Has anyone had a PAE performed by Dr Picel at UCSD?

Thanks for sharing. I'm considering Dr Picel and PAE. Could you share some more info regarding your conditions before PAE, like your symptoms, prostate size, large median lobe or not, etc. ? Hank

Yes. I would be more than happy to discuss I experience. First of all I have a very large 155 ml prostate. I am 71 years old and started having trouble urinating about 10 years ago. I live in Ketchikan Alaska And there is no Urology expert here. I did have hey urologist who I saw in Anacortes but he retired 3 years ago. I had been taking Cialis instead of Flomax for about 5 years. It helped but my condition continue to deteriorate. last December, I decided it was time to take action since I knew that eventually I would go into retention And not be able to urinate at all. oh, I started researching on the internet for the latest procedures that would relieve the constriction. That is when I came acrossed the pae procedure. After researching everything I could find on PA I decided that this new procedure would be best for my situation in that I did not want to risk all of the negative possibilities that come with having a turp. I acted leak or responded with dr. Pisco in Portugal. You can actually have this procedure done there for a total cost of about $10,000. I had inquired with Medicare and was told this procedure was still experimental which meant they probably would not pay for it. However, I then noticed other patients who have had this procedure stated that Medicare did in fact pay for the procedure. Since I have Medicare and also a private insurance available the pae did not cost me anything out of pocket. after realizing that Medicare would take care of it cost I started researching where I should have the procedure performed. I had not found this patient site so I did not know about the prominent doctors in Virginia and in Florida who pioneered the pae in the United States. I research the doctor in Denver a doctor in Seattle and then I heard about the trial that UCSD had just started. I wrote all of these doctors emails. The only doctor who answered me directly was Doctor pycelle from UCSD. I spent about a month corresponding with these doctors or their assistance. I sent three doctors detailed information about my prostrate issues. As I mentioned before, I have a prostrate that is very large and at the time of the pae it measured 155 ml. The median lobe was somewhat enlarged as well. After evaluating all the various aspects, I decided that UCSD what is my best option for a number of reasons. I was a little concerned that at the time which is back in the February March time frame of 2018, that dr. Picel had only performed a dozen or so pae. I questioned him about this extensively and he told me that the pae procedure was very similar 2 one of his types of operation that he performs on women and that he has lots of experience with this type of surgery. I exchanged approximately 15 emails with doctor pycelle, I had lots of questions for him. He took the time to answer every one of them comprehensively. I felt that he was really concerned and interested in my predicament. It is probably this personalized interest that swayed my decision. I did have fly down to San Diego for a pre-op visit one month prior to the procedure. I had a CAT scan, a urine flow meter test, a PSA test, and then based on the flow meter test they decided to perform a cystoscopy to make sure that I did not have another type of constriction within my urethra that had nothing to do with prostate. Based on this test they decided that it was indeed my prostate that was causing the problem. However, that particular test cause me to go into retention and I had to have a long-term catheter placed which turned out to be the worst part of this whole situation. I had waited too long to take care of this problem. anyway, I return to San Diego a month later and on April 18th had the procedure. Dr. Picel head to other doctors and two nurses in the operating room. It took about 4 hours in total. Probably an hour of prep, then 2 hours for the actual operation, and then an hour of post-op related procedures to ensure that my leg artery had and successfully secured to prevent internal bleeding. Normally, you do not have to spend the night but in my case, the doctors decided that it was pretty late at night and they were concerned about my wife driving us back to where we were staying and recommended that I just stay the night at the hospital. I did that but it was not totally necessary. The UCSD Jacob Hospital is magnificent and it was like I was staying in and expensive hotel. Even the breakfast was really good. All the nurses and the doctors couldn't not have been nicer. I checked out the next morning and drove myself to where we were staying. My catheter stayed in place during the operation and 4:15 days thereafter. after removing the catheter I was able to urinate better than I had in the number of years. remember, this was 15 days after the procedure so during that time my prostate had shrunk. I doubt that you would see that type of relief within a day or two of the procedure but some patients have reported that being the case. I had a transrectal prostate ultrasound performed at 40 days and discovered that my prostate had shrunk to 97 ml. I am now passed the 90-day mark and have continued to notice Improvement in my urination. I did have a low-grade infection for the first 60 days that caused some burning during urination but that stopped about a month ago. I only have to get up about 1 time a night now instead of four five. My Stream is not quite as strong as I would like but it is not restricted and seems to rely a bit on gravity and that is perhaps because I waited too long and damage the muscles of my bladder. Overall, I am very happy with the outcome and it has improved my life considerably. please forgive all the misspelling and the typos because I am dictating this and too lazy to go back and clean it up. I hope I have given you information that may be helpful. If I miss something, just send me your additional questions and I will be happy to answer them. my recommendation stands, you will be in good hands with dr. Picel in his team.

Thanks for the detailed response. I corresponded with Dr Picel last year, and he left good impression on me. For once, he suggested that I wait until this year when I qualify for Medicare to save money. Your testimony only reaffirms my belief that he is a good and caring doctor.

Congratulations for the successful outcome. It will get better, I think. You picked the right procedure and the right doctor.

One more question. Did you have problem starting the flow before ? If you did, has it been improved since ? Hank

Yes. Pryer to PAE, I had big problem starting flow. Sometimes it took 2 minutes to start and forcing took a toll on my bladder muscles. If you have this condition now, it will get worse and one day you will be at ER having a catheter placed which ruins your life. Do not wait too long!

Thanks VGA. I do indeed have this problem, though not as bad as 2 minutes. I noted that you had catheter, Foley I assume, on for 15 days. Isn't it kind of long for PAE ? Hank

Actually had catheter for aprox 45 days.  Had it changed once.  Yes, a long time to ruin your life.

Do you remember the name of the test that got you into retention, and putting you on catheter, one month before PAE ? Hank

Cystoscopy of urinary tract.  Some STDs cause scare tissue that builds up and causes another form of blockage.

Thanks. Hank