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Any bad results from prostate artery embolization?

Posted , 22 users are following.

richard11472
richard11472

My family doctor was all for PAE until she checked with another doctor in the practice when she changed her mind.  She says there is a large danger if blocking the wrong arteries feeding either the bladder, rectum or both, obviously leading to very serious issues.  This could lead to surgery possibly having major consequesces.

Has anyone encounter such issues and did the doctors performing the procedure address the possibities beforehand.

I was ready to have the procedure but am now also looking into MRI guided prostate ablation----has anyone had that performed?

1 like, 53 replies

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  • david41064
    david41064 richard11472

    Posted

    Richard,

        It is a theoretical risk but if you have a great IR who has done many, the risk is close to  zero.  Dr. Isaacson did my PAE in Sept of 2016.  It has improved my life dramatically.  I believe this is the future for guys with large ( 80 gm or larger ) prostates.  It is also being studied for prostate cancer treatment and for general LUTS symptoms.  Unlike Turp and all the other treatments there are no sexual side effects and no burning or cutting or lasering.  I would guess Isaacson has done 1000 or more at this point and he is the go to guy.  Now covered by Medicare.

    • kenneth1955
      kenneth1955 david41064

      Posted

      David glad you have a good doctor.  I think that is the key to any procedure. How good and caring your doctor is with you concerns.I know you said that you had no sexual side effects.  Did you have a decrease in you ejaculation. That seams to be the only thing because your prostate is smaller so it makes less.  Stay strong and enjoy life  Ken   
    • Howard31850
      Howard31850 david41064

      Posted

      Hi David - glad for your great results but I also had Dr. Isaacson a month before your procedure and it had no impact on my BPH even though it was a technical success. He also dropped me like a hot potato after 3 months when he saw the procedure was ineffective so he would not have to include me in his statistics as a failure. So like all doctors, some guys have good results and swear by them and others have bad/no results and swear at them! Good luck.
    • david41064
      david41064 kenneth1955

      Posted

      I had a slight decrease in ejaculate for about one month.  After that back to normal volume according to my wife.  Other good news is the drop in PSA.  I was 10.3 before PAE, 5.1 after six months and now after 18 months 4.8.  My prostate was 123 in size.
  • tomypasta
    tomypasta richard11472

    Posted

    Does anyone know if the pae can be done on a median lobe. Would li me to hear from anyone who had it done on medium lobe. Thanks
  • tomypasta
    tomypasta richard11472

    Posted

    Does anyone know if the pae can be done on a median lobe. Would li me to hear from anyone who had it done on medium lobe. Thanks
  • stan98754
    stan98754 richard11472

    Posted

    Sorry folks but be aware  to  PAE   in case you have BIG median  lobe.  There is a lot evidences  of poor results with PAE .  April  2017  my PAE in Lisbon.  No relief after it - even after 3 months  big worsening . I have had  CIC twice a day  with PVR 250-300 ml.   damage of bladder and hydronephrosis  on  kidney .  Now Im just 3 weeks  after FLA in Houston  and relief is comming ( Now I feel like 3 years ago  ) but better progress is awaiting in 2-3 months.   For those of you without big median lobe PAE is good decision , but be aware if you have Big median lobe. Stan    
    • kenneth1955
      kenneth1955 stan98754

      Posted

      You will get better as the weeks go bye Glad to hear it.  Just take it easy.   And if you need anything just call Dr. K  He is there for you  Ken  
    • stan98754
      stan98754 kenneth1955

      Posted

      Hi Ken  , did you processed FLA ?   I have you in my records  ( Excell table )  as Urolift patient.  Pls clarify.  Nice Mayday, Stan   
    • kenneth1955
      kenneth1955 stan98754

      Posted

      Hey Stan.  I did have the Urolift done over 3 years ago.  I like talking to Dr. K  He has called be a few times and emailed me I all ways send him prayers so he can help as many men as he can.  Very nice guy  I talked to him just before you had yours done  Take care and hope you heal fast Ken.  
  • sam19736
    sam19736 richard11472

    Posted

    there are good results from PAE and median lobe. my doc had forwarded me this link.

    https://www.ncbi.nlm.nih.gov/pubmed/?term=median+lobe+prostate+artery+embolizatinon

    • stan98754
      stan98754 sam19736

      Posted

      Hi Sam  ,  this is citation of mentioned scientific paper :

      Intra-vesical Prostatic Protrusion (IPP) Can Be Reduced by Prostatic Artery Embolization.

      BACKGROUND:

      Prostate artery embolization (PAE) is a new approach to improve lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia. PAE results in global reduction of prostate volume (PV). There are no data available on the efficacy of PAE in reducing intra-vesical prostatic protrusion (IPP), an anatomic feature that is clinically related with bladder outlet obstruction and LUTS.

      OBJECTIVE:

      To assess the results of PAE in patients with significant IPP due to median lobe hyperplasia and to compare the IPSS decrease and IPP change.

      MATERIAL AND METHODS:

      Prospective analysis of 18 consecutive patients with significant IPP (>5 mm) related to median lobe hyperplasia undergoing PAE using 30-500-µm-calibrated trisacryl microspheres. We measured IPP on sagittal T2-weighted images before and 3 months after PAE. IPSS and clinical results were also evaluated at 3 months.

      RESULTS:

      PAE resulted in significant IPP reduction (1.57 cm ± 0.55 before PAE and 1.30 cm ± 0.46 after PAE, p = 0.0005) (Fig. 1) with no complication. IPSS, quality of life (QoL), total prostate-specific antigen (PSA) level, and PV showed significant reduction after PAE, and maximum urinary flow rate (Q max) showed significant increase after PAE. No significant change of International Index of Erectile Function (IIEF) for clinical evaluation after PAE. A significant correlation was found between the IPP change and the IPSS change (r = 0.636, p = 0.0045).

      CONCLUSION:

      Patients had significant IPP reduction as well as significant symptomatic improvement after PAE, and these improvements were positively correlated.

      ......................................................................................

      My Discussion.

      -18 patients is  very small  quantity to  confirm  this conclusion .

      - big IPP is stated when  is bigger then  5 mm .  But my  IPP median lobe was 18 mm long ! And fully blocking  bladder neck acting like "pressure valve "  see scan from MRI 

      - I collected about 20 PAE  patients with poor  effect in case of Big median  lobe.

      - there are only 2 methods effecitve in case of BIG median lobe : REZUM and FLA  . I selected FLA.

              

       

    • sam19736
      sam19736 stan98754

      Posted

      Stan, with all due respect your collecting info from people on here without being at all scientific. Consider that’s you are comparing a journal articl with failures you hear about from a forum and don’t know any details that are needed like size lobes. You could have collected 20 out of 200 which then makes it misleading. Also, havtnbeard rhat fla and resum are good for median lobe from doctors. There was a guy on here who had serious issues after fla and you should

      Be careful 

    • sam19736
      sam19736 stan98754

      Posted

      The average line here was 15 mm ans went upto 21 mm as the study says. It was bigger than yours. 
    • stan98754
      stan98754 sam19736

      Posted

      HI Sam ,

      Im collecting data from forum  here,  you are right its not scientific  approach .  But  18 patient  in study is fully  unsufficient for any  conclusion, too .  My PAE last year in April failed.  there was relief maybe 1-2 months  but very small  ,but after the situation  worsened , bigger retention  often  CIC, so I  searched for other options.  and decided for FLA.  Considering between  REZUM and  FLA. Now after 4 weeks Im  happy with relief  , No CIC anymore, no infection,  no more medications... 

      YES there is one patient  with poor  results.  I spoke with Doctor  about him  a lot...   one contraindication  for  any   mini invasive method  is  former long term prostatitis  , and probably there was  small injury of nerves, too.   Anyway what is your treatment  ?   Take care Stan   

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