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I had my second PAE yesterday - my first was in 2015, and technology has improved, so I felt it was worth a try. My first procedure was done through a groin puncture, and was unsuccessful. The Interventional Radiologist only treated one side, and that side missed the prostate artery. He could not find the artery on the other side.
The treatment yesterday went in through the left wrist. The right side was treated successfully, but the left side was problematic. The artery was located, but was too small to embolize. The IR claims he can solve this problem, and I will need to return for another attempt.
Overall, at least in my case, this was four hours of torture. If I get good results, it will have been worth it, but I won't know that for at least two months. The procedure is done awake, with very little sedative, so the doctors can communicate. My biggest mistake was not demanding a foley catheter before the procedure started - I went into retention in the middle of the procedure and had to be catheterized. The promotions claim that a "pinhole" is used in the wrist to access the artery. The "pinhole" is about the diameter of a 20 penney nail.
You are in a steady x-ray for the entire procedure, so radiation exposure might be an issue.
I should mention that last October, I had a Urolift, 5 pins, which left me in worse shape than before I had it, which is why I elected to undergo another PAE. The Urologist was pushing for me to get a TURP, of course, which is their favorite obsession.
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