BPH - natural treatments vs TURP, open surgery

Thanks Craig.

Yes, I did a little digging today per your suggestion.  It does sound very promising. I hope it catches on at major urology centers (like Mayo or Johns Hopkins) - in that case, the insurance companies will cover it and there will be much more data collected to compare it to TURP and other procedures.

And, the procedure does not sound that daunting (unlike TURP, which sounds very intimidating).

 

Hi Michael,

    PAE is performed by interventional radiologists, not uro docs, so you probably won't see it done in urology centers, but in a vascular disease treatment center. It is currently sometimes covered by insurance, sort of hit and miss. There are several studies already reporting on its effectiveness. There are long discussions in this forum with many, many posts from men who have had the procedure. I am scheduled for one on March 27th with Dr Bagla in VA who has done over 400 of these. Dr Pisco in Portugal has done over 1000.

Yes, I'm in the US.  Also, my insurance is good so I think I will be financially safe w/ any procedure I opt for.  PAE could be too new for insurers to cover.  From the little I've read (today) it seems minimally invasive - much less so than TUIP or TURP.

There have been reports on this forum from some men that their insurance covered PAE.

Mecidare paid for most of mine.  $2400 out of pocket.

Thanks, that's reasonable. Likely less than out of pocket for TURP or prostatectomy.

Those who have problems with insurance coverage should look into "Concierge Medical" as a possible alternative. It may not be feasible for everyone but better than $2400 out of pocket.

Hi Lester,

Are you talking about the field of "concierge medicine"? As I undertand it, that's a service that mostly primary physicians offer where you pay the primary extra (beyond a normal fee and/or your insurance converage) for "perks" such as faster appointments, etc. 

So unless I'm missing something, joining a concierge practice will cost you more money, not less.

-- Jim

Instead of paying an insurance premium you buy an annual contract from participating physicians which will entitle you to most medical exams and procedures. There are of course exclusions which have to be discussed before entering into it. Whether it costs more or less is negotiable and may be worth looking into for those whose insurance will not cover certain procedures. It is not for everyone and is not a substitute for regular insurance.

Lester,

Thanks for the heads up. After a little reseach, turns out there are three kinds of concierge plans. One is what you describe where certain services are covered, and the other is what I'm familiar with where you pay a premium for "perk" services such as same day appointments, but all actual services are additional. And then there's a hybrid. That said, I doubt any of the plans would cover something as specialized as PAE.

Jim

Jim, just wanted to let you know how much I appreciate your investigations and posts. Thank you!

Rich, Your welcome! I've learned a lot here and happy to help out with any knowledge I have.

 

Unfortunately, I think you are right, Lester.  I've tossed more than a few thousand $ at "natural cures".  Have barely seen any improvement after 2-3 years.

Rx meds (Flomax, Proscar) have some brutal side effects.  I tried Proscar years ago.  But only for a short time.  Flomax is still a drug I've come to depend on. 

I bled for weeks from the biopsy. I dread having a TURP or any procedure thru the urethra. 

Thank you.

HOLEP is done through the urethra. I'm the same age as you and my prostate is about the same size as yours. I was dead set on having HOLEP and it still is my second choice. Recevery time is reasonably short, no bleeding, low chance of ED. Biggest thing is retrograde ejaculation is just about guaranteed. I'm planning on having FLA done. 

Is FLA different than PAE?

I have not heard of either until this thread. 

I thought my only option was open prostatectomy to get life-changing results - and I figured it would buy me many years (that is, TURP might buy you 5-10 years but a partial prostatectomy may not have to be repeated).  I could be wrong about this.

RE sounds like a bad side effect.  Am I over thinking this, but if you have at some point a prostate infection develop and suffer from RE, won't that then lead to a bladder + urinary tract infection if you were to ejaculate?

These prostate problems are complicated on so many levels.

 

FLA and PAE are two different animals, but both are definitely worth considering.

PAE (Prostatic Artery Embolization) is less invasive, inserting microbeads into arteries feeding prostate to partially block the blood flow and cause the prostate to shrink.

FLA (Focal laser ablation uses) highly targeted heat to destroy prostate tissue that is impinging on the urethra.