Considering PAE. Where to get transrectal ultrasound

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Hello all.  54 years old, recently started having retention issues.  Urologist has me on flomax, hated the side effects, now trying Uroxatrol (alfuzosin). While it mostly works, I suspect that I may not be fully emptying my bladder as even after urinating I feel like I should have to go.  I can sleep through the night, it is more of a general discomfort during the day.

Anyhow, urologist recommends UroLift although he reiterates that TURP is the "gold standard".  Told him to forget TURP.   I was going to schedule UROLIFT but am now learing more about PAE and did speak to Dr. Issacson at UNC.  Of course, my urologist is not keen on the PAE idea, asked if I really want to be the guinea pig and told stories of problems with AE in general.

Anyhow, Dr. Issacson noted that a good candidate for PAE has prostate of 30g or larger.  I have no idea how large mine is.  He suggested that a transrectal ultrasound is best way to determine size.  My question now is, who does transrectal ultrasounds?  I contacted two local "imaging centers" but neither offers this procedure, they said I may need to have it done in a hospital. It seems like it should be a fairly quick in-office type of thing?

And yes, I do feel old as I find myself looking at a forum for "prostate problems"!

Thanks.

 

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  • Posted

    Hi Mike,

    Your urologist should be able to do that. The doc uses the same probe to measure the size of the prostate when he perform the biopsy, but you do not want the biopsy at this time. Ask him.

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  • Posted

    Hi Mike - I would suggest you also look into Dr. Bagla for your PAE. He has performed at least 4X as many as Dr. Isaacson and is more thorough with his methodology. I had a PAE with Dr. Isaacson back in the summer with no benefit from it but worse is he didn't seem to care at all about my outcomes. I would not recommend him. Good luck to you.

    Neil

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  • Posted

    Standard Urologists perform ultra-sounds in their offices on a regular basis..It seems they're capable of offering a transrectum ultra-sound...They normally perform ultra-sounds to determine the Amount of Urine Retained in the Bladder after a normal void...Ultra-sounds are very quick, 1-2 minutes, and painless...FYI- Per Published Clinical Trial Results, PAE's and REZUM's had the highest success rates with the least amount of pain and complications, the quickest recoveries, etc...Dr. Isaacson appears to be an excellent PAE doctor, but some of his patients have had problems...GOOD LUCK!......

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  • Posted

    It seems like your symptoms aren't bad enough to go through the trauma of surgery. If you can sleep through the night, or get up once or twice only, your prostate can't be restricting your urine flow to any substantial degree. I always think that surgery is one of the last options to consider.  

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    • Posted

      Thanks,  That is in part why I cancelleed the Urolift.  I figure the longer I can hold off on surgery the better.

      At the moment I can indeed sleep through the night.  The weird thing is that during the day I often feel bladder pressure as if I do need to go.  That can happen even a few minutes after urinating.  I can hold it for hours or go a little bit at will (not sure which is the better thing to do).  Could be the prostate, could be the meds, maybe something else?

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    • Posted

      Lifestyle choices haven't been discussed much in this forum, but I think they can influence BPH symptoms. For example, last summer I was riding my bicycle a lot and consequently,  (I believe) my symptoms worsened considerably. Most of the problem was in relaxing the muscles so I could initiate urination. Also, of course, diet and exercise play a role in prostate health. 

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