2nd PAE just done

I had a PAE done in Aug 2017. They went in through the right femoral artery. I was awake during the procedure and I thought it was a pleasant experience - I was very comfortable. The only discomfort was after when I had to be horizontal in a hospital bed for hours while the puncture wound healed. By 1pm I asked for a Foley catheter as my bladder was filling up. Released at 4pm. Foley out. There was some pain and discomfort for a couple of weeks after which I managed with two tamsulosin per day and Tylenol. Not too bad. Unfortunately, due to median lobe issues, the PAE was only slightly successful. Symptoms came back so almost two months ago I had a bipolar TURP under general anesthetic. I was in and out of the hospital in four hours. No pain or discomfort. Went home with a Foley and that was in for three days - the only discomfort from the whole process. Once that was out there has been no pain, no blood, just the usual lack of full energy that one experiences after an operation. I am slowly improving each week. Still having some frequency/urgency/and nocturia issues, but all is better than before the operation, when I was in almost total retention. I would happily do another TURP if necessary.

I can't believe you were in 4 hrs of agony. What they gave me was a nice what seemed like 10 minutes which was closer to 2 hrs. My PAE was a big success and still is 3 years later.

No median lobe

i had my PAE in tampa florida 8 days ago and had not really been told what to expect how long before you see any improvment what so ever? Finished all my meds CIPRO a the like just felt it was to eazy to be successful and was told your tip will feel a burning and that never happened just feel i did it and now just wait to see any improvement NOT PATIENT please help me know when to expect some reduction in BPH symptons ??

Hi Ramblin,

Sorry to hear of you troubles but I can empathize. One week ago I had my 3rd PAE. I'm going to type it another way so that people searching for information will find this post. Third PAE done May 20th 2019. I had a similar experience to you in that after my 1st I saw only a slight improvement. In my second PAE, I got even less of an improvement in symptoms. There was however a slight reduction in blocking the urethra. I know this because of specific testing.

I think that we need to know what is actually causing our symptoms. It's a bag and a hose. Start with the bag (bladder) Is it getting the correct signals from the brain to cause it to contract and is the valve at the bottom (bladder neck) getting the nerve signal to relax? This can be tested with a urodynamics test. It shows the presence of these signals and the bladder pressure. If that part of the system is working, ie: the bladder is contracting and the bladder neck is relaxing and opening up to release urine, then we move on to the hose (urethra, prostate and the last sphincter muscle ). To know if the prostate is actually out of the way you need a cystoscopy, literally running a catheter with a tv camera up the urethra through the 1st sphincter muscle past the prostate through the bladder neck and finally popping up into the bladder. If the whole path is clear and the brain signals through the nerves is there, then there is a problem with the sphincter muscle or the bladder neck "function" when we're trying to pee.

The valves may not actually be opening or opening all the way.In my situation, the first PAE resulted in almost no improvement and I had to keep taking Flomax. Disappointed, I had the urodynamics and the cystosopy and it showed that the signals were there, but two things were wrong: First, the camera made it all the way to the part of the urethra where the prostate was and you could see the channel squeezed off. Next the camera pushed through the prostate and the bladder neck into the bladder. Once in the bladder they turned the camera around and we could see that the bladder neck was being pushed upward from below. It looked like a volcano instead of a downward leading funnel. We can't be sure, but think that it was the prostate pushing it up from below. This is not the normal position for the bladder neck so it's possible that its proper functioning is impaired by this pushing up. My urologist say that they just don't know. (hate being one of those "we don't really know cases"). So two years later I had a second PAE and then tested again. This time the prostate was mostly out of the way so there was a reduction of prostate tissue. When inside the bladder, the volcano shape of the bladder neck was noticeably lower but still not a funnel pointing down. I still had to take the maximum dose of Flomax to pee. I then went on Finasteride to see if that would help, but it made no difference.

So now, three years later I decided to give it one more whack with a PAE. This one went through the wrist like yours, took about two hours and I was also awake and needed to get re-anestitized twice so I could lay there comfortably. I had no catheter either.Today I am 8 days out from the procedure. I have had pain during urination that diminishes slightly each day. Still getting up three times a night to pee, but there may be inflammation present so the jury is still out. We all know the results can take months anyway.

All this to say that you won't be the first to go for a three-peat on a PAE and arteries can be hard to find. I suggest that you get tested for the signals and see what's actually going on with the camera if you haven't already. Wish me luck and I certainly wish you the best.

To Arlington, I think the Doc who asked for consent for $1000 in the middle of the procedure was way out of line! Nearing malpractice! Where did you have yours done?

I feel so lucky, I am only 5 weeks post PAE and I am experiencing incredible improvements in ALL symptoms of BPH. Knock on wood , I hope it lasts. I wonder if the percentages add up as far as success rate. There are so many poor results reported on this forum ( for all procedures ). And probably those with good results never report to us, and those with poor results are back on here reporting and searching for answers.

This is a difficult road to travel and I wish for the best to all of my BPH brothers!