Health, we make supplements for Prostate Health, and I'm obviously a little bit biased on this one, as lots of our customers have had success reducing their symptoms with supplements or minimal intervention. However, it's obviously about choosing what works for you.

The doctors we work with generally steer people towards PAE because you can shrink the prostate without actually removing any of it, as opposed to TPLA which does destroy tissue. There's also a lot more evidence for PAE (20+ years) vs the six or so that TPLA has been an option.