Does anyone know if a HoLeP procedure can be as easily and safely performed after a PAE procedure

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Does anyone know if a HoLeP procedure can be as easily and safely performed after a PAE procedure if it subsequently found PAE hasn't been effective in treating a very large prostate.

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  • Posted

    I am wondering why did you in the first place have PAE? 

    It is known and confirmed multiple times even on this forum that this procedure is just bandaide and it failes in the first 6-9 months in about 97%. 

    Procedure itself is very expensive, performed by radiologists who are not trained in urological problems and is still just EXPERIMENTAL.

    I would not take my Mercedes Benz to Chevy shop to be fixed. 

    I am wondering why guys are taking their prostate to radiologists?

    Would anyone with heart problems take their heart to orthopedist?

    I would not?

    MK

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    • Posted

      MK sounds like a urologist. Nice plug there...Happy or satisfied people tend to not say as much as dissatisfied people when it comes to reviews. So you're not getting the true picture on these kinds of sites.. PAE looks like new gold standard for BPH treatment. Getting the PAE, doesn't preclude any future procedure, according to Dr. Bagala.

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    • Posted

      Thanks for your input.  I'm actually intelligence gathering.

      As yet I haven't actually undergone any of the two procedures which I mentioned.

      I'm very surprised indeed at the 97% failure rate you quoted, Could you let me know please where that statistic came from?

      Regards,

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    • Posted

      Most grateful for your input.  Very true observation about happy satisfied people saying less than the dissatisfied.  Something that I think most sensible thinking people take on board and would very much agree with.  Particularly the case I would say though when reading forum posts…

      I'm pleased your information comes from the excellent and extremely experienced Dr. Bagala.

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  • Posted

    The answer to your question is yes.. I had PAE 18 months ago and everything is working fine. I would never let a Uro. do the PAE procedure period. Not sure where MK gets his information but PAE works well and the reserch confirms it. Like with anything you need to check out the doctor to be sure he has done many  before he/she attempts the surgery or procedure on you.
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    • Posted

      Very grateful for your reply.  Delighted to hear you are pleased with your PAE result. From past reading on this forum about PAE, I believe that you are substantially in the majority.  That's why I'm currently looking PAE as a possibility.

      As you sensibly point out , always check out the Doctor Outcome success rate for the procedure.

      May I ask the size of your prostate when you had PAE.  Mine is 140cc considered somewhat extra large I believe!

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    • Posted

      my prostate size was 140 when I had PAE procedure... I did not do a follow up MRI so I have no idea what it is now. The main reasons for rejection of someone for PAE procedure

      is the location of the arteries to the prostate since sometimes the same aritereis supply the neck of the bladder and in one case the colon. The other reason for rejection is the health of the arteries themselves. I am sure there probably are a few other reasons to reject someone but thiese are the two major ones.

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    • Posted

      Thank you very much for your helpful informative information.

      Would you know if they can tell from a previous recent contrast used mpMRI T3 ones suitability for a PAE procedure.  Or Is it a case of only knowing the answer regarding suitability when the PAE procedure has started?

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    • Posted

      I assume they might be able to tell where the arteries are located and what organs and tissues they feed. But I would image you would be required to have another one at the time of the procedure to be sure. I only had the one MRI the day before the procedure. My insurance covered the MRI, but not te PAE procedure.
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    • Posted

      I'm once again grateful for your further input ed.

      Last night I did further online research into the PAE system..  And although reading several related reports it doesn't specifically answer my initial enquiry.  The online information does significantly suggest you are correct in that an MRI would be required and used by the PAE Interventional radiologist practitioner group to verify suitability for the procedure.

      Incidentally, unless you've already guessed, I'm in the UK and I'm not covered by private insurance..  Procedures like HoLeP and PAE unfortunately at present aren't financed by the state run NHS medical system. I believe a PAE procedure in The UK the total bill is typically in the region of £10k .  Presently I'm not sure about the HoLeP  procedure cost. Given hospital recovery time, I suspect the bill could be even greater than £10k!

      Just out of interest, if your Medical insurance would cover a further MRI, why not get scanned again to check what reduction in size the procedure has achieved for you.

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    • Posted

      In my message just posted, I should have made more clear, so as to check for suitability for PAE , an MRI would be done at or near the time of the procedure to make sure of suitability.
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    • Posted

      The insurance part was paid since it was stated as a requirement to determine the problem with the prostate. My insurance would not pay for another one unless there was a problem with the prostate. Just wanting to know the size change would not be covered. The totat cost in dollars for the PAE procedure at the Unv. of North Carolina medical center was a flat rate of $6500 dollars including the MRI in Oct 2015. This was about the same price for having it done in Lisbon, Portugal counting air travel and a weeks stay. If you decide on the PAE procedure you might consider the Lisbon option.
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    • Posted

      That's interesting.  Comparing similar procedure costs here in the UK, I would say what your insurance covered is quite cost-effective.

      Actually before I close my question, I have to admit I did suspect, at least to an extent, that your insurance wouldn't cover the cost of another MRI if it didn't relate to some kind of further prostate associated problem.

      Yes, Lisbon is an option I've not entirely ruled out as yet.  Many thanks Ed for your reply.

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  • Posted

    I'm don't think there is anything about PAE would prevent you having HOLEP down the road

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    • Posted

      Thanks.  As I'm sure most would agree, it's always best to have a reserve if the first doesn't work. 

      I should add not that it's a definite PAE will be My first choice!

      I suspect however there might be a number of variables involved with the PAE procedure which will be dependenton as to the exact answer to my initial post enquiry.

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