Has anyone out there had a "Prostate Artery Embolization??

Hi bruce19007,

It looks like it's been just about a year since you've had your procedure.  Any updates that you are willing to share?  Were there any sexual side effects such as erectile dysfunction or ejaculatory dysfunction?  Also, did you consider other procedures such as Urolift?

I live in the SF Bay Area, so you having your procedure done in Oakland, CA is of interest to me.

My urologist recommend that I go with Thulium laser.  When I brought up PAE he said that it can lead to erectile dysfunction and a bunch of other complications.  He was okay with the idea of Urolift, but I think that is because he performs that procedure too.

Yes it is  nearly a year since my procedure.  I had significant improvement about 3 weeks post procedure, but for my case, it wasn't enough.  I get up once in the night to pee now instead of 4-5 times.  I still have to take the Floxmax medication though.  I got an approximately 37% reduction in the size of my prostate.  Sexual function is unaffected, same as before in every way.  I did not consider any surgical procedures that carve out the inside of the prostate with all the serious side effects that can occur, especially if the urologist isn't that good a surgeon.  Tearing out some or all the plumbing with a hot wire, laser or other device has several complications and the PAE procedure is much less invasive.  I don't know what research your urologist has done, but I would challenge him to produce any study that shows PAE has the same risk for erectile disfunction or even any risk at all.  The reason urologists don't like PAE is because it reduces their business volume.  PAE is performed by Interventional Radiologists so it takes patients away and with them their revenue.  I had an MRI and a systoscopy in the summer and it showed my prostate, while smaller, was still blocking the way and pushing up into my bladder.  So I had the PAE procedure a second time a month ago and waiting for the additional reduction to occur and see if i get more improvement.  I'm not a doctor.  But I scoured the internet for information about PAE and felt it was a much lower risck procedure and even if it didn't help, I could still have the other more risky procedures.  The whole thing lasted two hours and I went home the next day and was back at work three days later.  Very minimal discomfort for me, but others on this forum have had different experiences.. If you go for TURP or other trans-urethral resection of the prostate, you will absolutely have sexual side effects.  You will have retrograde ejaculation where the semen goes into your bladder and not out through the penis.  This is a garanteed side effect.  The sensation of semen moving through the penis is gone.  Still, we all gotta pee. And if that's ultimately what it takes, then it may be a necessary compromise.  But I suggest you look seriously at the literature before making your choice.  As for the urolift, i saw a video from the manufacturer of the device and it looks like a viable option that at least doesn't come with the same risks the Trans Urethral procedures do.  It does puncture the prostate though so that's gonna take a while to heal up.    I hope that helps.  We have to be our own advocates and not put all our faith in these doctors.  They are a part of a troubleshooting procedure and need to be respected for their knowledge, but when it comes to there advice, trust but verify...

 

My urologist's main objection to PAE is that it treats the outer lobe of the prostate and not the inner, so while it shrinks the prostate, the part that obstructs the uretha does not get smaller.  This sounds like what you are experiencing.  If you don't mind me asking, how did you find your physician?  I would like to set up an appointment, for consultation, with someone in Northern California who does the PAE procedure.  Thanks in advance.

It treats the center more than the outside because most flow is in the center

I think your Urologist is wrong. If you look through this forum you will see multiple posts from me. I had my PAE eight months ago at UNC Chapill Hill NC. I had a 40% reduction in prostate size and it has completely eliminated all of my BPH symptoms. I am a new man. I no longer have to think about peeing at all. It is just something I do now like I did when I was a teen.

 

william79680, thanks for sharing your experience.  UNC and Inova are a couple of the places that I have considered looking into.  Unfortunately, I live on the West Coast, so travel is a little inconvenient.  Also, I don't think my insurance, Aetna, will cover it, but cost is secondary to me.  I just want return back to normal as I am under 50.

Are there any negative side effects that I should be concerned about with PAE?

I assume you are referring to the particles that block blood flow to the prostate.  Is that correct?

I am with Kaiser so my IR Doc is a Kaiser employee.  He is Dr. Douglas Hadley.  He's great!  He has continued to follow up with me even though I live in southern california. 

T90373,

i have had absolutely no negative side effects from my PAE. I had very mild burning for one week, but no bleeding or real pain.. Also no catheter afterwards. As I said I was very fortunate. The PAE definitely shrunk whatever portion of my prostate was blocking the urethra. I had negative sexual side effects from the BPH meds for years prior to the PAE. Now I am not on any Meds and the pre-PAE symptoms have all gone away. 

 

I have had no negative side effects. If you are near Spokane

,Wa i suggest youi contact Dr.Jayson Brower who did my PAE.

The outside of the prostate is relatively inflexible, like a strong balloon, and doesn't expand easily. The urethra, the tube that carries urine and semen, goes right though the middle of the prostate. It is easy to see how when the prostate expands inside that "balloon" it puts pressure on the urethra, and makes it difficult to urinate. It is also easy to see that decreasing the size of the prostate inside the balloon will reduce that pressure and help. Your doctor either knows this and is lying to you in order to get your business, or, at least should know this, and is inept. In either case, you need a new doctor.

Neal

Hi nealpros,

I think you are right about my urologist lying to me.  When I told him I had to do some research on Thulium he said that I was wasting my time because I could not learn enough in a month to make an informed decision.  He then goes on to tell me that he is on some review committee that evaluates urological procedures before the FDA approves them.  He also said that Venture Capitalist asks him to evaluate new technologies before they invest in them.  Finally, he said that he graduated at the top of his class.  Seems like he spends more time telling me how good he is instead of spending time addressing my concerns and the pros and cons of each procedure.

Yup, he sounds like a nut case. Get another one, and an interventional radiologist, and look at PAE.

Neal

How did you wind up seeing Dr. Hadley?  Did your urologist refer you to him or your primary care physician?  Was PAE covered by your insurance?  I'm with Aetna which does not cover PAE, thinking about switching over to Kaiser HMO California.  Many thanks!

It was a long and winding road.  I was following the clinical trials at Stanford University and the nurse who was running the trial told me about Dr. Issacsson at UNC Chappelk Hill.  I talked to him and he recognized my area code as west coast and told me about a patient who had a PAE in CA at Kaiser!  It took another few phone calls to find out it was in Oakland, CA  and I looked up all the IR docs in the Kaiser online directory and emailed them all.  Dr. Hadley emailed me back.

The PAE was completely covered, even the parking.  I had to pay for travel, hotel and food.  With Kaiser, your coverage varies with the plan your on so make sure it's covered on the plan you select.  My Urologist never heard of the PAE and frankly treated me like a child for even suggesting it.  I fired him.  I got a new one who is partnering with me on this diagnostic and treatment journey and she's been great.

I spoke with Dr. Isaacson at UNC last Friday.  He was kind enough to call me after I sent him e-mail.  He told me he heard of Dr. Hadley through a patient from an online message board.  He also mentioned clinical trials at both UCSF and Stanford, and that I should look into them.

When I told Dr. Isaacson about what my urologist said about PAE (i.e. it will not work because it only shrinks outer lobe of the prostate and can cause ED), he said that it was a common misconception about PAE (it actually shrinks the entire prostate) and he hasn't seen a case of ED to date.  To make a long story short, he encouraged me to consider PAE as it is relatively safe and it will leave all other options open.

Kaiser HMO California is the only Kaiser plan offerred by my employer, so I will switch to that and cross my fingers.  Luckily, I only live about an hour from Oakland, CA, so I can easily drive there.  If things don't work out in CA, I will most likely fly out to UNC and pay out of pocket to have it done there--I've had a bladder stone removed so I can't be considered for the PAE study.

BTW, my urologist also treated me like a child saying that I could not do enough research online to make a good decision about BPH treatment.  He also downplayed the significance of retrograde ejaculation, but from what I have read on these boards is that a lot of men are angry and depressed because of this.

Hi t9, 

Im 6 months out from my PAE and couldn't be happier. 

Strong flow, no hesitancy, get up two times a night and that's only because I have three mugs of tea before bed. On top of that I have better erections. 30% of PAE patients report improved sexual function. 

Dont listen to urologists ...I have no time for them. I had one female urologist who wanted to do open surgery on me for BPH for gods sakes. The urologists are terrified of PAE because it has the potential to halve their incomes. Take everything they say with a grain of salt (or two).

I wondered why I stopped getting emails from this forum and then looked in my junk mail and there was about a million there. :-)

Yup I'm 6 months as well and have my life back. Smartest thing that I have ever done. Similar experience. Despise urologist. 

Some nights I sleep right through but usually I get up once and once inawhile twice per night.

 

+1. It sounds like a pork pie from that urologist.

@Caringbah: I had a CT Angiogram and MRI in Sydney yesterday and now await discussion with Dr Schlaphoff to see if they think the procedure is needed as much as I do.

Thanks for your guidance and your willingness to share your expreriences with us. ... With me in particular

Stewart

Hi Stewart....Well you're well on your way now..I hope Dr Schlapoff got good pictures so he can do the procedure.  Keep us informed. I got a call from his offsider a couple of days ago...they want me to do a 6 month scan to see how much my prostate has shrunk. 

That would be Dr Catt. He's a darn nice guy, and very professional. Drs Schlaphoff and Catt are now guiding Interventional Radiologists in Brisbane. I guess that one day some Melbourne-based radiologists will take an interest and the procedure will become more widely adopted in Australia. 

Hi Stewart, that's good news about Brisbane.

I'm sure that PAE will become the no 1 treatment for BPH once the word spreads about the excellent results with virtually no side effects and a 30% chance of improved sexual function. 

 

Hi Caringhba and Stewart,

Both Drs Schlaphoff and Catt are extremly knowldgeble and professional in the science and art of PAE.

I was # 10 in the lineup and underwent tge procedure last week.

They used the 2f catheter on me which they had received just that morning I believ. This catheter allowed them to get deeper and be more precise with the target.

the standard catheter is 4f but they used size 2.5f previously .

I also understand that the Dr from Brisbane was in attendance during my procedure.

Dr Norman Swan Radio ABC National - Health Report had also carried a report on PA oon Monday 23November by another Dr from Brisbane .

Any way I am feeling emotionally and physically better and have witnessed definate improvements in my general wellbeing. No sense of urgency and frequency but cannot at this stage claim total success as far as flow is concerned . That i am assured will happen within the next 3 months.

i have consented for images to be used for teaching and training purposes with some restrictions. And will undergo another MRI in 6 months .

On another note these Doctors at Liverpool Hospital need political support as they have pushed their necks out to provide this procedure in the current medical, economic and political climate. Not necessarily fully supported by their superiors.

Anyway thank you Caringhbah for pointing me and others in this direction. Much appreciated .

@Caringbah & Sam05687: Given the costs and damage done by urologists with TURPs, I am amazed that the issue isn't taken up by insurers such as Medibank which would save money for both themselves and their many affected male customers. I guess it just takes time for such knowledge to diffuse through GPs and other professionals.

Stanford University Medical Center is conducting clinical trials of PAE covered by Medicare. Contact Denise Haas

Hi Bruce:  Thanks for sharing details of your PAE experience.  It has been almost a year since your posting and was wondering if things improved after  that posting and if you were able to get off of medciations?  Thanks for your response, Lenny 

Rereading this old post.  On Dr. Bagla's release sheet to be signed, erectile dysfunction is listed.  I asked him about this.  I thought there was no sexual dysfunction with PAE.  He said it is nowhere in the clinical literature, but there is a small chance, maybe 1%, for erectile dysfunction.  

Are this clinical trials only for Medicare patients or otheir patients with commercial insurance like Aetna are welcomed?

William thank you for sharing your experience - I am seriously considering having the PAE procedure at UNC Chapel Hill - I spoke with Dr. Isaacson over the telephone - is this the Dr who did your PAE procedure - Dr. Isaacson informed me that the procedure is not pain free and there would be some pain associated with the procedure - What if any discomfort or pain did you have after the procedure - How long after the procedure did you actually begin to see results - My local urologist tried to talk me out of the PAE procedure and he has told me that TURP is better, yet everything that I have read about TURP have been negative with multiple complications - Dr. Isaacson indicated that the size of my prostate that I would be a good candidate for PAE rather than TURP 

T90373 - thanks for shaing your information - did you have the procedure at UNC (Dr. Isaacson???) or Inova (Dr. Bagla???) - If you had the procedure done what if any side effects did you have - I have been informed that my health insurance carrier will not cover the cost of the PAE and that the clinical trials are closed in UNC and INOVA - What if any pain or discomfort did you encounter after the procedure  

Hi Caringbah - Thanks for sharing your information - I was wondering where you had the PAE procedure done? - My urologist has tried to talk me out of this procedure and he mentions TURP instead - Everything that I have read about TURP has been negative feedback associated with a lot of pain- I agree with your 3rd paragraph when you state "Dont listen to urologists" - 

Hi James. I live in Australia. I had mine done a year ago at Liverpool hospital in Sydney by Dr Glen Schlapoff. 

Your example of your urologist trying to talk you out of PAE and have TURP is typical and despicable. 

I really think they are doing themselves a great disservice as their reputations will be tarnished. Whatever happened to the Hippocratic oath where doctors commit to doing the best they can for their patients. They think their patients are ignorant with no acces to the Internet . 

Unfortuneately some guys just take what their urologists say as gospel. I saw three urologists....one of them a female, wanted to do open surgery on me for Gods sakes. I would have taken six months to recover and almost certainly had incontinence and impotence. 

All three had a very smug if not arrogant attitudes. 

Can you read between the lines ?....I really don't like them. :-))

The trial at Northwestern University is still open.  You don't have to pay for the procedure.  You pay for getting there and lodging.

Hello James, I had mine done in Jan of this year, not good results at all. Please ask lots of questions. Like if the procedure has complications, is it reversable.

The problem is simply one of "following the money".  Urologists do very nicely out of doing TURPs, but PAE is done by Interventional Radiologists.  When I saw my first urologist (in Truro, UK) I could see he was thinking of the nice holiday/car my TURP would fund.  I didn't go with him, and happily found the Southampton (UK) trial where the urologists were more enlightened.

It's now nearly three years since I had my PAE and couldn't be more delighted with the results.

I totally agree with you Roseland. Maybe I'm naive, but when did the ethics cease to be important? 

I have quite a few medical issues over the years including lymphoma of the lung and heart issues. My heart surgeon and oncologist are brilliant, nice and highly ethical people...it's only the urologists that display this incredibly arrogant money grabbing attitude. Maybe I just got three bad ones in a row?

Hi there,

I Had my PAE done in UK at Oxford UK under the Uk ROPE Trial by a Doctor Tapping and Dr Little. it was a breeze and thre months later I continue to improve. You are an "early adopter" Do you know how much your prostate shrank by? What is the position 3 years later? has it continued to grow back? THere are a lot of people on this Forum who would be very interested to know.

Where was yours done?

regards

Jeremy

Don't worry about the pain. By any measure it is less than having a tooth filled with anesthesia. For a few days after your visit to the dentist, your mouth is sore. This is the same. If you have Dr. Isaacson do it, you will be given some meds for post operative pain. I only took one, and I'm no hero. You'll never find a better doctor and staff than Dr. Isaacson and UNC.

Neal

I am going to see my GP to see if I can get support to see Dr Tapping, could you tell me a little about the procedure and the improvments to your BPH?

Thanks in advance Philip.

I had mine done only 10 days ago, and I continue to see better results in that short amount of time. I was getting up at times before the procedure at least 8 sometime 10 times a night ... so far 2 times and I'm emptying my bladder more completely each time I pee. Just feel better over all, after suffering from BPH for years. Looking forward to next week,..reclaiming my life back, and feeling blessed that I'm finally able to reclaim some of my life back.

Great to hear you are seeing such good results. I have had BPH for years, and was offered a TURP, without any diagnostics or tests, so didn't go back to the urologist, have just about coped with hot baths, pills and control my liquid intake at night. But I am getting to the point, I can't control the symptoms anymore. Going for PAE, whatever it takes to get it done. Thanks again. Philip.

Your description of you BPH sounds EXACTLY like mine. I was told by my urologist at the time, "get a TURP and your attention will never happen again." After asking more questions I did the same as you, pills...patients and more and more visits to different emergency rooms depending on what city I was in at the time. It had gotten to the point where I would start shaking at times because I could feel it coming on and dreading that I would have to go to an emergency room once again for a foley catheter.. But I knew as I prayed that something better had to come alone. I'm thankful for PAE because after years of waiting I can attest to the fact that it does not get any better, it only gets worse. I pray you peace!

I knew I had to do something more than pills, when I was stuck in London, teaching and had my pills and they didn't work and I couldn't pee. I managed to get home to the east midlands and had a hot bath and relaxed, more pills and managed to get some relief. I know this is going to get worse, and I have to keep working and it includes lots of travel, I don't want to end up in an emergency room facing the catheter. Hopefully, my GP will agree tonight and I can get it done in July. BPH has taken over my life and I want it back. Thank you again. Philip.

GodSpeed Philip!

Thank you.

Hi Philip

 will respond on pc in more depth as 1 finger typing on iPad annoying. But my case is unusual I think as I had complete retention and ended up with Foley catheter for about 6 weeks. Horrendous mainly due to lack of advice and support with the damn thing. This all happened nearly a year ago and I finally had my pae on Feb 9th this year by which time my symptoms had already improved possibly due to non pharma products ie saw palmetto and stinging nettle root extract. The actual pae procedure was a walk in the park. I enjoyed the whole day actually! And I have very slowly improved over time from say 7 out of 10 to 9 out of 10. My 3 month check up showed prostate volume reduction from 82 cc of about 25%. If you inbox me I'll give you my phone number if you like and answer all your questions. Don't hesitate to get the pae done, I'd say it's very low risk and the guys at oxford are world class.

Many thanks, I have PMd you. Thanks again.

Philip.

 

Dear PAEdoc

I have had my PAE procedure a month ago I still have very weak urination stream which is not big problem while still waiting for the good results in three months time as my doc says. My big problem happens when I wake up and try to urinate. I find great difficulties. Every time I sleep and wake up I suffer a lot trying to pass the urine. my doc believes that the prostate is still inflammed and swollen. I take 0.8 mg Ominc but there is no much benefits. Do you have an idea how can I speed up the healing process

Fouad

Hi Bruce, Did you have a uro lift procedure done at UIC/ I recall reading some info on this ,perhaps it's a different Bruce. I live in Chicago and if you did have this Uro Lift done there,i sure would like the name of the doctor.

Thanks a lot Bruce.

 

Hi William, Thats great,The PAE was good for you.I was curious to know how old you were when you had this PAE done?

Thanks 

 

How are things going since your second procedure?

Thanks for the update Bruce

Is the Second time better now have you seen more improvements because I'm like you I would rather have the PAE done twice if I have two and having turn or green laser. Let me know how you doing buddy thank you

Do you have a contact number for Stanford?