Prostate Artery Embolization (PAE)

Hello Rich,

I have been considering doing the same as you and was wondering if perhaps you and I may have some similar history?

I am 58,  had urolift 2 yrs ago,  did not do much good.  No when I void it is only around 100cc and immediately following I will self cath with the Speedee Cath and I consistently remove an additional 450-500cc.

so it's obvious that I need to do something.    Also would you be so kind to private message me Dr. Bagla phone number?

Thanks Rich!

Hi Anthony,

I'm a bit older (69), and have been dealing with LUTS for a couple of years, maybe longer. I started taking tamsulosin a couple of years ago, and it definitely helps my symptoms. Unfortunately, it causes terrible me sinus problems, so I switched to taking it every other day. So one day I'm OK with peeing and can't breathe, and the next day I can breathe but peeing is difficult.

Relaized that I would need to do something eventually. After perusing and participating in the many discussions on this site, I narrowed my choices down to either PAE, FLA, or switching to daily Cialis. I spoke with Dr Bagla, and also Dr Isaacsson (in NC), and Dr Karmainian in TX who does FLA. All three were amazing available and helpful. I can't say enough good things about them. All three choices (PAE, FLA, Cialis) had pros and cons, and I finally decided to go with PAE, and to go with Dr. Bagla.

I will PM you contact info for Dr Bagla. Let me know if you'd like conatct info for Dr I or Dr K.

Rich

 

Hi Rich. 

Just had PAE by Dr. Nutting in Denver exactly 3 weeks ago. Good doc with great credentials and attends conferences with all the main players in the field.

I am having more aggravated night time voiding/frequency issues and some low ejaculate volume issues. My Urologist states that it is probably a swollen median lobe that is putting pressure on the bladder sphincter muscle and that I must be patient. 

Just wondering what the recovery looked like for men in the first month or 2 after the PAE procedure and what they did to speed their recovery.  Thanx. 

Rich,

We're ever able to get off the meds after the PAE? Would you consider that procedure a success . In reading your mail, it appears that you are still on the tamsulosin, which by the way is what i am taking as well, have been for years,

Thank you for the ph#s. is the FLA done by a uro doc or IR? I would like the dr # who does the FLA,If I go with the PAE I think I will go with Bagla, many thumbs up from the guys!

Rich I wanted to report in on the progress of the FLA procedure as today is my ONE MONTH( (actually it's 33 days) anniversary. Today I had another milestone improvement that just happen. Dr. K told me this would come in the next month and so far he has called it  evey time. They just keep happening a little quicker than he says they will.  

The ability to delay my urinatination urges has improved to the point that the urges no longer control me. As I told you earlier the boys at work bought me a Varidesk for my office. You can sit at it or lift it up and stand up to it. The extensive sitting at my job hurts my prostate. Standing has been great the past week but standing I have been having  trouble fighting off the urge to go when I get the urge. If you sit it helps fight off the urge. This concerned me so I called and ask Dr. Karaman ian about this and he said that I should be patient. First it will heal more and the strengthening  of my control will do nothing but improve. I asked about doing the Kegel exercise and he told me to wait 2 more weeks and as my control starts to improve then I can start them. Well today it has happen as I have been able to stop the urge every time today and extend my times between urination which I have not done this well before today. My knew normal has become to get up to pee once a night. But,  I got up 2 times last night and I peed 450 and 575 cc those two times which is still increasing in volume. The flow is like I am 45 years old again. The best surprize was the ejaculation improvment which I never expected. The ejaculate fluid amount is greatly increased from before the procedure and with no blood. The force of the ejaculation is like a 30 year old and that has not happened since many years ago. I was afraid of deminished fluids with the recovery but just the opposite has happened. No retrograde. No erection issues what so every. Again Dr. K claims it will improve over the next 60 days and he said then what you have is what you will have as you will be totally healed. I dont know what can improve now but I am interested to see. I want to thank all of you for your support and interest. I hope this story helps others. I cant wait for Dr. K to start his clinical trial and publish. It will help everyone..

I had PAE at Univ. of North Carolina Medical center on Oct. 28, 2015, I was taking two Flomax a day and after the procedure I cut it to one and then cut out the other one the first week of Jan,  I have not taken anymore since then. I urinate about the same I did when I was taking two Flomax aday so I am satisfied. In the morning it still takes a few extra seconds to get started and I drink 3 cup of coffee each morning plus a large glass of water, which creates a lot of bathroom sessions over the next hour or so. The rest of the day is normal. If I forget to drink and get a little bit dehydrated then urination is a little bit of a problem, but something that is easy to live with.

The only problem that is still an issue once or twice a month is if I do not concertrate when I have held off urinating for awhile I may have a slight amount of leakage.This is very slight but still something I am working on to control. All other things are doing ok. Will probably need to repeat the procedure in a few years or so.

Anthony,

Before giving up on the UroLift (UL), return to the Urologist who performed the procedure. Your Urologist should be able to determin the cause of the failure and fix it. PAE is not always a benign procedure and once your prostate has been intentionally mutilated by PAE side effects are very possible and especially long term. By contrast there is the possibility that the addition of a single UL clip in the prostate could lead to a correction of your current problem.

Hello Bill,

i did return to my uro, and as we discussed what could be the issue I requested a cystoscopy and perhaps he could see something wrong,   came back 2 weeks later to have that performed and as we watched on the screen I asked where are the implants, he told me they have made there way into the tissue,   Hmmm,   It was only 4 months after the Urolift.   I thought that was kind of odd.    So then he referred me to university level urology in San Francisco,   So went to SF University and met for 15 minutes with that Uro, he did not even examine me, and after the 15 minutes he told me that he could only offer me a TURP!  That's BS.

    Fortunatly,  thanks to this site,  when I saw my original Uro I requested to be shown how to self cath.   He didn't even suggest that.

    I consulted with another Uro closer to my home, who now does urolift and he told me that more devices won't help long term.   Wanted to start me all over again with tons of tests and all the stuff I had already been through.

    I threw him a question of which I already knew the answer to and his answer was so incorrect that I  walked out and have not been back.

so the answer is "yes" I have been back to see my "X" Uro doc.

Please watch for a response by me to Rich in the next few moments.

Go Trump!  M.A.G.A!

Good afternoon Rich,

Good Afternoon Rich, and Happy Inauguration Day to you!

just an update.    I contacted Dr.Ks office yesterday, and he called me this morning in regards to concerns and questions to the FLA procedure, we spoke for nearly 45 minutes I told him that I am considering either that or the PAE procedure by Dr. Bagla,   Who I have also contacted and received email information on today and to speak directly to on Monday.   So I thank you sir for message with contact #s.

A couple of things with the FLA is 3-5 day with a cath. No big deal there, I would use one without a bag, just a small valve and cap on the end and just pee when I'm ready, just like self cathing,  just open and close valve whenever I want.   Said 2-3 weeks to get back to where I currently am and then 30-60 days to start seeing improvements.    He said he can do PAE as well but does not do them because he believes in the FLA.   However the PAE has no recovery time just the waiting game to see if it is working or not.

Dr. K did say that if the insurance does not cover the procedure that it cost $20,000.00 cash price,  if that's the case.   He does not do the PAE but said he has heard the cash price for that is something like $12,000.00.    

He  also mentioned to me,  like you said,   that he is conducting a long term study and looking for candidates to get the FLA for free.   Unfortunately I did not qualify because I have had the Urolift procedure done already and that could  interfere with results for his study.    So if any of you guys out there feel you may qualify for it, he is located in Houston, Dr. Karmanian,  713-904-4014.

M.A.G.A.!!!    Warm Regards Rich.

Had my PAE at the Unvi. of North Carolina medical center and they gave a flat rate cost for cash payers of 6500 dollars. My insurance paid for the MRi and I paid the rest. Used this amount as a tax deduction which allowed me to recovery some of the cost.

Hi Ed

Sounds like a great price.How long ago did you have it done?And how are the results holding up? Been looking into something and PAE is one of them.

Regards.

Anthony it was Oct, 28, 2015, They gave me the price over the phone before I agreed to the procedure. I called Georgetown Univ. medical center and their cost was 13,500, then called UNC medical center and their cost was 6500.. I checked into all the cost to fly to Portugal and have it done. With airfare and staying a week after the procedure it was about 6500 dollars also and the euro has dropped since then. The results so far have been good. I have been off any medical to help me unirate for a little over a year. I expect to have to repeat it again in the next 3-5 years. By that time insurance should cover most of the cost.

Anthony. Moderated yet once again stopped my first message. Never are Told why with this site. If I mention Dr K. They block it but I saw you did used his name AND phone number with no issue. Just don't understand and wish they cared enough about us to tell us or even improve the site but you can't even inquire? You just lose what you type in with no warning. 

I had FLA in December. First met With Dr B in Virginia. I loved him. My wife really loved him and gave him the best looking doctor award!! I was sold on FLA until I talked with Dr. K and when to meet him. Then I saw all the reasons and the logic that FLA was the best for me. With FLA my results were better than I could have imagined. Yes I paid $20 k and it was worth it all. I put it on 3credit cards and will use my IRA money to pay it off as no more  penalty on using it.

That clinical trial could have saved my enough that it would have been about the same as DR. B. Doing PAE. But I did not want to wait. My BPH was really bad. Now I have none of the symptoms I have had for 8 year. I do not now and did not take those flowmax type drugs because of the side effects. I have no side effects now. FLA was the best Pm me if you need any more facts from me.

Hi Fiora,

    Are you taking any meds to reduce any possible inflammation?

    There are a number of other discussions about PAE on this forum. One that probably has a lot of posts about post PAE recovery experiences is: My PAE Experience Today.   I would definitely check it out. If you have trouble finding it, let me know, and I should be able to figure out how to send you a link to it.

Hi Anthony,

    I haven't had the PAE yet. It's scheduled for late March. I'm hoping that it will be successful and that I'll be able to stop taking tamsulosin.

     FLA is done by IRs. I will PM you Dr K's conatct info.

Rich

 

Hi John,

   Thanks for the update! So glad to hear that things are going so well for you. Your posts have been very helpful.

Rich

Hi Bill,

    What PAE side effects are you referring to?

 

Hi Anthony,

    If your insurance won't cover PAE, Dr Bagla's office told me that self pay cost is $ 8,000. I think it might be a bit less at Dr Isaccson's at UNC.

   One thing about the FLA that did concern me, is that after the intial cathing is removed, there is the possibility that there will be retention, and that the cath would need to be reinserted for a couple of days. I'm in a rural area, and that could present problems for me.

   Let us know how things proceed aftder you speak with Dr B.

 

   Warm regards to you as well.

Rich

 

Rich,

In speaking with Dr. K yesterday he did say that after the procedure there is going to be swelling and the cath needs to be in place for a couple reasons,  one is obvious, to keep bladder drained and two, the cath keep pressure on the walls of the area swollen which helps in the healing process,  he said if possible it's best to keep it in for 5 days, which is the part I cringe over.

My concern would be that after the 5 days, am I going to have any problem continueing the self cath process until the healing process is well under way?   I feel that the overall results compared to the PAE would be better,

however the PAE has no recovery period,  as far as I know anyways.

in regards to cost of procedures,  that is definitely a concern, but so is getting what you pay for,  not every doc has enough experience in this field to make me feel comfortable with their ability especially if they encounter any type of problem during the procedure and making the right call or how to deal with that issue.    So 6500.00 compared to 12,000.00 for a PAE is a big difference, but not if the success rate for and experience is much higher than other "less expensive" docs may charge.    There is a reason for those charges.

Have a great day!    We are all on the right track here!

My concern would be that after the 5 days, am I going to have any problem continueing the self cath process until the healing process is well under way

A good question for Dr. K.

Re: PAE recovery period. No catheter. From Dr B's office email to me:

Your symptoms do become exacerbated for approx 7-10 days following the procedure.  That is from the embolization.  It causes a certain degree of inflammation, but we do prescribe medication for that. 

Re: cost. Agree with you completely about that. Dr I at UNC has done many of the procedures, and the reports on this forum from men who rec'd PAE with him have been very postive. With that said, Dr B has done considerably more, and the reports as you know have been glowing, and I decided to go with him.

Spring time in January today here in the northeast!

 

Anthony, I experience with the Catheter in the FLA was like Dr K told you. I had my cath and on the sixth day I took it out my self. I was scared to death of even getting a catheter as I had never had one before. It was the number one fear I had for many stupid reasons. All of the fears were totally wrong for me to have had. 

What acutally happened is that they use concious sedtion instead of a valuim and a pain shot and I never knew when they put it in. Nor did I feel or remember any of the procedure or getting on the MRI table. I never felt a thing. I signed some papers, then I was waking up and planning to go out to eat lunch with my family. The catheter never hurt or caused any issues. The reason is because the Doctor gave me a pill called Uribel and it stopped all the bladder urges and any urin stinging from the catheter. I went out sightseeing the next day and for four more days then drove myself home on day five for six hours the catheter still in. I took it out the next day and it was nothing. I was a little shocked as I expected it to bother me as it came out but I removed the water presure on the ball of the foley and gave a little pull then started to pee and it just peed right out of me. I actually missed it after it came out because I had to start peeing again and at first that was about every 2 hours. Still no pain in the process as i stayed with the Uribel and that is great stuff. Remeber the name of it no matter who you use or which procedure you select. Now I pee about every 5 or 6 hours and 350 to 550 cc each time with a strong flow. Up only once a night and I dont wake up to pee. I pee because I woke up! There is a difference.

Dr. K also uses a silicone made catheter and not the hard rubber ones. This makes a difference and is not uncomfrotable it is more expensive for them to use but he cuts no cost and as he told me "I do not believe in using something on a patient that I would not want to use on myself". 

Good luck 

John

was procedure successful?

I would like the contact phones for Isaacsson and Bagla. Considering PAE

I will put the phone numbers in the next pots (not sure if the moderator will OK the message)

Dr Issacson: (919) 966-4292

Dr Bagla: (703) 763-5224

I had PAE done yesterday at University of miami. I am having a lot of pain. How did yours go?

Hi.  Must say I had little pain.   Some when they plugged the opening in the leg artery at the completion and urinating following the removal of the cath. 

I am considering PAE. How are your symptoms today? Did the pain go away? Have your BPH symptoms removed with the PAE procedure? Would you recommend procedure? Doctor?

REVISED

I am considering PAE. How are your symptoms today? Did the pain go away? Have your BPH symptoms improved with the PAE procedure? Would you recommend procedure? Doctor?

Hi Robert,

I have been taking daily Cialis (which is approved for treatment of BPH) and I take Saw Palemetto and Beta Systosterol each day. I am also on a plant based diet to cut down on inflammation. I very much still have BPH but some days seem much worse than others. In any case I have an excellent cardiologist in Long Island who strongly discouraged me from getting a PAE. Trust me I was very much leaning to this procedure. If you do it make sure you get an interventional radiologist who has done many of these procedures. I'm from the NYC Long Island area. In my area I was leaning towards

Aaron Fischman, MD

Interventional Radiologist at Mount Sinai, Klingenstein Pavillion 1176 Fifth Avenue MC Level New York, NY 10029 Phone: 212-241-4046

or Raj Ayyagari, interventional radiologist at Yale in Connecticut

In spite of what my cardiologist says the NEJM indicates PAE is a viable alternative to Turp.

"August 7, 2018

Prostatic Artery Embolization: An Option for Benign Prostatic Hyperplasia?

Paul S. Mueller, MD, MPH, FACP reviewing Abt D et al. BMJ 2018 Jun 19

This procedure is one of several newer alternatives that are less invasive than transurethral resection.

Less invasive alternatives to transurethral resection of the prostate (TURP) have been developed for patients with benign prostatic hyperplasia (BPH) and refractory symptoms. In this randomized, noninferiority trial, Swiss researchers compared one such alternative — prostatic artery embolization (PAE; performed under local anesthesia by an interventional radiologist) — with TURP (performed under spinal or general anesthesia) among 103 men with refractory BPH symptoms.

The primary outcome was change in the 35-point international prostate symptoms score (IPSS) from baseline to 12 weeks. Mean reductions in IPSS after PAE and TURP were similar (−9.2 vs. −10.8); although this difference isn't considered important clinically, it failed to establish noninferiority statistically. Reductions in scores that assess quality of life, prostatitis symptoms, and erectile dysfunction also were similar. Differences in urine flow rate and postvoid residual volume clearly favored TURP; whereas patients' bladder diary outcomes (i.e., mean voided volume, daytime frequency, and nocturia) showed no differences between the groups. Mean procedure time was shorter with TURP, but bladder-catheter duration and hospital length of stay was shorter with PAE. Treatment-related adverse events were half as frequent after PAE than after TURP (36 vs. 70 events).

Comment

PAE, which is FDA-approved, might be a reasonable option for some patients with refractory BPH symptoms. However, we don't know how PAE compares with other new procedures, such as transurethral needle ablation, transurethral microwave thermotherapy, and urethral lift.

So to sum things up I have stopped looking for a perfect cure as none exists and am trying to live with BPH but attempting to lesson the symptoms with the medication , supplements and diet shown above. I am 66 years old, I am very hesitant to have any surgical procedure unless the benefits outway the risks. Don't rush into anything unless there is clearly a benefit, and be VERY skeptical of all advice given whether by doctors or even the very kind people on this site." Best of luck to you and keep me informed.

Hi Robert,

If I were you, I would be very hesitant to give an advice regarding PAE without having a personal experience with it. The paper that you site is one of the very few negative(neutral) small comparative studies of PAE vs. TURP. There are much more recent comprehensive reviews of PAE vs other procedures for BPH (circa 2018), which have much more positive outlook for PAE safety and efficiency vs. TURP. Needle ablation is in its still experimental stage, not approved by most insurance and performed by very few IR. It's expensive also ($20K). Remove that from the table and you will be left only with alt garden variety of thermal of treatments that damage the nerves surrounding the prostate capsule and resulting in substantial percentage of cases in long term impotence or incontinence. Full healing, unless in early stages of BPH in very young and fit men, takes up to 12 weeks.

I was in you situation at 66 and decided to wait like you. I was for years since age 50 on Saw Palmetto, daily Cialis since age 62, alfuzosin twice daily, althose highly praised statins and and very healthy diet with supplements of Mg, Zn, etc. It's all is a big fallacy. They all obsolete , which is proven by dozens of clinical studies and statistical analysis of t metadata. Lifestyle has little to do with BPH (except maybe STDs). Nothing helped me at least, and unbeknownst to me, due to the negligence of the arrogant URO and Primary Doctors , who believed that their digits and yearly DRE exams tell them the size of my prostate better than a standard MRI scan or TRUS, my prostate has grown to the size of 135 cc, when everything, except HoLEP, which my HMO didn't offer, was not working and I was offered only a TURP (which is malpractice). I was strongly advised against PAE by both and told those standard advice about the "golden standard" of a procedure that make many older men with a larger prostate due to the years of the ill advised conservative management , miserable with their impotence and incontinence (almost 40% in the age group over 70) . I ended up with regular bleeding, UTIs, selfcath few times per day, going to bathroom every hour day and night and horrible quality of life, not even talking about sexual performance. My bladder neck became partially obstructed, varicose veins of the prostate, which are close to the urethra were bleeding at any strain, partial incontinence and multiple diverticula of the bladder developed. Do you wish it for yourself in 5 years? Finally, while being scheduled for a standard TURP (not even a button plasma TURP), which very few very skilled UROs apply to prostates larger than 80 g, I went to UCSD and agreed to become a part of the clinical trial not even knowing how it will be covered. HMO refused to cover it on the same premises as your and my doctors calling unproven and experimental with huge risks vs. standard and proven TURP. Calling it unproved and woo-do science. THe IR Professor at UCSD (I skip his name, but he is the only one there ), who underwent training under Dr. Isaacson from NC. performed the PAE in two weeks after I have seen him first. I was his patient #13. He is a brilliant IR and did a great job on me. After a few unpleasant days/weeks a substantial improvement started to on the week three. It still going on after 9 month, as somebody described recently in steps/platos. So far it's the best thing that ever happen to me. I don't wake up at night, my LUT and sexual performance was rolled back in time by almost 40 years. The same effect as other, improved erections, stronger orgasms, ability to perform 5 times longer time during the intercourse. Flow rate tripled, not even a minor drop on my underwear. The bladder relaxed to normal to it's normal functions. I regret dearly that it was not available to me 10 years ago. Of course everybody is different. It's an axiom of medicine.

But If done correctly and according the latest protocols that us a detail angiogram mapping prostate feeding arteries and targeting some inner areas of the prostate, it can produce a substantial relieve without much risk. It's expensive, if not covered by insurance. Medicare covers it since 2017. It was approved by FDA in July of 2018, contrary to strong resistance of AUA. It was tried even for late stage inoperable PC. Used for years in females uterus fibroid treatment with extreme level of success.

The downside is high doses of radiation to the abdomen (dependent on the skills of IR and equipment used) and absolutely unknown long term (10-20 years down the road) results. Given that the method uses the local infarctions of the PG due to the artificially induced ischemia, pretty much like in heart infarction during the herat attack. People live 30-40 years after heart infarction, so hopefully the same is true for male's "second heart" -prostate, which ages and undergoes changes as our heart does. Lifestyle and some medicine can (or can't in most cases) help you, but eventually you will hit the same wall as everybody else. In my final opinion, watchful waiting is not a great idea for aggressive BPH (well monitored by so denigrated PSA, BTW). It's exactly opposite for on-aggressive PC even Gleason stage 6 or higher. Most of them wil never grow outside prostate.

Chose for yourself and on't listen to the doctors who didn't experience it, never performed it, never had a patient who underwent the procedure, and are not even UROs. Why should be cardiologist opinion better than mine or yours?

5 or 6 recent testimonials on this forum from people who recently underwent PAE demonstrate 80% of success with minimal side effects, but in some cases vast improvements of their LUTS/UTI, sex life, quality of life index.

Of course, IR doctor should be very experienced and well trained 1012 years in IR. Best of all a Professor from a good Medical School.

I wish you all, sufferers from BPH, a great improvement in the near future, and Happy Holiday Season with your partners.

P.S. Don't repeat my mistake. Don't procrastinate. Insist on detailed MRI (bette 3 T MRI) scan and size evaluation. Then, decide for yourself what is the best treatment for you, based on the PG size and median lobe location enlargement. I believe that in early case with smaller median lobe, URoLIft is appropriate, with larger than 80 g PG - PAE. Everything else is the dice roll.

I had the PAE EMBOLIZATION

IN 2017.

IT WAS A GODSEND FoR ME.

My IPsS SCORE WAS 23 before and now 9.

IN SEVERAL thousand procedures now PAE HAS HAD VIRTUALLY NO negative side effects.

TURP HAS MANY risks AND ALMOST ALWAYS RESULTS IN INABILITY TO EJACULATE EVER AGAIN.

ONE PROMISJNG NEW PROCEDURE IS THE REZUME Steam ablation but I CANT say because i havent had that.

ONE THING I know for sure is that waiting and taking drugs like flomax and home remedies like diet and saw palmetto only allow the adenoma areas to continue to grow and the bladder to GRADUALLY be damaged along with prostatitis UTIs and all the rest.

I’m strongly considering PAE.

Can you kindly answer the following questions based on your own experience and outcomes?

Before

1. When did you have your procedure:
2. Who performed your procedure:
3. What was the size of your prostate:
4. What was your Prostate Symptoms Score:
5. What was your Post Void Residual results:
6. What was your Flow Meter results:
7. How many times did you wake up to go:

After

8. Prostate Size:
9. Flow Meter Results:
10. PVR Results:

Thank You!

Robert

Agree with every word Lymn wrote. My experience is absolutely identical. I regret all the years spent taking flomax, saw palmetto, beta-phytosterols, and waiting until my prostate has grown to 135 g, bladder neck obstructed, bladder distended and developed diverticula. Life and sex are absolutely different now. Pity that is available only to few in US. Most insurances refuse to cover it.

MY PAE EXPERIENCE Ane results are On this site in my previous messages so if you search back you can find them. this app is hard to write on so I don’t want to do do it all over again however there are a few things I could say...

One thing a lot of people don’t understand is that the overall size of the prostate is not what causes tge restriction...

some people with large prostates are fine and have no symptoms and other people with smaller prostates have considerable problems and the reason is that it’s the growths called adenoma’s that are in and around the urethra and that press on the urethra and restrict the flow that are the problem.

AN enlarged Prostate is not just a larger version of a normal prostate ... its a prostate that has developed growths and irregular areas that press on the urethra.

MY PAE Was done in June 2017 by interventional Radiologist DANIEL SZE at Stanford medical center. MY IPSS What is 23 before and is now 9.

I was able to discontinue Flomax which I had taken for years - about two months after the procedure.

Being able to get off of that drug and all its side effects was a huge blessing in itself.

sorry about all The typos.

this site for some reason is very difficult to message in

PS

A great Thing about the pae embolization procedure is that in almost all cases there are no side effects or negative problems or damage.the one possible exception is that it does deliver a fairly high dose of radiation but people of been having other types of embolization and interventional radiology procedures for years without problems.

(The Radiation dose is approximately 1/10 of the total radiation given during prostate cancer radiation treatments)

pps

An interesting result that the urologist at Stanford who ran the study noted - and that they were somewhat baffled by- was the fact that all 10 of us who were in the clinical trial study and had the PAE - had an improvement in sexual function they don’t know why but all of us had that added improvement... (Which is the opposite of almost all of the other procedures. )

ALSO Before the PAE I got up at night on average two or three times and now usually sleep the entire night thru without getting up at all.

Thanks for your reply. Yes there are two types of BPH. BPH with LUTS and BPH without. I was looking for evidence based information regarding before and after PAE. There are specific test the doctor orders before and after PAE. Usually MRI, Flowmeter, PVR and IPPS score. I suspect a doctor wouldn’t recommend PAE for patients who have BPH without LUTS. Therefore, I am interested in Prostate size as it does relate to shrinkage and symptoms improvement. Thanks for sharing your experience. I’m looking for additional information regarding follow up testing and results.

Ed

Has your PSA gone up since your PAE procedure 4 years ago ?

Yes the PSA went from 3.4 after the procedure to 7.1 just prior to this last procedure... It dropped to 3.7 this time and will probably go back up to 6-9 over the next three years or so. Before the first procedure it got as high as 12 one time. When I took a round of antibiotics the PSA would drop 3-5 points each time, so an infection was creating some of the increase.

Three biopsy over six years all negative. Last one was done using a 3T-MRI image to focus the biopsy.

Did you get a good result? Did you have a median neck issue? Where was obstruction?

You need to be cathed to do the PAE? And for days after? Why?