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ChuckP ChuckP

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

I had one on September 10th, 2014 and would love to compare notes with anyone else that has had one.   Thank You.  ChuckP   PS Some people just call it a "PAE" for short.

1959 Replies

  • jimjames jimjames ChuckP

    Haven't had it, but would love to hear your experiences. From the little I read, sounds very promising without some of the sexual side effects from Turp and laser.



    • ChuckP ChuckP jimjames

      I had the PAE surgery in Alexandria, Virginia on September 10th, 2014 by one of the pioneers of this procedure.  Today is friday November 14th, 2014 some 2+ months later and I have gotten NO improvement whatsoever.  Iam still getting up anywhere from 4 to 5 times a night the same as before the procedure.  The flow is a little stronger but nothing to write home about.  So basically Iam still frustrated and trying to stay positive.  The Interventional Radiologist told me it would take anywhere from 30 days to 6 months to see positive results.  I guess we'll see.  Please feel free to ask any questions but as of today I would NOT recommend it.

    • jimjames jimjames ChuckP

      Sorry results aren't coming in yet. Has your radiologist done an imaging study since your PAE to see if your prostate has gotten any smaller? Other than the frequency you mention, what other symptons did you have prior to the PAE? What about retention, for example. Was that every a problem or was it more frequency.

    • lenny2cancun lenny2cancun ChuckP

      Hi Chuck:  I was wondering if your finally had good results from the PAE procedure done in September, 2014.  I am considering having the procedure and would appreciate your feedback.  Thanks, Lenny 

    • caringbah caringbah lenny2cancun

      Lenny, I'm 7 months out from my PAE which I had in Sydney Australia. 

      I had a scan 2 weeks ago and my prostate has shrunk by a third from 120 cc to 80 cc. From day 5 I noticed a big improvement in urine flow. I only get up two times a night,down from six. 

      I thought things might plateau after a while but things just get better and better. Sexual function has improved dramatically now as well....I'm on the verge of giving up the viagra as I almost don't need it anymore. 

      I had no side effects whatsoever. 

      My interventional radiologist was Dr Glen Schlapoff of Liverpool hospital in Sydney. 

      Any Australian readers can private message me for contact details for Dr Schlapoff. 

    • Sharebare Sharebare caringbah

      Hi Caringbah

      I'm in the initial stages of having a PAE with Dr Schlaphof - had MRI etc and will see the Doc next week.

      I'm up up to 6 times per night.

      Is everything still ok with you?



    • ramakant16481 ramakant16481 caringbah

      Hi Caringbah,

      I've been "managing" the urinary issues for over 10 years now, turned for much worse recently with the uro advising TURP as the only option.

      I am in Aus (Melbourne). 

      I am on flowmaxtra with some imporvment which buys me some time.

      I am searching the forums for any medicos in Melbourne that would perform PAE under Medicare. 

      Was your surgery covered by Medicare ?




    • caringbah caringbah ramakant16481

      Hi Rama, ...typical Urologist, I'm disgusted with them. He's either ignorant or deceptive...either is no good.

      I live in Brisbane but had my PAE done in Sydney at Liverpool hospital by Dr Glen Schlapoff.

      It was done at no cost to me under Medicare. As far as I know, Sydney and Brisbane are the only places in Oz that are doing PAE.

      Please private message me for contact details for Dr Schlapoff .

    • caringbah caringbah Sharebare

      Hi Sharebare, 

      i just noticed your comment now.

      Yes everything is great. Still getting better if anything. I'm in the lucky 30% who report improved sexual function. 

      The greatest thing about PAE and restored urinary function is that I just don't think about peeing anymore whereas before it used to dominate my thoughts. 

    • ChrisRed ChrisRed caringbah

      Hi there its Chris I contacted you some time ago on here  regarding a horrible experience with anaphalctic shock whilst having a CT scan and MRI with Doctor Schlappoff was wondering how your PAE is going any side effects or problems ? I contacted Dr Schlapoff again asking if there is anything I can do due with regard my allergy to the contrasts so I can have the PAE done he called me and said he can do it under controlled conditions but I  never heard back from him ?? so I just sent him another email to contact me again. Im aware that you are also allergic to the contrasts too and wondered what he did with you regarding this? So I may be able to discuss the same measures with him and also wanted to know how you are going and if all went well with your PAE and any further problems or progressions ? Please let me know thanks so much kind regards


    • caringbah caringbah ChrisRed

      Hi Chris, PAE is great....getting better all the time. I'm very happy. 

      I knew I was allergic to contrast dye, but the worst reaction I experienced was coming out in a rash. Having said that, I was told I could experience anaphalectic shock at any time in the future. 

      Schlapoff gave me a three day course of Prednisone injections plus antihistamines to prevent any reaction. It must have worked because I didn't even get the rash. 

      Make sure you have IV prednisone not the tablet form. I had the tablet form for the CT scan and it nearly destroyed my stomach. 

      Hope that helps.

    • joe74831 joe74831 ChrisRed

      Hello Chris, I wanted to ask what kind of reaction you had to the dye? 

      I had a PAE done back in Jan of this year at UNC, and I had a terrible reaction to something. The doc gave me the list of meds used but its hard to narrow it down.

      About an hour after waking up from the procedure, I broke out in a heck rash from my neck down. The docs gave me several meds to counteract it, but the rash was so bad the skin actually blistered up in several spots. It looked like I had been burned in several places. Its been over 2 months now, and I still have scars from it.

      As bad as I wanted the PAE I would never have done it if I had known this could happen. 

      The good news is the PAE seems to be slowly working.

      thanks joe

    • peter15520 peter15520 caringbah

      Hi I am interested in getting this PAE procedure done ... I live in Melbourne Australia but would go to SYD if I have to. How can I get a contact no. for DR Schlapoff maybe I can arrange an appointment.

    • caringbah caringbah peter15520

      Hi Peter, you can call the radiology department at Livetpool Hospital and tell them that you would like to make an appointment with Dr Schlapoff for PAE or else you can private message me and I can give you a number.


    • fj20848 fj20848 joe74831

      Hi Joe74831

      My name is Fouad. I am 68. I have been suffering from BPH for about 20 years. 20 days ago, 5th of July 2016 I have done PAE procedure at UNC. I would like to how long it took you to feel better concerning BPH symptoms and was there any problem during the first month. Thank you

    • joe74831 joe74831 fj20848

      Hello Fouad, sorry I cant help you much. I am 7 months out from mine, and have actually gotten much worse.  You might check with some of the other guys. I had what appears to be a bad reaction to the beads they used, and my prostate stays in a constant state of inflamation. Which makes it very difficult to pee. I also have sores on my arms,legs and crotch that will not go away. The Doc has told me there is no way to relieve all the symptoms other than a complete prostate removal, since there is no way to remove the beads.

      Have you not gotten any results yet?

      thanks Joe

    • joe74831 joe74831 fj20848

      3 weeks is still fairly early, do you still have blood in your semen? Also did you take the prednisone they gave you? Hopefully you will still improve.

      I had mine at UNC also.

      thanks Joe

    • fj20848 fj20848 joe74831

      Yes I still have blood in my semen though little. I took the steroid medicine for only one week as recommended by doctor Isaacson. As a matter of fact I got little improvement the second week but three days ago I started to have sever difficulties in passing the urine. In your case why don't you see a urologist to treat the inflammation. Did the doctor explain to you why the prostate reacted sensitively to the beads they used in UNC, why it is not possible to reverse the PAE and why they still using the same beads if they were irritating. Have you heard of similar cases ?


    • joe74831 joe74831 fj20848

      Dr Isaacson has been treating me for it, but unfortunately prednisone is the only option. I am just fishing up a month long taper which started at a very high dosage. But unfortunately it has not helped at all. There are instances of allergic reactions but it apparently is pretty rare.

      As far as a urologist goes, Dr Isaacson originally had me set up to go back to UNC to see one he knows there, but decided it really wouldn't do me any good.

      It is not reversable because apparently the beads actually go into the veins inside the prostate, and there is no procedure to remove them.

      Hang in there, you are still in that time frame where hopefully you will still improve.

    • bob120 bob120 joe74831

      Hi Joe,

      Thanks for your post. Up to now I thought the only bad outcome of PAE is that it wouldn't work and you would only be out some time and expense. But after reading your posts I am leary of going for it.

      There have been a number of posters reporting poor outcomes, but yours is by far the worst outcome I have seen.

      I had a TUMT, two greenlight lasers and a turp in the past 5 years and still have a 200g prostrate and median lobe protruding into my bladder. I finally pee OK and have a very low PVR, but have occasional heavy dribbles when I get up from the toilet (maybe the median lobe moving from the bladder mouth), and get up 2-3 times a night on average to pee in my bedside urinal. I am taking dutasteride for the last 9 months to keep my prostrate from growing, which has decreased my libido and lessened the intensity of orgasms (but I'll take whatever I can get).

      All of my procedures have reported 95% success rates, but I always wind up in the 5%, so I'm probably a good candidate for a PAE reaction as well.

    • Camster Camster bob120

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    • joe74831 joe74831 bob120

      Wow Bob it sounds like you have tried it all. I would never discourage anybody from trying the pae especially with a prostate as large as yours. Mine was only 45 gms lol.  Not sure where I will wind up but its probably not a good outcome.  I keep hoping things will improve but not so far.

      Thanks for posting


    • bob120 bob120 joe74831

      Hi Joe,

      Thanks for your posts. I seem to be the guy who has the worst outcomes on procedures. After the first greenlight I had two major hematurias, and I never took blood thinners. Apparently the greenlight made me vulnerable to spontaneous bleeding of the prostate and bladder neck.

      18 months ofter the first greenlight, the first hematuria prompted the second greenlight. I needed 8 pints of whole blood on that one, and the second prompted the turp 15 months later, and a follow up operation two weeks later, and a second follow up operation scheduled but not needed when the bleeding stopped. I bled frank blood for 30 days and needed 6 pints of whole bloodon the second hematuria. About 4 months ago I was diagnosed with afib but can't take blood thinners, and lymphoma, so the prostate is on the back burner as long as symptoms don't return.

      'll go for an ultrasound in the next month or so to measure the prostate and PVR (in Nov 2015 it was 203g and a pvr of 32ml.) If it is growing I'll have to reconsider my options, but if the dutasteride has stopped the growth and the pvr is still good, the dutasteride is my safest option for the forseeable future. At 69 I've used up a bunch of my 9 lives. After what you experienced, I can't see taking a chance on PAE if the dutasteride is working.


    • joe74831 joe74831 bob120

      Wow Bob no offense but I thought I was the only guy that had luck like thst lol. You have really been thru the wringer buddy.

      You may be making the right decision, have you been reading the posts from  fouad43380 on here? Sounds like he is having a lot of the same issues as myself.

    • terry59461 terry59461 bob120

      Bob, I would not accept a no-go from anyone on the PAE short of a Dr. who does these proceedures.  I would contact Dr. Bagla of Vascular Institue of Virginia and get another opinion.  Dr. Bagla has done more PAE;s than anyone else in the US and performed my surgery.  I have had fantastic results with absolutely no negative side effects.


    • bob120 bob120 terry59461

      Thanks Terry,

      If I have no other options I'll do that. The fact that most people get great results doesnt mean some won't have terrible results. I never heard a doctor discourage me from following their advice because of a small percentage of people with adverse effects.

      Medical errors and pharma interactions kill 250,000 + people a year in the US, according to conservative estimates by the US government NIH. Other sources estimate at least 400,000. That's a 911 every 3 to 5 days. That's a statistic that doesn't make the news.


    • PAEdoc PAEdoc bob120

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    • garyh1954 garyh1954 bob120

      Dear Bob,

      I had the PAE procedue at Hackensack Medical Center in NNJ on June 14,2016 and I'm happy I did. My prostate was 200 in size and the uroligists was talking a 'supraprostalectomy', whatever, which sounded bad. Anyway, the procedure took 5 and a half hours with another 5 yours with the sand bag on the groin area. Released that same night. It's now 60 days since procedure all urilogical areas have improved. My urinary tracking score went from 26 to like 8 in a matter of weeks after PAE. Also, I'm off both Finesteride and Tamsulosin!.

      I'm 71 yrs. old, 6' 1' // 198 lbs // and bike a lot/maybe 50 miles a week.

      For me, the most bothersome item is retrograde ejaculation buy, the doctor says that'll improve now that I'm off Tamsulosin.

    • bob120 bob120 garyh1954

      Hi Gary,

      Thanks for your post. The Hackensack Medical Center is the nearest location to me offering the PAE. My prostate was 203g. the last time it was checked in Nov., 2015. I don't have symptoms now, but if my prostate continues to grow I would have. Prior to my Turp about 17 months ago it was 313g.

      When are you going for another prostate measurement (probably at the 6 month mark?) I would be very interested in how much your prostate has shrunk and if it is expected to start to grow back in time. Maybe this is unknown at present. I believe i read that results lasted at least 3 years, based on current histories.

      Did you have a median lobe protruding into the bladder? I do. I don't know if the median lobe is affected by PAE or not.

      Who were your doctors at Hackensack? If my prostate continues to grow despite the dutasteride I have been taking for 9 months, PAE is a very likely procedure for me. Thanks for sharing.


    • bob120 bob120 arlington

      I guess the question is whther the median lobe is affected at all by the procedure. It is part of the prostate, does it get a similar shrinkage, or is it unaffected.

    • arlington arlington bob120

      Hi Bob,

      Yes - in my case, it was improved 5-10% (and the large median lobe pressing in to the bladder neck is my main issue).  My prostate is relatively small: about 50cc's.  So, I think the PAE helps even in the case of median lobe issues - it just makes it much harder to get the desired result.  I also had gone in to acute retention and had been self-catheterizing for about 14 months at the time of the procedure.  I still am - and I'm still on the same drugs, however my symptoms have improved a bit.

      I think it's still theory at this point but someone on this forum mentioned that Dr. Bagla in Alexandria VA was going to target the median lobe directly rather than relying on the results that flowed from targeting of the left and right lobes.  If true, I'd be very interested in following his results.

      Good luck!


    • bob120 bob120 arlington

      I guess we can both afford to wait as neither one of us is now in retention or has a large PVR. It would be great if they figure out how to shrink the median lobe as well.

    • arlington arlington bob120

      Agreed!   (unfortunately, I am still in retention).

      I just sent a message to my doc, Ari Isaacson at UNC Healthcare, who is excellent.  I asked him about the possibility of the trilateral embolization.

    • bob120 bob120 arlington

      When I used to cath I could feel my median lobe about 3/4 of an inch inside my bladder mouth. So my median lobe didn't block the bladder mouth. When I got my sonograms I asked for a copy of the sonogram on CD. I could see the median lobe took up about the bottom 15% to 20% of my bladder.

      Unless your median lobe actually blocks the entrance to your bladder, your problem could be in the bladder. My cousin's husband got a turp but his bladder lost it's elasticity so he started cathing again 4x a day.

    • garyh1954 garyh1954 bob120

      Hey Bob. I expect to have a cat in 6 months in Morristown. I would call Dr. John DeMeritt in the Special Radiology Procedures to get the ball rolling. From initial phone call to procedure day was about a month. It's been 60 days and urgency is gone and is dripping and partial bladder emptying.

    • bob120 bob120 garyh1954

      Hi Gary,

      Thanks for the info. When and if I am ready I will call Dr. Demeritt. I have no symptoms now and still need to get an ultrasound to check if the dutsteride shrunk the prostate and if my PVR is still low. I'm presently being treated for lymphoma so the prostate is on the back burner for now. But at some point I expect it to regrow and a return of symptoms. AT that point I'll have to decide on a course of action, and PAE seems a better alternative than a prostatectomy. Aftter 2GL's and a Turp, the surgeries don't seem to last for me.

    • caringbah caringbah allan 88

      Hi Allan, 

      Call Liverpool hospital in Sydney and ask for the radiology department. Tell them you want a PAE and would like to make an appointment.

      When you meet him say hello for me. 


      Peter from Caringbah. 

    • Les3178 Les3178 peter15520

      Hi Peter

      I had the PAE last Monday at Warringal Private in Heidelberg (Melbourne). Done by Dr Dinesh Ranatunga under Dr Schlapoff who came down from Sydney to supervise. It's been just 7 days and I'm down to being up just once a night, from 3-4. So, very happy so far. No side effects, no pain. Just an awareness that something had gone on behind the bladder. I was under for 5hr15m so some parts must have been tricky.

      More men need to know about this. I'm very pleased my GP found Dr Ranatunga and referred me.

      So it is available in Melbourne.

      Good luck


    • garyh1954 garyh1954 Les3178

      Congratulation Les on your PAE procedure. As time goes on I'm hopeful you'll continue to progress. My PAE was in June and took 5 1/2 hours. Like you I began seeing results almost immediately. My prostate was 220 in size and because of Tamsulosin and Finesteride I had retro ejaculation. After a few months, that's ending as well. Wish you the best in the future.


    • Ozrural Ozrural caringbah

      I want to thanks you Caringbah. I had a PAE in August in Sydney Australia, largely because of the research I did which started with this forum. Like many people here, I have had issues for years. I have managed it pretty well (I thought) but basically it controls your life. I found myself just wanting to stay on the farm mostly as it is easy. Anyway it was starting to really annoy me so I did go to two different urologists and got the usual story. TURP is the only option. Well it wasn't in my case. My wife is medical and supportive, but it was interesting that she didn't really understand why I wouldn't just have a TURP either (I assume I was a topic of conversation at her work).

      I live in Victoria (about 1000KM from Sydney) so there was a bit of back and forth. I went up for a consultation and CT/MRI on one occasion then when that was OK went back for the PAE a month later. The procedure went for a long time. About four and a half hours watching them take turns to play space invaders, zapping vessels. My arm got pretty sore but it was OK. Apparently they couldn't get to the top of my prostate, but Dr Schlapoff seemed confident afterwards it would be OK as there had been similar (successful) cases in Portugul.  I liked his confidence but felt disappointed as I thought it might not work as they couldn't get to it all.

      I booked accommodation close and asked to be allowed to go straight there rather than stay the night in hospital. That was OK and I felt a bit weak (punch drunk) but pretty good. I spent the night sitting on the toilet reading a book as every time I went back to bed I needed to get up again. I wanted to go home on Thursday (procedure on a Monday) and admit I was a bit concerned on Wednesday that I wouldn't be able to manage the flight. Side effects were urgency and a bit of burning when I pee'd but it was more uncomfortable than painful.

      Anyway, by Thursday I was great. Got a 6.30PM flight that was stuck on the tarmac with an additional 40 minute delay I got to Melbourne and drove a hour home before I realised I hadn't been to the toilet for hours. Like you I am still improving. I have been a bit paranoid about stopping flomaxtra (even though I don't think it has worked for years) but I haven't had one tonight. I have had no side effects at all after the first few days post procedure. I still wake up one or twice a night but that is minor compared to what it was, and during the day it is amazing. It really hit me when I rode a horse for about 3 hours (impossible prior), at a fairly fast pace and realised I had been going slow for years because of the constant need to pee! I am 60, and feel like a new man!

      I understand that everyone can have a different experience, but in my case it has been amazing. I was a few thousand out of pocket ($900 for CT and MRI) but that was mainly because of where I live. It was worth every cent. I also like the idea of the procedure being done by someone super experienced in a big hospital. I am also happy to answer any questions.

    • caringbah caringbah Ozrural

      Glad it went well for you Oz. 

      The single greatest result of the PAE was returning to normalcy. It's not normal to think about peeing all day. When I had BPH it dominated my thoughts. It suddenly occurred to me a couple of weeks after the PAE, hat I could go four or five hours  between voiding with no sense of urgency and I hadn't had a single thought about ruination all day. Halleluia ! 



    • Ozrural Ozrural caringbah

      You are right Peter. I didn't realise how many things I avoided subconsciously. I might even have to go to South America with my wife, now a flight isn't an issue. Then again that might be ruination!! 

      Cheers, Ian

    • roberto 32832 roberto 32832 caringbah

      Dear Caringbah

      my name is Roberto G.

      I am a 67 years old male and I have an very enlarged Prostate ( something like 370cc. !!) I have been checked at the Fiona Stanley Hospital in Perth,Western Australia,and they are keeping me in waiting because here there are no Specialized Radiologist......I am rather desperate cause my symptoms are really bothersome,like I spend my life in the toilet day and night....have you got some suggestions on what I could do? I am rather depressed and so is my family,because it is now since May that after all the scans,Mri,etc etc and the promise of the hospital nothing has happened and somehow they cannot find an expert radilogist ...the Urologist has excluded the Turp given the size of my hyperplasia.....I read you had the Pae,I hope it is going good with you and I hope to get some info from you or other patients in this forum...thank you very much.


    • richp21 richp21 roberto 32832

      Hi Roberto,

           Just checked my less than complete notes that I take when reading posts and came across three posters from AUS that might be helpful for you to search for:

      Les3178 and Wanderinghans were definitely in this discussion.

      mike588 was probably in another PAE discussion on this forum but I didn't note which one.


    • frank74205 frank74205 jimjames

      Hi Jim, I  am concerned not to touch the speedi cath ,so i bought some sterile pre powdered gloves. Is this powerdered glove good to use for this ?

      Jim , bless you for all the good you have done to help all of us on thei form.



    • bob120 bob120 frank74205

      Hi Frank,

      I have used the speedicaths. They come in a sterile package of saline and become slick when exposed to air. I never used gloves. I got some betadyne wipes to use on the tip of my penis. Then extended my penis upward. Holding the handle at the end of the cath I dropped the tip into my penis which was held with the other hand and once it entered, I slowly pushed the cath inside. The first bit of resistence is the start of the prostate, and a few inches later the second resistence is the bladder mouth. I pushed the cath about another 1/2 inch and let the urine empty into a 1 liter urinal with markings so I could measure my pvr. If done right, the only part of the cath you would touch would be the handle.

    • richard11472 richard11472 fj20848

      Hi Fouad. I am thinking of getting the procedure at UNC. Can you give me a breakdown of how you did in the weeks and months following the procedure. Did you have any problems with urination in the weeks after and was there any pain. Have you had improvement in urination and getting up at night to pee? Any sexually issues like retrograde ejaculating?

      Dido Dr. Isaacson perform our rocedure?

      Thanks, Rich

    • gary 14233 gary 14233 terry59461

      Hi terry, I am considering using Dr bagla and I would like to know how long ago did you have your paw done ? How long did it take ? How long is recovery ? And can you add any information that I may be interested in . Thanks Gary

    • victor17370 victor17370 Les3178

      Hello Peter are you still seeing improvements? I am about to have the PAE done just a little concerned.

      Can you tell me how do they know

      How many pallets to use ? Can they

      Kill the prostate if they use to much?

      Please let me know thanks

    • francis19873 francis19873 gary 14233

      Hi Gary, I had PAE done by Dr Bagla 4 months ago. The results have been spectacular. It took a month to get the results, with no significant change thereafter. The discomfort after the procedure was minimal. Some urgency and slight burning while urinating. I stayed in my hotel room the day of the procedure, went to the restaurant the next day, and was sightseeing in DC for the next three days (museums, restaurants, walking in th streets). I chose to stay in the area for five days because I was afraid of the long flight back to California too soon after the procedure. Compared to TURP, this was a breeze. My recommendation: take stool softeners for two days before the procedure. The main source of discomfort was constipation. I had some painless bleeding that started 4 days after the PAE, and intensified during the third week. on the 4th week I passed a lot of clots, and there after my BPH problems were gone and my flow as strong as it used to be 30 years ago. No retroejaculation or incontinence. over the last three months, I have been able to stay for 3 or 4 hours without going to the bthroom.

      Dr Bagla and his team are very nice, competent and efficient. I wouldn't hesitate to do it again if needed.

    • cosmopug95804 cosmopug95804 caringbah

      Hi caringbah, I am 62 years old, with recently diagnosed BPH. My urologist in Perth does not recommend any treatment. However, I am planning to seek consultation with a radiologist, probably your Dr Schlapoff, to see if I am a suitable candidate for PAE. As it is such a new procedure, I am a little concerned about its long-term efficacy (ie two or three years out). As far as I can see, the operation does not shrink the BPH so much as soften the tissue, allowing urine etc to flow more easily. I would be interested to hear how you ar getting along, a few years after your own operation?

    • jimjames jimjames cosmopug95804

      Hi Cosmopug,

      What are your symptons? Do you have retention? Have you tried a pharmaceutical approach yet like Tamsulosin or 5 Mg Daily Cialis?

      You might want to go online and google "IPPS Score" and take the simple 5 minute test. It will help you see how you stack up with others who have BPH.

      You mention your urologist does not recommend treatment. Why is that? It could be that he doesn't think your symptons are signficant enough to warrant the risk of surgery or procedure like PAE, and make no mistake, they all have risks.

      Like you say, PAE is new. No doubt it will be refined over the coming years as well as newer procedures that are starting to come on board. So, if you really don't need a procedure now, watchful waiting may be your best bet.

      The fact that a radioloigst may think you're a "suitable canidate" doesn't mean it's the right decision. 


    • richard11472 richard11472 garyh1954

      Hi Gary, glad you had such good results from the PAE. It has been 11 months since this post. How are things now? I have read a few cases of good results in the short term but return to pre procedure situation after a short time.


    • joe74831 joe74831 richard11472

      Hey Richard, thanks for the email.  Not lots of improvement, still have the skin spots, I am guessing they are permanent. But I  had about 6 good months with no infection, but currently back on the prednisone and antibiotics. Wouldnt be too bad if I had at least gotten some improvement in the urinary symptoms, but I can not tell any difference at all pre PAE.

      Really looking at FLA now, to see if thst might be the answer.

      thanks Joe

    • jimmyjohn jimmyjohn richard11472

      I have previously posted on this forum about my immense satisfaction with my urinary tract improvements following my PAE done in early April this year.  I now find that I have joined the growing list of those who have had good short term results but who are looking gloomily at a rapid decline back to pre procedure symptoms. What has been hard to come to terms with is the sheer speed of the turn around. It took about 2 weeks. I am taking a course of antibiotics to ensure that the change has not been caused by a bacterial infection but the early indications are not giving me any cause to celebrate. My issue was an enlarged median lobe. I suspect that the median lobe and the latereral lobes might shrink at different rates or at different times which allows the urethra pinch to be temporarily removed only to be reapplied as the uneven shrinkage progresses. How things settle into their final positions is just the 'luck of the draw'. I will be contacting the interventional radiologist who conducted the procedure to work out a 'where to now' strategy if one exists.

      Looking to the future, can anyone advise where I can get good information about the FLA procedure and who might be performing same in Australia. Is there an FLA forum on this web site?

      It would be tragic if I end up with a TURP as my only viable option.


    • jimjames jimjames jimmyjohn

      Hi John,

      Several ongoing threads on FLA. Also, check out the thread on "Aquablation", a new procedure now waiting for FDA approval in the U.S.A.  Early studies suggest TURP like improvement without the sexual side effects. Keep in mind both FLA and Aquablation are quite new and come with early adapter risks. 


    • jimmyjohn jimmyjohn jimjames

      Thanks for that Jim. I have found a urology clinic that performs FLA for prostate cancer down south of Sydney. I have emailed them to find out if they have gone the FLA for BPH route. I have also emailed my interventional radiologist requesting a follow up consultation and scans to get a better understanding of what is really occurring.

      One concern that I have iwith the FLA is the fact that they enter through the rectum to do it. The potential for highly infectious faeces to leak into parts of my body where it was never intended to be concerns me a lot.


    • jimjames jimjames jimmyjohn

      You might also want to check out Dr. Peter Gilling, Professor of Surgery, University of Auckland, Academic Head of Tauranga Clinical Site. He is the lead researcher on Aquablation.


    • Camster Camster jimmyjohn

      I had PAE April 2016.   I was showing some improvement finally early this year.  In April, I had the same thing happen.  It turned around in about a week.  I thought it could be a mild infection.  Tried a course of antibiotics. Nothing changed.  

    • jimmyjohn jimmyjohn Camster

      Thanks for sharing with me Camster. A challenge that continues. Life is never dull. One step forward, two steps backward. The trouble is I have already researched most of the other options and I don't like any of them. I might just bite the bullet and go for the TURP like my dad recommended. He had 3 of them. At present I am still in better shape than I was before the PAE but not much. John

    • Camster Camster jimmyjohn

      JimmyJohn, I'm going to see a new urologist tomorrow a little out of my area.  There is nothing new going on in the Pittsburgh area.  His office does Urolift, Prostiva (transurethral needle ablation), and Cooled Thermo Therapy which is microwave therapy.  They are done in the office under local and maybe some sedation.  Both of these tend to have high redo rates aroud 12 to 14% which is a drawback.  I'm there to ask questions.  My prostate can't very big after the PAE, maybe around 29 to 30 cc by the post-PAE MRI.   I'm looking for something minimally invasive with an excellent side-effect profile.  By bladder could be an issue too.  This could be more of a problem than my prostate.  I agree.  There isn't a lot out there that I'm impressed with. The PAE had a great side-effect profile and one didn't need a catheter after the procedure.  They have to work on somehow pinpointing it better to problem areas.  The last two urologists that I saw just offered Greenlight Laser and they felt that was the answer to everything.  That was all they knew how to do so there was no discussion of other options.  It's like having once choice on a dinner menu.  I will continue to keep in touch with Dr. Bagla who did my PAE.  My feeling is that there may be something else involved here than just my prostate.  The MRI didn't tell me as much as I wanted.  Dr. Bagla and Dr. Karamanian both reviewed it.   Cam

    • jimmyjohn jimmyjohn Camster

      Thanks Cam

      I went to Pittsburg once back in 96. Thanks again for your helpful comments. I just found out that the urologists I found who do FLA don't use it for BPH. Let me know how you fare with your next round of appointments. John

    • jimmyjohn jimmyjohn Camster


      I have just come across IRE (Irreversible Electroporation) for prostate cancer treatment so I have just messaged a clinic in Sydney to see if it might have application as an alternative to TURP. I hope so as it has all the minimally invasive hallmarks that I am looking for. I await their reply with anticipation.


    • Camster Camster jimmyjohn

      Keep me posted on the IRE.  Have never heard of it.  Was studying AquaBlation.  It still has retrograde ejaculation potential.  It has not been approved in the US.  FLA is about $20,000 here and most of the time not covered by insurance.  When the procedure is done through the urethra, more problems can be expected. Also looking at High Intensity Focused Ultrasound.  It has been approved by the FDA for prostate cancer. It is done through the rectum by a transducer.   It does not penetrate the rectum.  It is done by a urologist.  I talked to the company for about 20 minutes.  It would be cashpay for BPH problems.  Can ablate about 10 grams of tissue per hour.  It is done under general anesthesia because one cannot move.  Outpatient with Foley catheter few days depending.  


    • jimjames jimjames Camster

      @Camster: (Aquablation) still has retrograde ejaculation potential.


      As of last year, no retro ejaculation for Aquablation in 33 patients enrolled in 3 phase I trials per Peter Gilling, lead researcher, Australia. 


    • Camster Camster jimjames

      I read about a gentleman that was in the Aquablation trial.   The doctor told him that there is a chance for retro ejaculation, as much as a chance that there isn't with TURP.  The study divided men into TURP or Aquablation.  He was happy that he didn't develop RE.  I will continue to look at your studies.  Thanks.  Cam

    • jimjames jimjames Camster

      Hi Camster,

      There were only three trials that I know about for Aquablation, and so far zero retro in 33 men. Please let me know if you find another trial. 

      If you google "How I do it: Aquablation of the prostate using the AquaBeam system" , you will find a good description and results of the trials in the Peter Gilling Paper. 

      As far as "a chance", I suppose that is true of any procedure, since they all insult the prostate to one degree or another.  


    • richp21 richp21 jimjames

      Jim, is one of the studies you know about in Albany, NY? Three was/is a study at what was the Urological Center of NE NY, which recently became part of a bigger institution (Albany Medical?). One of the docs involved is Dr. Welliver.



    • jimjames jimjames richp21

      Hi Rich,

      No. This was done in Australia. Upon further research, it seems that there have been at least one trial since and possibly more ongoing. You can find more about the completed trial by googling the citation below. It would be nice to be able to track all of the trials and results. Note that the conclusion of the trial cited here does not deal with sexual side effects on way or another.











    • ditzpro ditzpro ss3234

      Very late to this forum ...I had this done and had no good results at all .

      Prostate did not shrink any at all ..Total waste of time and my guy was Bagla .

      Now 10 years later I have a blood clot in the leg and wondering if there is any connection ..I am extremely healthy and no smoking , alcohol ,etc .

      I know they used a metal clip to close the artery .

    • jimmyjohn jimmyjohn Camster

      The IRA is also known as 'Nanoknife. The Sydney office that I referred to seems to be just a portal for an outfit in Germany who quote really big dollars for the service. They are advertising it for BPH as well as cancer. I also found that St Vincents Hospital in Sydney are using IRA for prostate cancer. I have emailed them to see if they are into BPH yet. I will then hold my breath while I wait for an indication of what they might charge.


    • Camster Camster jimjames

      Jim, this what I came across as well.  I have to research further, but this doesn't sound like a clearance for AquaBlation.  Just came back from a new urologist.  His feeling is that any procedure that goes through the urethra has a chance for Retrograde Ejaculation.  He feels that Urolift has a very small chance.  He also told me that if the median lobe is not protruding far up in the bladder, Urolift could be done.  He does Urolift.  

    • Camster Camster ditzpro

      I had Dr. Bagla do mine.  My prostate did shrink but the results were minimal.  Others have gotten great results, so good that they no longer come up on this thread.  It is hard to predict results with PAE since it is general shrinking of the prostate.  One doesn't know if there will be enough shrinking in the right spots.  The alternatives aren't that great.  I didn't want any chance of incontinence, retro ejaculation, urethral stricture, sexual issues, etc.  I'm not aware of the clip causing a blood clot.  Maybe others could chime in who do a lot of research.

    • Camster Camster

      Just a follow-up.  This urologist today told me that TUMT (microwave) has gone by the wayside.  He no longer does TUNA.  He said it is being replaced by Rezum.  I asked him if he does it.  He stumbled around for an answer for some reason.  I know there is an investment in the technology. 

    • jimjames jimjames Camster

      The Jersey doc says Rezum is the newest version of TUNA. Not sure if that's literally true, but that's what he said. I've heard the same about TUMT, just didnt work or didn't last very long. The conondrum seems to be the more they take out (TURP is a good example), the more symptomatic improvements, longer durability, but the greater the risk of side effects. The less they take out, less symptomatic improvements and/or less durability but less risk of side effects. I had hoped that Aquablation would break the mold and offer the best of both worlds but I"m guessing it will still result in 10-15% retro although they are being somewhat secretive with their data. So for at least now, no free lunch. 


    • Camster Camster jimjames

      Jim, my urologist said the same thing as the Jersey doc.  Also, the urologist said that everyone wants the procedure with no sexual side-effects and great upside.  This is the Holy Grail of BPH treatment that everyone is chasing.  My sense is that Aquablation will have retro issues.  When the channel is being widened, this can be part of it.  Let's hope for the best.  This is the great part of a procedure going from the outside of the channel like PAE and FLA.  The channel is left unperturbed. 


    • Camster Camster

      Last note before bedtime.  The urologist said that 5-10% of patients using 5-alpha reductase inhibitors will have permanent side-effects.  Something about the myelin around nerves being destroyed in the prostate.  I have never come across that in my research.  

    • jimjames jimjames Camster

      @Camster: My sense is that Aquablation will have retro issues. 


      It already does per the citations I gave. They are not breaking down the data as clearly as I'd like, but my guess it's 10-15% retro from the last trial. PAE seems to have it's own issues and FLA has mixed results so far.  The Holy Grail is still the Holy Grail and still out of sight. 


    • richard11472 richard11472 jimjames

      Jim, I have read that PAE has had some failures, allergic reaction to beads and sometimes just not working at all. But, from what has been posted the results with FLA have been all fantastic. The recovery has been slow for some patients with the catheter, but after 5 weeks every review reports great results with no side effects.

      Have you heard of some FLA failures that have not been reported?


    • jimjames jimjames richard11472

      @richard11472: :... after 5 weeks every review reports great results with no side effects... 


      Hi Richard,

      At least 8 men have reported their FLA results on this forum. Two are having mixed results after 4 months and 1 is reporting no improvement at 4 weeks. 



    • Camster Camster jimjames

      Jim, In the urology field, retro or anejaculation aren't considered sexual side-effects by some.  The urologist that I just saw said it is part of procedures going through the urethra.  He said there are procedures that don't have sexual side-effects.  What he meant was impotence and orgasmic issues.  You can see the same things in studies, trying to find ejaculation issues mentioned.  It is something glossed over because no transurethral procedure has totally solved that problem.  

    • jimjames jimjames Camster

      "Sexual side effects" is a very general term, and I imagine it is used diffferntly by different doctors. It is unfortunate that any doctor would use it in a way that doesn't address retro and/or anejacultion. This is one of the problems with many in the urology community. That said, retro and/or anejaculation are listed and quantified in many studies. So needless to say, always best to do your own research and ask the right questions.

      As to "being glossed over", it seems to depend on the study results. For exmple, the Aquablation study made a big deal about no retro ejaculation in their phase I and II studies. However, when they started to get some incidence of retro in the larger phase III study, they somewhat buried that fact to a footnote!


    • jimmyjohn jimmyjohn Camster

      Hi Cam,

      I have just finished my antibiotics. To my great delight my deterioration has halted and turned around. I have recovered about 60% of the loss and my kidneys have stopped hurting. I cant say it was the antibiotics because I also abstained from sex for a week as I had been overdoing it big time for a couple of weeks prior. I also stopped using some natural suppliments I have been using to Boost my testosterone production. Maybe the extra testosterone was not to my urinary tracts liking. I have restarted the suppliments but at a much lower dose rate. Sex will be back on the menu soon but also at a reduced rate.


    • 718wwwww 718wwwww garyh1954

      Hi Garry,

      Considering Dr. Timothy McClure for PAE . Another option is for Dr Richard Lee to perform urolift. They are both at NY Presbyterian. Who did you use at Hackensack and would you recommend him or her? 

    • bob120 bob120 jennings21352

      I considered it, but my TURP is still working after 30 months. I empty my bladder and don't have frequency or urgency. I've also been taking Dutasteride for 2 years to try to minimize future growth of the prostate.

    • Jezzaman Jezzaman bob120

      HI Bob

      I am interested to know if you have any side effects from the Dutasteride?

      I have had a PAE in Feb 2016 but to be honest I do not have severe problems although I have BPH   Only notice a problem if I go out drinking then I need to pee every 20 minutes or so until all the Beer is drained through! Or I will end up in retention which has happened 4 or 5 times in total over last 2 years. I think it’s down to my bladder not my prostate but the urologists disagrees and recommends GL laser TURP which I will not have! I was considering trying Finasteride or Dutasteride. Not sure of difference? Any info would be useful 

      Thank s Bob

  • derek76 derek76 ChuckP

    You are evidently one of the early ones. This is from the Southampton University Hospital web site. It sounds a promising method.

    " PAE is a non-surgical way of treating an enlarged and troublesome prostate by blocking off the arteries that feed the gland and making it shrink. It is performed by an interventional radiologist, rather than a surgeon, and is an alternative to a TURP (trans urethral resection of prostate) operation. PAE was first performed in 2009, and since then over 200 men have had the procedure performed predominantly in Portugal and Brazil. University Hospital Southampton has been offering a PAE service from April 2012 and is the first UK centre to perform this procedure"

    • ChuckP ChuckP derek76

      This is exactly why I had this particular procedure rather than a turp or something else that is more invasive.   Unfortuanately it has been about 2 months and a week with no good results.  I still get up 4 times a night and that was the problem I was trying to correct.  Some of these other procedures really scare me alot.  Iam concerned about having to wear a "catheter", impotence,  reverse ejaculation, etc etc.

    • stan38413 stan38413 ChuckP

      I am considering having PAE at the same INOVA hospital. Besides not having improvenent of symptoms  any side effects?

      Was the procedure painful? How was the recovery?

      My prostate is 47ml and the median lobe is pressing into the bladder. Was it your case as well?

    • stan38413 stan38413 ChuckP

      I am considering having PAE at the same INOVA hospital. Besides not having improvenent of symptoms  any side effects?

      Was the procedure painful? How was the recovery?

      My prostate is 47ml and the median lobe is pressing into the bladder. Was it your case as well?

    • ChuckP ChuckP stan38413

      Hi Stan;  Sorry for being so "tardy" back to you.  My prostate was twice the size of a normal one according to Dr. Sandeep Bagla my surgeon at Inova Hospital in Alexandria, Virginia.  My symptons are and continue to be getting up to the bathroom 4 to 5 times nightly.  This is why I had this surgery done.  It didn't work for me plain and simple.  I had the surgery on Sept. 10th and have not seen any improvement.   Lots of pain the first and second day.  Peed blood for about 4 to 5 days.  What he does is blocks the arterys and veins that lead into the prostate and it is suppose to shrink the prostate by 20 to 25% anywhere from 30 days to 6 months after the procedure.  I did not have any problems getting and keeping an erection before the surgery but now that is a "new problem" that has arisen after this procedure.  I guess you can color me not impressed with the results.  For the record I was number 116 PAE procedure done by Dr. Bagla.  He's a great guy but if I could do things over I would not do this procedure. 

    • ChuckP ChuckP mike88486

      Hi Mike;  No I don't have any idea how much my prostate has shrunk. The only way to find that out would be to have a second MRI which costs about $5,000 and I know that BC-BS would never authorize it if all I was wanting to find out how much it shrunk.  No, have not read Ron Bazar's book.  Is it worth reading????   Iam not being critical just asking an honest question.  Is he a surgeon or Urologist????  Don't know if I told you but in all truthfullness Iam not happy with the results of my "PAE".   My sex life is great but Iam still getting up between 3 or 4 times a night.  Got no real results in that area. 

    • derek76 derek76 ChuckP

      Your urologist could do a simple procedure called a TRUS.

      Prostatic volume estimation by transrectal ultrasound is a common clinical procedure. Uses include pre-treatment assessment of prostate size, interpretation of elevated prostate specific antigen (PSA) levels (PSA density) and, in the field of research, measurement of the effects of prostate shrinking drugs.

    • fj20848 fj20848 ChuckP

      Hi Chuck

      It seem you and me among the very few people who didn't achieve much improvement after PAE. You mentioned that your IR doctor blocked the arteries and the veins that lead to the prostate while the procedure blocks only the arteries. Are you talking about Vascular problem you had in addition to prostate enlargement?

      If it was Vascular problem your IR doctor should have told you. Have asked your IR doctor why your PAE procedure didn't work and what should you do next step or perhaps he told to give it some more time and the results would come. That is what I heard from my IR doctor and I am waiting


  • hungupdown hungupdown ChuckP

    Hi chuck, sorry you havn't seen much improvement following PAE.

    I underwent PAE last month and had immediate improvements. Just 2 hours afterward, first visit to toilet, flow rate about doubled. I guess this immediate change must be due to the prostate no longer being inflated so much by incoming bloodflow.

    I've had no bleeding and little discomfort. Just some tightness in groin around artery where catheters inserted which mostly eased off after 2 weeks, and a feeling of lower stomach cramp or trapped wind starting to ease off towards 3 weeks.

    My main problem, Nocturia was 5 or more visits a night, now mostly 1-3 visits but 3 nights I've slept through for 7-8 hours.

    I was also suffering retrograde egaculation which was quite uncomfortable. There's been some improvement here, more would be good but at least it's not as uncomforable anymore.

    I'm in Scotland and went to Professor Martins Pisco in Lisbon.

    Southampton is only place in UK doing the procedure, but their charges are much higher, Lisbon total PAE prices plus flights and 11 day stay (for two) cost less!

    I was PAE patient 723 at Hospital St Louis.

    From the CT scan I appeared to be a straightforward case, but ended up taking longer than expected as one artery turned an acute angle. They had to use a special catheter to get around the corner, this was their first case where that catheter was ever necessary. It sounds that Southampton would probably not have been able to complete the procedure, so very glad I chose Lisbon.

    Hospital St Louis in Lisbon is a centre specialising in uterine fibroid embolisation, a procedure that's been around since the 70s. I guess experience in that would also help in PAE.

    Found your post when looking for place to get my 1 month checkup done. Required checks are flow rate; residulal urine volume ultrasound scan, trans rectal ultrasound scan of prostate (dimensions and volume); PSA blood test. Ive put up a new post looking for place to get the trans rectal ultrasound. Also you have to fill in questionairres including IPSS and IIEF.

    They ask for these at 1 month; 6 months; 12 months then yearly as it part of ongoing research.

    The incentive is that provided you return the results you can get the procedure re-done, I think at no cost or possibly for just the materials cost (1500 Euro) the pagagraph isn't clear. Says this depends on if your prostatic arteries have too much atherosclerosis, if bad then not free.

    Before you had PAE did CT scan show atherosclerosis (tortuous or highly divided) to be a problem? more lightly in smokers and as you get older.

    At my checkup after six days, Prof Pisco said the next day he was doing an 80year old smoker with atherosclerosis, he'd been advised of low chances of success but patient wanted to proceed.

    After PAE were you told if embolism had been sucessfull on both sides?

    Have you had results from any follow up checks yet? Would be interested in any changes acheived.

    My pre procedure t-r ultrasound results were: dimensions 66x64x74mm; volume 162cc; median lobe 12mm.

    There's a google group you may have seen, someone else with good result, try search "Prostatic Artery Embolization, Prof. Pisco in Lisbon"

    The hospital site has a large testemonials section - good reviews but I trust reports on independant sites more.

    • hungupdown hungupdown

      Just had 1 month check up. 

      Prostate volume 136ml was 163ml.

      Retained volume (after urination) 2.5ml , was 127 ml.

      Go 7 or 8 hours at night now, used to be up 4 or 5 times.

      Had retrograde ejaculation for about a year. That's not perfect, but much better.

    • 4827 4827 hungupdown


      My name Is Leonid

      I d like to visit dr Bagla and have that thing dane

      Any problems with erection for you now?

      Any problems at all?

      Thank you very much for response


    • ernest72104 ernest72104 hungupdown

      Hi just came across this forum. Glad to see your improvement. I am an an Australian and considering Prof. Pisco. I have prostate cancer as well and can't be treated with PAE in Australia but Pisco will consider doing it. Is PAE not covered by NHS in Southhampton. If not why not? Is it considered to be too experimental perhaps? Hope you are still following this forum.

    •  nealpros nealpros ernest72104

      There is another procedure called FLA which is written about a great deal on this blog. If you search for it on the Web you will also find a great deal of information about it. As I understand it, in this procedure, using MRI guidance, a laser filament is threaded, I think, through your rectum, and directly into the cancerous lesions in your prostate, where it destroys just the lesions. While using this technique to remove cancerous lesions in the prostate, doctors and patients were surprised to find that it also cures BPH. It has not yet been cleared in the US as a cure for BPH, but it is cleared for use on cancer in the prostate, so it is funded for cancer by MEDICARE, and most insurance companies, but not for BPH. It looks like it might be made for your situation. Importantly, it is NOT done by urologists, but by a different kind of doctor called an interventional radiologist, so it will never be recommended by a urologist since they make no money off of it.


    • ernest72104 ernest72104 nealpros

      Hi Neal,

      I have checked FLA out with the only specialist who does it in Australia.

      He said I am not suitable because my 2 lesions are too big and may have breached the capsule wall unfortunately, so I have moved on. Thanks for your reply and interest.


    • ernest72104 ernest72104 richp21

      The primary thought is that since the cancer grows out of the prostate and grows necessary arteries for its nourishment, PAE might block the cancer arteries also, hopefully killing not only the prostate but the cancer at the same time. This is of course quite experimental, and not yet done at all, as far as I know, so knowledge of the pros and cons is limited.


    • richp21 richp21 ernest72104

      Thanks Ernest. If the PCa has breached the capsule I imagine that you are considering other treatments as well.

      Also, if you are considering Dr Pisco (in Portugal) for PAE, would it make sense to also consider FLA in the US as an alternative?


    • j12080 j12080 nealpros

      Hey Neal. 

      I have made up my mind. I am going with the FLA in the next two to three weeks based on my wife's treatments. I really want to use karamanian. He is definitely the best I can find. I still cannot get the references on FLA for BPH out of sperling. I have tried 8 times. The last attempt, I was told they would have him call me. I have waited now a week and it is not going to happen. If

      I have never called k that he did not return my call in 24 hours. If I cannot line up with dr K  because of schedules, I will schedule with his associate walser.  They still work together at UTMB. Maybe I can get both! Walser is the mentor but K is the genius with the bio medical engineering and interventional radiology degrees. He is really great to speak to as he never makes you feel like you are just a number that should just trust what is thrown at you. 

      Last time I spoke with dr k, he was talking about doing his own clinical trial offering to support part of the cost for 5 -10 patients. I think he will make a special offer. He is really a good doctor and just saved one of my friends from a bad disaster he was getting into with a Uro. He got him a great doctor in Oregon for a special situation.  His talents are beyond anything else I can find and I am so pleased he has dedicated himself to PCa and BPH for men. 

    • Roseland Roseland j12080

      Did you see the results of a trial at John Hopkins in Baltimore under Sam Denmeade where they treated PCa with high doses of testosterone and shocked it into submission?  I thought it was very interesting.

      If you want to know more google bipolar androgen therapy.

    • j12080 j12080 nealpros

      Neal, it is in Galveston and around Houston. The cost will be the normal 20k but I do not care at this point.

      I think dr k is going to do a clinical trail he can do a paper on and he will subsidize some of the cost for each person out of his pocket. The equipment companies don't care yet about us BPH boys. At least enough to fund a trial. They are working on the heart, brain and cancer problems now. If dr k does this, it would be a lot less out of pocket than 20k for a few people that qualify but I can't wait. My back is against the wall on this. I must do it and I have borrowed the money already. If it works I am happy don't care about the cost. But if you can wait till he is set up and if you get in before it is full it would be a sweet savings I am sure. l will let you know. About my procedure as it goes.

    •  nealpros nealpros j12080

      Hi Jim,

      Thanks for the information. I'm looking forward to reading how it goes for you, and wishing you the best of luck.

      I had a second PAE, from Dr. Isaacson at UNC on 3 November, so I will need to wait until at least 3 March or so to see if that works better than the first one did, before I can commit to whatever is next.


    • joe74831 joe74831 nealpros

      Hey Neal, did Dr Isaacson give you any indication why the dirst one did not work? Dont know if you recall, but I had one by hm I Jan of this year, and from what I can tell I got zippo, other than a really bad prostate infection lol.



    • joe74831 joe74831 richp21

      Well a noral PAE causes quite a lot of inflammation but I also had an allergic reaction to the beads they used which caused even more inflammation that became an infection.

    • sergio72874 sergio72874 richp21

      Just had my annual physical, the first one after my PAE procedure back in June this year. To my surprise, my PSA score jumped from a relatively stable (for the last several years) value of 5.5 to 9. The doc who did my PAE says that he sees more evidence that PAE may cause prostatitis, which in turn may increase PSA. Still, he was puzzled by this PSA jump. From literature review, PSA usually decreases after PAE by about 30%.

      Did anyone else experience a PSA increase after PAE?

    • richp21 richp21 sergio72874

      Hi Sergio,

          Have you experienced any prostatitus symptoms? Did the doc recommend going on antibiotics, or anything else to investigate why your PSA jumped? Are your BPH symptoms better at this point? Thanks!



    •  nealpros nealpros richp21

      Hi Rich, and others who have posted here today,

      I had no side effects from the second PAE, except some very minor pain in my prostate. It was not even nearly enough to bother with medicating after the first day or two. I also have my same BPH symptoms, but they seem to very slowly be getting better. I sometimes go 2-4 hours without urinating in the daytime, and slightly longer than 2-3 hours at night which both are better than before I had this PAE. But other times, it is just as it was before this procedure. I'm continuing to be optimistic, and we'll see what the next 3 months bring.

      Dr. Isaacson said that the main problem with the first) PAE was that I have an extra major artery going to my prostate that most men don't have, and that he missed the first time. Also, he planned to embolise the arteries further from the prostate to make it more difficult for me to grow arteries around the embolisations. Time will tell if this is going to work this time.


    • bill80656 bill80656 nealpros

      Hello Nealpros,

          I haven't posted since last spring or so. I have a seasonal business so no time to post.

         I had my PAE 19 months ago June of 2015. I had wonderful results very quickly. Perhaps a 75% improvement. (Note, I had a terrible and barbaric TURP a year before that with no improvement whatsoever).

      Now I am experiencing some increase in frequency during the day.

      Nights I still have to get up only once when pre PAE it was 4 to 6 times.

      I'm still very happy with the results but feeling a little nervous about the future. When Dr Bagla did it they said it should last 5 to 10 years...but they really didn't know for sure about how long I might benefit.

         So now I am asking two questions. First, what are others experiencing after the fact of having a PAE? How long are the improvements lasting?

      And secondly has medicare started to reimburse for the PAE?



    • jjjj57989 jjjj57989 bill80656


      Dr Bagla did my PAE on Sept 28, 2016. Medicare paid all but about $2200.

      By the end of my first month my AUA score had dropped from 26 pre-PAE to 6.

      Since then it has crept back up to 21 and like you I am nervous.

      I have been unable to find any information about maintaining a PAE.

      So I had an ultrasound last week that showed my prostate has shrunken 25%.

      And yesterday I asked Julie, Dr Bagla's nurse about it. She said that I probably have an inflammation and recommended that I take ibuprofen three times per day, Which I started yesterday.

      I'm waiting to see what happens.

    •  nealpros nealpros bill80656

      As far as I know, and as of November 3, 2016, MEDICARE does not pay for PAE for BPH unless you are in a study, or it is being done for some other approved reason such as blood in the urine.


    • richp21 richp21 joe74831

      Wow, you've really been through the ringer. From your question to Neal, are you considering a sceond PAE even with your reaction to the beads, or am I reading too much into your question?

    • richp21 richp21 jjjj57989

      Hi jjj,


          Do you have Medicare supplemental or Medicare Advantage? I think Medicare only pays 80% of most charges if you don't have either suppmental or Advantage..

         Please keep us posted on whether the ibuprofem works. Wishing you good luck with that!



    • richp21 richp21 nealpros

      Hi Neal,

          I think we've been back and forth on this before. According to Dr Bagla's office, they have been getting Medicare coverage when it's not a study. Dr Issacson's office siad it doesn't cover except for a study. I asked Dr Bagla's office about the difference, and they didn't really know why. Where does your info come from? Anyone else have info on this?

    • jjjj57989 jjjj57989 richp21


      I have only basic Medicare.

      Anyone with questions about coverage should speak with Dr Baglas insurance coordinator. I did, early on. It was helpful in making my decision.

      I'm going to give the ibuprofen a few days then post the results.


    • sergio72874 sergio72874 richp21

      I've been diagnosed with a chronic prostatitis long time ago. Maybe after the PAE it became more acute. No particular symptoms, except some discomfort in the pelvic area. My doc adviced me to take Advil, retest my PSA in 3 months and a biopsy if it does not go down. I am hesitant about the biopsy.

    • richp21 richp21 sergio72874

      If the PSA doesn't go down, another option is to do a 3T MRI of the prostate to see if a biopsy is necessary. If the MRI showsone or more suspicious areas and a biopsy is advisable, then at least it would be a targeted biopsy rather than a random one.

    •  nealpros nealpros richp21

      My information came directly from Dr. Bagla, about PAE being only covered for NON BPH conditions like blood in your urine. Apparently, a lot of men who are operated on by him have that. Also, Dr. Isaacson's office charged me about $6,500 for each PAE.


    • jimjames jimjames nealpros

      Hi Neal,

      Insurance aside for a moment, are you suggesting that Dr. Bagla performs PAE for patients with blood in their urine (hematuria) who do not have BPH? Or are you saying that he often performs PAE on men with BPH who also happen to have hematuria? The latter makes sense because hematuria is often associated with BPH.

      But if he performs PAE on non BPH patients with hematuria, I'm curious what is the mechanism of how that would work and how he in fact could conclude that there may not be other causes of the bleeding.


    •  nealpros nealpros jimjames

      Hi Jim,

      I'm not sure how to answer your questions. The original question was about whether or not MEDICARE pays for PAE for BPH.

      The answer is that it does not, unless the patient is in an approved study. It does, however, pay for it as a treatment for blood in the urine, whether or not the man has BPH. When used to treat blood in the urine, it also usually helps BPH, if the patient has that. Many men who have shown up on his doorstep for BPH have found that they also have blood in their urine, and have gotten a PAE paid for by MEDICARE.

      I hope that clarifies it. If not, send me a pm, and I'll explain it further, if the above doesn't make it clear enough.


    • jimjames jimjames nealpros


      I just saw a few papers where PAE is used to treat refractory hematuria of the prostate. Not sure if that is the same as the garden variety hematuria that many of us, including myself, have from BPH or even prostatitis. If it is, then I guess I get my PAE paid for by insurance if I decided to go that route. And same with others. Thanks for pointing this out as hematuria is not at all that uncommon with BPH.


    •  nealpros nealpros jimjames

      Hi again Jim,

      I didn't answer your last question because I don't know the answer. PAE must work for cases of blood in the urine, because it has passed FDA screening and has been approved for use for that purpose. The answer to the financial questions is in my earlier post.


    • joe74831 joe74831 nealpros

      Hey Neal, if I were you I would insist that they at least send it to your insurance, and ask for them to pay.  My BCBS of TN covered mine last year. I am really surprised that they would cover something that medicare would not.


    • joe74831 joe74831 richp21

      I had had all of the other medications used during the procedure before, And they used the contrast the day before the procedure with no problems. The reaction started within 2 hours of have the procedure completed. And the DOC thinks it was the beads because the reeaction has continued for so long, and anything else would have long ago left my body. Unfortunatly once the bead are installed there is no way to take them out, other than prostate removal.

    • joe74831 joe74831 richp21

      Not immediatly for sure. I had to go back on antiviotics this week for yet another prostate infesction.  I am very interested in the ablation tho, I just wonder if getting rid of the median lobe might help with the weak stream, and the prostatitis/infections.

    •  nealpros nealpros joe74831

      Hi Joe,

      My insurance is MEDICARE and TRICARE.

      TRICARE automatically covers anything that MEDICARE covers, and nothing else. MEDICARE covers procedures approved for specific conditions by the US FDA. PAE is not approved for treatment of BPH by the US FDA. The US FDA won't cover the PAE for treatment of BPH until relevant studies have been completed. Most studies are funded by the US FDA. There are at least 5 times as many urologists in the US as there are interventional radiologists. Interventional radiologists do PAEs, urologists do not do them, so urologists don't make any money from them. If ultimately PAE is shown to be effective in treating BPH, urologists and many large companies that make equipment used in the many flavors and colors of TURPs stand to lose a GREAT deal of money, many millions of dollars, so they lobby against the allocation of the money to do the necessary studies. The urological associations have more members, and therefore more funds for lobbying.

      That's why MEDICARE, and most insurance companies don't cover PAE for treatment of BPH.


    • joe74831 joe74831 nealpros

      Got ya, I knoiw Dr Isaacson said mine was the first insurance that he had gotten approved, but they will not cover anythin considered experimental, so I guess I just got lucky. Now if it had only worked LOL.

      Keep us up tp date man.

    • j12080 j12080 nealpros

      True point Neal. Let me point out a mathmatical fact in this war. 

      The normal TRUS blind 12 needle biopy that is the second step for the Urologist rigth after the DRE is an average cost nationwide of $1,100. This simple procedure takes less than 10 minutes and is done in the Doctors office. Last year there were approximately 1,200,000 of these wonderful procedures done last year in the US. 

      That is an annaul market of over $1,300,000,000 that is with a "B" as in billion. 

      Now you know why they fight so hard and this is just one of the many products a Urologist has in his bag of tricks. 

      Imagine having a product for sale that has that size of ANNUAL  market place. 


    •  nealpros nealpros j12080

      Hi J,

      I don't know, but my guess is that any TURP, done in a hospital, with general anesthesia, and frequently an overnight stay, costs many times what any biopsy costs. We're talking big bucks here .

      I have before suggested that we write to our Congress people, and senators, and bring this problem to their attention, and point out that many of them will have these problems if they don't already.

      This same situation holds for FLA, Focused Laser Ablation, and probably soon, other promising technologies that will potentially cut into the urologists' monopoly.


    • richp21 richp21 nealpros

      Thanks Neal. Did Dr. Bagla's office confirm that Medicare will only cover if there is blood in the urine or if it's a study? I'm planning to call Julie and go over this, and want to make sure I have all of this straight.


    •  nealpros nealpros richp21

      Hi Rich,

      I believe that Dr Bagla said something to the effect that blood in the urine was one of the conditions under which PAE was covered, but BPH, by itself, was not one of them.


    • joe74831 joe74831 fj20848

      No sir I do not,and after all I have been thru I am somewhat skeprtical. But if they can remove certain tissues, such as the median lobe without damagaing the surrounding vital tissues, it sure sounds promising.

    • caringbah caringbah victor17370

      Hi Victor, 

      i had my PAE in May 2015. I'm going great thing I ever did. I really don't even think about it's like I never had BPH.. 

      Don't worry about's one of the easiest medical procedures I've ever done. 



  • icejohn icejohn ChuckP

    I have the opportunity to choose between Green Light Laser and PAE.

    Is there anybody there who has had PAE and would be willing to talk to me about it?

    I could phone you, or you me.

    • ChuckP ChuckP icejohn

      Hi Icejohn;  See my posts above.  I had one performed by Dr. Sandeep Bagla of Inova Hospital in Alexandria, Virginia on Sept. 10th, 2014.  Its been about 4 months now and Iam seeing a "little improvement".  I use to get up to the bathroom atleast 4 times a night and now I get up 3 times a night.  Your lifestyle has alot to do with this as well.  I have learned to drink my liquids (water, wine, whatever) in the early part of the day.  When it hits around 4pm I don't drink a whole lot more for the day.  I drink about 4oz of "tart cherry juice" at bed time as it is a "natural sedative".  Not the blended crap the expensive real juice.  It really does help.  I also take 2 passion fruit capsules as they also are a natural relaxant as well.  Back to the "PAE".  Its outpatient and you go home the same day.  Dr. Bagla told me I was number 116 so he has done it "alot" and knows it like the back of his hand.  He's a good man but don't expect to get him on the phone for a long conversation.  These Doctors are so busy it just doesn't work that way.  HIs intake coordinator is Nicole Tolleson and she can help get it set up.  The first 2 or 3 days after the surgery you do "pee blood" but thats all very normal.  Yes, there is "some pain" but they send you home with pain meds.  As Ron Texan said above he goes in and blocks the arterys to the prostate which starves the prostate of blood and oxygen and it will shrink it around 20% to 25% over a "6 month period".  I still have 2 months to go before I get to the 6 month mark.  I have seen a 25% improvement.  From 4 down to 3.  It doesn't seem like much but its better than a kick in the pants.  Hope this helps.   ChuckP

    • Kc110 Kc110 icejohn

      Good results from Dr. Bagla at Inova. Previously  Was on 2 Flomax a day for about 9 months and hated the side effects. In just over 3 months, there is enough improvement to say I would do it again even if I don't improve from here. Not painful but the after effects of the contrast medium were rough the first night. Initially I was told to up the Flomax to 3/day and then cut back after 2 weeks and I stopped completely at 30 days. I hope this is helpful to you. 

    • caringbah caringbah Kc110

      Hi Kc, How did the contrast affect you? Did you have any reaction to contrast prior to the PAE?

      I'm lined up for a PAE but am worried about the contrast dye. I just had a CT angiogram a couple of days ago and despite a precautionary loading up of cortisone and anti histamine , I still came out in a rash on chest arms and back. 

      Im worried that the contrast reaction may become progressively more severe. Being diabetic doesn't help either.

    • Kc110 Kc110 caringbah

      I hadnt had contrast previously.  My legs ached badly all the first night but that was the extent of it. I think it's helpful to drink as much water as possible (despite the concern that you won't be able to pee). Be sure to tell the Dr. Are you going to Inova? Maybe your doctor can tell you if it's a different agent or use another one. 

    • caringbah caringbah Kc110

      I'm in Sydney, Australia. Interventional radioligist is Dr Glen Schlapoff. They are already using the more expensive , "least reactive" dye. When I had the mapping angiogram they already had the emergency trolley on standby with adrenalin shots ready to go in case of anaphalactic shock. 

      Im waiting to have a chat to the doc re the contrast dye before I go ahead. 

      How severe were your BPH symptoms before you had the PAE?

    • Kc110 Kc110 caringbah

      Couldn't travel, painful to pee, burning, retention, urgency. I had a TUNA procedure that helped for about a year because I didn't want to take Flomax. Then about a year ago I had no choice and started with Flomax 2/day. It only worked to a point and didn't eliminate the burning. 

    • caringbah caringbah Kc110

      You symptoms were a lot worse than mine. I'm currently taking one Flomax a day plus supplements. I was getting up five to six times a night...the Flomax reduced that to four and the supplements have brought it back to two times a night...I don't have any issues during the day. So you can see that I'm managing relatively Ok. Because my symptoms are not severe now and because I'm worried about the contrast, I'm in two minds about proceeding.

    • Camster Camster caringbah

      For everyone's reference, here are the prices for PAE by Dr. Martin Pisco in Lisbon, Portugal as of Jan. 29, 2015.  I converted the Euro to dollars.   He has done over 750 PAEs.  

      Dear Cam,


      Consultation - 95€  ($107)

      Angio CT - 150€   ($169)

      PAE - 4.350€.     ($4910)

      Emis Moderator comment: I have removed website etc names as we do not allow posting of these in the forums. If users wish to exchange these specific details please use the Private Message service .

    • ChrisRed ChrisRed caringbah

      Hi there I live in  Sydney Australia and Im seeking a urologist or surgeon that is performing PAE in Sydney or Australia do you know of anyone please .

      Thank you so much for you help

    • caringbah caringbah ChrisRed

      Hi Chris, 

      I had my PAE in Sydney 6 weeks ago....worked like a charm. 

      Dr Chris Schlapoff of the radiology department at Liverpool hospital did my procedure. Great guy and very competent. Call the radiology department and ask for Alda to make an appointment. 

      He is the only guy in Australia doing PAE's as far as I know. 

    • ChrisRed ChrisRed caringbah

      Dear Peter,

      Thank you so much for your fast reply Im so thankful.

      Yes we do have to stick together I have found these doctors and urologists are so uncaring and are only in it for the money as you said.  Thank you for the info Im so greatful , its terrible that I was only given 3 options of horrific surgery with horrible side effects and that I had to find this forum by complete mistake. I feel sorry for all the guys that have gone ahead and listened to these butchers and had there prostate and urethra & sex life ruined  becuase they thought they had no other options ! Spread the word so other men are not treated this apallingly by so called "medical professionals " just digusting .

      take care and I sincerely thank you

      Kind Regards Chris

    • ChrisRed ChrisRed caringbah

      Dear Peter

      Do you mid if I aks you a few questions about your PAE ?

      How long did the procedure take ? How long does it last for ? Do you you have to have it done again & is  it permanant ? What are the risks and any side effects if any ? Was it painful ? Did you have a full anasthetic or general? Have you or did you get any pain or strange symptoms after it ?

      Im sorry Im asking so much but thanks so much for  your help.

      kind regards


    • caringbah caringbah ChrisRed

      Hi Chris,

      Proccedure took about 2 hours.

      I think it is supposed to last for at least 10 years.

      If it doesn't work sufficiently well first time you can get it done again.

      Im not aware of any  risks except that the radiooligist has a theoretical possibility of embolising the wrong organ. With the superb imaging they have available that would be extremely unlikely. A side effect if you can call it that is that 30% of men who have PAE report improved sexual function. I fit into that category with a fuller thicket penis when flaccid and thicker stronger erections.

      i had a general anaesthetic and stayed in overnight. There was  some pain but it was managed pretty well....nothing to worry about. I did have bladder spasms and burning when urinating and incontinence for three days. 

      From day four e erything improvrd dramatically and a week later all unpleasant post op discomfort was totally gone and peeing like a horse. 

      It is wonderful to pee normally and not think about urinating . 

      i had it done for free on Medicare. 

      Hope that helps. 

      The urologists are worried about this procedure as it is a threat to their incomes. I have no time for them.....they have had the prostate monopoly for far too long . 

    • mike88486 mike88486 caringbah

      What an awesome side effect. Haha. I'm glad you forged ahead with PAE despite your initial reaction to contrast. I feel like there should be some sticky at the top of the forum to consider PAE before getting butchered.

    • caringbah caringbah mike88486

      Thanks Mike ....couldn't agree more. I feel sorry for those poor guys having a TURP right now because they didn't realize there was a far superior alternative. 

      Mike , thanks for all your help and support and encouragement. 

    • ChrisRed ChrisRed caringbah

      Dear Peter ,

      Words can't thank you enough for this encouraging news and information gosh I'm so excited ! and finally feel there is hope for me at last ! I'm so happy for you too!! I know how vile depressing and debilitating this disorder is , I bet you have a huge load of stress taken from you thank you so very much for your time and enjoy life at last yay !! ... I will keep you updated with my progress . Thanks so very much .

      Chris (((( hugs )))

    • bruce19007 bruce19007 caringbah

      I had my cystoscopy and found my prostate is still too big and protruding into the bladder neck.  The first made a huge difference, but not enough.  I have decided to have a 2nd PAE and will have it done in November.  Stay tuned...

    • bruce19007 bruce19007 lou051947

      Didn't get a size number, but had a ~38% reduction from the original size.  The Doc says that shrinkage can be different on the inside than on the outside though.  I did get some relief, just not enough.  I must have had a whopper!

    • bill80656 bill80656 ChrisRed

      Hi Chris,

         Had the PAE almost 4 weeks ago and peeing great now.

      Do the research and then have the PAE. All other procedures are barbaric compared to this. (had the TURP 2 years ago with no success) The PAE was a breeze. Nothing to worry about. No pain during or after, no blood, no catheter, no peeing razor blades for 3 months, no infection, etc. etc.

      Take it easy for two weeks. I did physical work 3 days after the procedure and the artery leaked a little into my leg...causing black and blue. I was over zealous on my job.

      It is a miracle to me that I can pee now. So many years of aggravation.

      Capt. Bill

    • bill80656 bill80656 lou051947

      Hi Lou,

        I think that it was over 125 grams? The urologist said that it was bigger than my bladder.

      Pretty scary.

      Almost 4 weeks after my PAE I am sooo pleased that I can pee normally. Most of the bad symptoms are now gone.

      I slept through the night last night for the first time in decades. 

      I would do this procedure again in a heart beat. 


    • ChrisRed ChrisRed caringbah

      Hi there ,

      I've got an appointment with the doctor on the 20th of this month is there anything I need to discuss with him have you had any problems , all is still going well after your PAE ? Do I need to discuss PAE methods with him as you mentioned I'm very nervous as you can imagine .

      Kind regards


    • william79680 william79680 ChrisRed


      don't worry about the PAE. It is a breeze. I drove home fron North Carolina to Atlanta (7.5hrs) the day after mine. I am back in NC today for a 3 month follow up. If the Dr was a female I would kiss him for sure. This is the best thing I have ever done. I have not gotten up at night for several months now and pee great during the day with no urgency. No pain or bleeding after the procedure for me and results were better after  a few days. It took about a month to get to where old symptoms were completely gone, but I would have been happy with the results I had after a week. Thank goodness it got even better as time went on.

    • bill80656 bill80656 ChrisRed

      Hi Chris,

         It has now been 1 month since my PAE. I am absolutely ecstatic about the procedure and the results. I felt relief and improvement after a week.

      The procedure was painless, no catheter, no blood, no side effects. Only the first night was a little uncomfortable.

      I did have a TURP 2 years ago and it was a horrible long term experience and didn't work.  

      They gave me several meds for swelling etc. and an antibiotic.

      My only mistake was that I started working at my campground, physical stuff, after 3 days. As a result I popped the incision open inside. Hence black and blue from my crotch to my knee. The internal bleeding stopped on it's own and the black and blue  was gone in about three weeks. Live and learn.

      Urologists don't do this procedure you have to find an experienced vascular surgeon to do it. Dr. bagla at Inova Hospital in Alexandria Virginia. did mine. Be patient and persistant to get in to have it done.

          In summary my stream is double what it was with no dribbling for 5 minutes, urgency is 95% gone, I get up once per night, previously 4 to 6 times. Frequency during the day is also half of what it was.

          (I was lucky to get through the TURP without ruining my sex life and getting the other possible side effects from it. Why let the butchers cut you up if you don't have to go through the medieval torture?.)

      Do the PAE and good luck.


    • caringbah caringbah ChrisRed

      Is that with Dr Schlapoff Chris? Don't worry about it...Its nothing like a TURP or even Holep for that matter. 

      Everything is fine after two months. It's amazing the before and after experience. Before it was always on my mind..getting up 5 times a night. I don't even think about peeing anymore...hard to believe I used to have a major problem. 

      Stop worrying'll be ok...its the least invasive method out there. 


    • ChrisRed ChrisRed caringbah

      Yes it's with Dr Shlapoff and thanks for your words of encouragement I'm very very nervous I'm glad to hear things are still going well for you thanks for taking the time and talking with me I will keep you updated .

      Thanks again


    • johnsv6 johnsv6 bill80656

      Did you have to have a referral or any special "something" to get approved? Chapel Hill is going to do mine but wehave to wait for a Veterans Association Urologists' referral. Why?   Me no know....I'm too big for the trials so there has to be some kind of waiver. The folks at Chapel Hill are really trying to help out as much as they can. What a pleasant surprise to be treated like a fellow human bean...

    • caringbah caringbah johnboy4150

      Hi John, 

      My PAE was free. It was covered by Australian Medicare. I'm not sure from your post whether you're an Australian citizen or not. Call Luverpool hospital in Sydney and ask for the Radiology department and ask for an appointment with Dr Gen Schlapoff. 

      Im three months out now and everything is sweet. 

    • larry23609 larry23609 caringbah

      Hi Caringbah,

      Hi Caringbah, I live in Bourke, NSW and have BPH. It is slowly getting worse so I anticipate that corrective surgery may be necessary. I heard about PAE on The health report of Radio National so looked it up and came across your posts documenting your experience with Dr. Glenn Schlapoff at Liverpool hospital. It would seem from what you have said that looks like a good move. If you have a moment could you update me on your experience and suggestions for proceeding to have an PAE? I got in touch with Liverpools radiology department, couldn't speak to Alda but did speak to Veronica who advised about getting a referral from a specialist ( I wonder whether a GP can refer: no specialist in Bourke! ). I am very grateful for an opportunity for communicating with you. I trust you are well and that you are continuing to benefit from your procedure, kind regard, Larry  

    • Sam05687 Sam05687 larry23609

      Hi Larry,

      i am writing from the Short Stay Unit of Liverpool Hospital 3. 5 hours since the anesthetic wore off.

      Feeling fine.

      And yes, my GP made the referral and i presume so can yours.

    • larry23609 larry23609 Sam05687

      Hi Sam,

      Thanks for for your comment about the GP referral, good to know. I trust your recovery is going smoothly. I would be pleased to hear how different the condition you had experienced before the operation is now that you have had a PAE? All the best, Larry

    • Sam05687 Sam05687 larry23609

      Hello Larry,

      Thanks for your comments and glad to help.

      You may have to educate your GP about PAE.

      The Interventional Radiology Teamat Liverpool Public Hospital have been fantastic from the start - supportive , confident, reassuring , professional, knowledgeable and highly skilled. I am sure you will have the best team working with you.

      I just had dinner and am walking around, a tad bit awkward with the hospital gown, drinking lots of fluid .

      a bit of light burning feeling scale of 2 out of 10... possibly because of the catheter.... but fine enough.


    • Sam05687 Sam05687 stewarta

      Hi Stewart,

      I found the processs so far without much hassel most importantly EMOTIONALLY reassuring , technically easier to understand and intellectually satisfying.

      I wish you the best


    • bi003 bi003 caringbah

      Hello caringbah . I am 29 yrs old male .

      Been suffering from frequent urge to urinate for abt a year . Been to urologist 2-3 time did all the check up .but nothing seems to improve.

      Recently i am having mild burning feeling and fell urge to pee after 5-10 mins of peeing. Have to wake up 2-3 time at night to pee.

      Do you reckon i should give this PAE a try?

    • stewarta stewarta bi003

      Pardon me butting in ... But I gather you must be in Australia. If so, get your GP to refer you for an appointment with Dr Glen Schlaphof, Director of Preventative and Interventional Radiology at Liverpool Hospital in Western Sydney.

      They will organise a CT Angiogram and a MRI of your nether regions. They will then advise concerning a PAE or otherwise.

      From a personal perspective, be very wary of Urologists and any procedure that biopses or cuts into the prostate.

    • bi003 bi003 stewarta

      Thank you stewarta. I have been to urologist a couple of time and i must say i havent been pleased with them.

      Will go my gp and get a refeeral letter asap as you have suggested.doe all this ct angiogram and mri get covered by medicare?

    • stewarta stewarta bi003

      We delete content if it doesn’t meet the requirements in our Terms & Conditions.

    • lenny2cancun lenny2cancun caringbah

      Hi:  I noticed you said you had your PAE done and it was covered by Medicare.   It appears you had a great result and would appreciate it if you could tell me where did you have the PAE done, who was your doctor and how you got it covered by Medicare  or  was it supplemental insurance.  Thanks for your response.  Lenny 

    • Wanderinghans Wanderinghans bi003

      This may be helpful for those who can access Brisbane, Queensland. 

      I listened to an interview between Dr Norman Swan and radiologist Dr Roger Livsey on the ABC RN podcast Health Report about a month ago. I contacted Dr Livsey and was directed to a Dr Duncan Walker at the Wesley Hospital in Brisbane. 

      I learned that a trial program was under way and after some preliminary tests i was invited to join in. 

      My PAE is to be conducted next Monday 4th, Jan.  

      I will report back on on my progress.  I did a considerable amount of research into the proceedure and an convinced that it is without peer for the non invasive treatment of BPH. 

    • caringbah caringbah Wanderinghans

      Hi Wanderinghans. I Iive in Brisbane but had my PAE 7 months ago with Dr Glen Schlapoff of Liverpool Hospital in Sydney. I was the third person on Australia to have a PAE.  It was an outstanding success with no side effects.  My prostate had shrunk by a third. 

      Dr Schlapoff consulted with the Brisbane team and offered his expertise and assistance. 

      I wish you all the best're right it is by far the best available treatment for BPH. 

    • Wanderinghans Wanderinghans caringbah

      Hi Caringbah, just under two months since my PAE at Wembley hosp Brisbane.  No after effects except for some bruising and pain in my arm; it was decided to enter through my left brachial artery. Only one side of my prostate could be embolised because of some arterial anomolies in the other.  I did not experience any post proceedural pain or bleeding.  My nocturnal visits to the loo dropped from 4-5 to one over the first month. I suffer no urgency or bladder emptying issues now although my flow is still poor and initiation time protracted. In general my quality of life is much improved and i look forward to continuing progress. 

    • va312 va312 caringbah

      I am considering PAE and talked to a surgeon , who is not a 'butcher' he advised that such a procedure should not preclude a biopsy for maligncy , also cautioned that if a minute  hotspot remains, one can be lulled into complacency when systems relating to urine frequency show signs of improvement.Though would share this and grateful for comments.

    •  nealpros nealpros va312

      Any biopsy should be guided by an MRI. To do otherwise is to be shooting in the dark, and runs the risk of missing a cancer that's there, or finding a non aggressive tumor while missing an aggressive, dangerous one. Also, the biopsy itself is dangerous. Think about pushing a needle several times through the wall of the inside of your rectum, teeming with good and bad bacteria, and into your prostate. Does that not sound like a great way to get a hell of a prostititus? They are very difficult to cure.

      So you should never consider a biopsy unless the MRI shows very dangerous areas that must be biopsied because they look like cancer.


    • Roseland Roseland nealpros

      I totally agree.  My first biopsy was ultrasound-guided transrectal, and I ended up in Accident and Emergency with septacaemia; four days as an in-patient - horrible.  My second biopsy was a template guided transperineal, and I had to be catheterised afterwards.  I got a CAUTI from that and spent three months on the whole spectrum of antibiotics, ending up with daily visits from the district nurse to put me on a gentamycin drip.

      It would be a cold day in hell before I'd agree to another biopsy.

    • frank74205 frank74205 william79680

      Hi William, Sounds great, so glad to hear the PAE was succssful? Were you in PAE clinical trial? Their is one going on in CHicago Northwestern Hospital.

      I wonder of age is a quailfied condition  for PAE? Did you have rentention and enlarged prostate before PAE?

      Thanks so much William for this info>

    • jimjames jimjames victor17370

      Hi Victor,

      I see you are asking around regarding PAE results which is good. If you read the threads, and I'm sure you have, you will find that some men have had excellent results and some not so excellent. 

      What I have concluded after seeing this good result/bad result phenomenon, be it PAE, Urolift, REZUM, TURP, GL, etc, -- 

      is that results often don't depend on the type of the procedure, or even who performs it, but rather the condition of both your bladder and prostate going into the procedure. And this is one reason why, for example, that trial results are often quite different from real world results -- because in a trial there are often very strict inclusion/exclusion criteria.

      I don't know your situation, but in general, prostate size reduction surgery or procedures are the most successful when the bladder is not overly compromised in terms of size, trabeculation and detrussor (muscle) function.

      Individual doctors have their own screening methods, and some it appears do very little screening. I read here for example that Dr. Bagla (PAE specialist) puts some credence in a trial by Tamusolin (flomax). In other words he postulates that those that do well on Tamusolin tend to have better PAE results than those that don't. This makes sense because Tamusolin works on the obstruction side (smooth muscle relaxant) but may tend not to work if the bladder is atonic. Even better IMO would be the gold standard in evaluating bladder function -- urodynamics, and preferably video urodynamics.

      Again, don't know your situation, and you may indeed be a good candidate for PAE, but if your bladder is very flaccid, if you have a median lobe, and/or if you have significant retention, you might want to pause and make sure your bladder is in good enough condition for a successful outcome.

      Because if not, all of the procedures here, even with the best doctors performing them, can have compromised outcomes.


    • victor17370 victor17370 jimjames

      Thanks for the information Jim I had a urodynamic performed,MRI, and blood work, I am 52 and have been suffering from BPH for 2 years now, I mainly struggle in the at night when I sleep.

      Wake up about 5,6 times and can't go.

      During the day I'm ok.. what other tests should I get? I spoke to Nichole and the lead nurse and that's what they recommended.. is there a way to check lobe size?

    • bob120 bob120 jimjames

      I would add that the procedures mostly do well in regard to preventing retention, but have more mixed results in regard to eliminating night time urination. For many people the number of times getting up at night decreases but is not eliminated.

    • jimjames jimjames victor17370

      Hi Victor,

      Good for nurse Nichole! Urodynamics, is often considered the gold standard in assessing the cause(s) of voiding function. I assume you "passed" which probably means no nerve damage plus adequate pressure (probably high pressure) with a low flow (from obstruction). Never hurts to get and read your own copy of the results because you will then be guaranteed that at least one person has read it smile

      Median Lobe size is computed with imaging studies such as  Transrectal ultrasonography (TRUS) and MRI. Since you've had an MRI, you should ask if you have an enlarged median lobe. If they draw a blank, pursue further.

      Beyond that, curious if you tried Tasulosin (Flomax), Daily CIalis or other smooth muscle relaxants for BPH? It's usually a first step before surgery. Also, do you know your PVR (post void residual) which is usually measured via bladder scan in your urologist's office and/or by ultrasound as part of a bladder/kidney scan/void test.

      What do you mean "wake up 5....and can't go"? Do you feel a strong urge? What happens when you try to go? Anything come out? Pain?


    • jimjames jimjames bob120

      Hi Bob,

      If the bladder is significantly atonic (stretched), then good results may be difficult from any of the procedures and there will be retention. That's why you read here so many people still have to self cath (CIC) after a PAE or Urolift. They still are retaining.

      Night time frequency (nocturia) is sometimes caused by retention, but often it's simply a byproduct of the aging process. As we get older we tend to retain more fluid during the day and release more fluid at night. That, combined with a slightly smaller bladder capacity as we age, results in more night time trips. There are also other non-bph causes of nocturia such as sleep apnea. 

      So, yes, we read here that many people have had most of their symptons resolved through this surgery or that but their nocturia still remains. For reasons given, I'd say that often this has nothing to do with the surgery but mostly with father time.



    • victor17370 victor17370 jimjames

      I wake up 5 or 6 times at night I find it harder to urinare in the evening hours and sometimes very little come out, I have to push hard, And I alway never emptie completely. I am on Rapid flow 4 mg

      I tried flow max but my body got used to it

      And it stopped working. I find if I don't go and my blatter fills up its harder to urinate

      So I try to go when the urge comes.

      I have to watch out for beer and driving home in traffic..

    • jimjames jimjames victor17370

      Sounds typical of BPH related retention. Did they tell you what your post void residual (PVR) is? As stated earlier, your PAE results will be in a large part dictated by the condition of your bladder going into the procedure. So, if it makes sense, check out your urodynamic results, median lobe size, etc, to make sure you have a good chance of success. 


    • victor17370 victor17370 jimjames

      You are very hopeful thank you so much

      For your knowledge you have a wealth of information. I think you should write a book to inform men who rely on the urologists because there are a lot of thinks to consider before surgery. I will have some great questions to ask now.

      Thanks again my friend.

    • jimjames jimjames victor17370

      Thanks for the nice words Victor. Unfortunately, many urologists tend to rush the process and steer people toward whatever surgery they happen to do. And it's not just urologists, it could be interventional radiologists or other practioners as well. Hopefully, at least they do a proper screening which allows them to present to their patients realistic outcomes, but we see here that is not always the case. 

      Like I assume yourself, I favor the less invasive procedures, like PAE, when the conditions are favorable for success. Personally, I was offered TURP three years ago, but chose self catherization (CIC) over surgery, and it turned out it was the right decision for me. At that time PAE, Urolift and FLA weren't really mentioned much.


    • jimjames jimjames victor17370

      Hi Victor,

      No PAE or surgeries of any kind. I was able to rehabilitate my bladder through self catherization (CIC) alone to the extent that today I have practically eliminated all of my BPH symptons and only have to cath maybe once or twice a month. It did take time, however, and I wasn't able to significantly wean off the catheters until year two. But even when I was cathing up to 6x/day, it really wasn't that big a deal once you I got used to it. This does not mean that everyone who practices CIC will be able to wean off catheters, but it did work out that way for me. There's more on CIC in the self cathing threads if you're interested.


    • bob120 bob120 victor17370

      Hi Victor,

      I had exactly your symptoms, being unable to urinate more than a little bit at a time, waking up at 3AM feeling like I was busting and not able to go at all until I had a drink of whiskey and walked around my kitchen for about 10 miutes. It sounds like you are blocked. 

      I second Jim's advice to find out your PVR (post void residual). This can be done by self cathing into a urinal with ml. markings, or with an ultrasound. They ultrasound your bladder, then have you urinate in the toilet, then ultrasound the bladder again to see how much urine is retained after you void. Before my procedure I was retaining about 400 ml. I think anything over 250ml can be a problem and may damage your kidneys in the long run as your urine backs up from the bladder back into the kidneys.

      I have had two Greenligh lasers, and finally a classic turp. I recommend the turp over the Greenlight laser. I think it does a better job (the turp slices away prostate, while the laser burns it away),  was an easier recovery (6 weeks vs. 8 weeks with the GL laser), and with the turp you can send tissue to pathology to check for cancer, with the laser all the tissue is burned up.

      Self cathing took a few tries before I got it right. Self cathing was better than waiting in the ER to be cathed with 1400ml of urine (very painful), but I personally couldn't see doing it 4 to 6 times a day, unless I had to. My cousin's husband had a stretched out bladder and even after a turp, had to resort to cathing 4 times a day for life.

    • victor94298 victor94298 bob120

      Thanks Bob for the information I really

      Am thinking about the PAE procedure .

      My urologist wanted to do the urololift

      But just the thought of staples smashing the prostate up, is not a fix, theTURP , where they remove the inner part of the prostate

      Then peeing razors for two weeks and still have a large Prostate with the urge to pee all the time. Retro ejaculation just to many side effects.

      I look at it like this prostate is enlarged

      There has to be a way to shrink it.

      And I think the PAE is a quicker recovery

      Less side effects and has promising results. If I can shrink it that would be the way to go.

      Thanks and good luck with that second go


    • frank74205 frank74205 jimjames

      Hi JIm , I need your advice on this? Sometimes i don't get the urge to pee.and was wondereing if i should do cic ?I can wait 5 or 6 hours at times. Is it best to just keep on a schedule,like every 4 hours even if i don't get the urge to pee?



    • jimjames jimjames frank74205

      Hi Frank,

      When the bladder gets stretched, the urge to pee isn't always a reliable indicator of when to cath. The best indicator is the actual volume that comes out of the catheter. If it's under 400ml most of the time, then your frequency is OK. If I remember correctly, in your case you have to cath 6x/day to keep the volumes under 400ml. 


    • frank74205 frank74205 jimjames

      Hi JIm, What you say makes good sense. I have a dysfuntionable bladder I assume that means it's stretched. You say even if one had urolift or PAE , one would still have to CIC? Do You think GL or Turp have the same effect?



    • jimjames jimjames frank74205

      Hi Frank,

      Yes, based on what you've posted, sounds like your bladder is stretched. It's unclear from your urodynamic test whether you could void naturally with a urolift or PAE. Maybe your upcoming cystoscopy will give more information. GL or TURP would probably give you a better chance of being able to naturally void, but no guarantees. Both of those are major surgeries compared to Urolift, with potentially more side effects, so you have to take that into consideration. 


    • bob120 bob120 frank74205

      If you go that route I would recommend the TURP. I had 2 GLs and a TURP and the TURP had better results than either of the GL's. Also with a TURP they send the removed tissue to pathology to test for cancer, while with the GL's the tissue is vaporized and there is nothing left to test. I was very concerned about retro, but it turned out to not bother me at all. You still get the pumping sensation of the orgasm, but the semen goes into the bladder instead of down and out. I personally haven't noticed any loss of sensation or pleasure.

    • bob120 bob120 frank74205

      Hi Frank, If you can get by without the surgery, do so. There can be a painful recovery for a couple of months, urgency, frequency. leaking, etc. One side effect can be heavy bleeding, another is just the pain of urinating for up to 8 weeks due to the trauma to the prostatic urethra. If you are in retention or retaining more than a few hundred cc's in your bladder after a normal void, you need to do something. Otherwise if it's just frequency during the day and getting up at night, there may be other things you can do, like cathing. If I remember correctly you are not getting the urge to void even when your bladder is full. In that case, surgery won't help you. When Dick Clarke died they said he had gone in for a routine prostate procedure. 

    • jimjames jimjames frank74205


      It depends on what your volumes are. If they're averaging 300-400, then I'd just leave things the way they are. If on the other hand, you're getting the urge at 100ml, then you could cut down on your cath schedule. In between that (250 range) it's really a judgement call what is more convenient for you. 


    • richard11472 richard11472 victor17370

      Hi Victor, I am in the same situation, okay during the day but trouble starting flow when getting up twice per day, I have been reading this site for the past 6 months as I try and decide between PAE, FLA, or Urolift. The FLA sounds like the most effective one, although it is more invasive with a tougher recovery.

      Have you had a procedure done yet? Please post how things are going for you.


    • victor94298 victor94298 richard11472

      Hello Rick just read your message

      And wanted to respond, I would like to say that FLA was the way to go I had the procedure done April 18 of this year 3 months ago.

      I am 100 % back to normal I am sleeping through the night, I don't even think about the restroom, my sex life is better! everything is better I am very pleased with the out come. I was worth every dime.

      I hated always running to the restroom

      Or going for a ride with my friends and get stuck in traffic wondering if I can reach our destination without having to stop somewhere.. FLA is precession at is best

      And the urethra is left intact Dr. K removes

      The part that is causing the problem nothing more. Recovery is about 2 to 3 weeks, and After that you are home free..

      I will send you a private message with my number if you want to talk..

      Don't do the urolift

    • jimjames jimjames richard11472


      What is your PVR? Do you know the volume of your night time and day time voids? You want to first determine if the reason you're getting up at night is because of incomplete emptying or something else such as nocturia polyuria. Many men, especially as they get older, produce a greater percentage of  urine at night than when they were younger. If this is the case, then a prostate reduction procedure will not help in terms of getting up at night. 


    • bob120 bob120 jimjames

      Hi jim, I think I got Frank mixed up with another poster who had overload incontinence due to large volumes in his bladder but no sensation of having to go. My cousin's husband is in that situation and has been cathing permanently. The TURP did him no good because he lost all elasticity in his bladder. Reading some of the previous posts I see Frank does have the sensation of having to go, but can't which indicates a blockage that probably would be improved by a procedure. A blockage can be in the prostatic urethra, the bladder neck, or a third lobe intruding on the bladder and blocking the opening. The problem is that one of Frank's urologist said he's too old for surgery, which might be the case. If he is doing well with cathing, then that might be the best path. I also used the 14F speedicath when I cathed because the 12F would just bend inside of me and couldn't push through the obstruction. I haven't cathed since after my 2nd GL in Dec. 2013, and the TURP in June 2015 finally got my flow and PVR straightened out. The third procedure finally worked like the first one was supposed to.

    • jimjames jimjames richard11472


      You might do a void log. Write down the time and amount of each void. If it turns out that more than 40% of your void volume is at night, then you have nocturia polyuria. If that's the case, a prostate reduction surgery or procedure may not help you. 


  • bruce19007 bruce19007 ChuckP

    Hi Everyone,   On November 21st 2014 I had a Prostatic Arterial Embolization procedure at Kaiser Hospital in Oakland CA.  I found that there is little information about what to expect after the procedure.  I know of one other person who had the procedure and he had a vastly different result.  He had a very painful 5 days after the procedure but then had a total relief of BPH symptoms and a return to normal PSA.

     For me the procedure itself was easy.  I was aware but drifted in and out of sleep.  It took 2 and a half hours.  I had significant bruising after the procedure that did clear up in about two weeks.  For the two and half weeks after I had a very small amount of blood in semen and a couple of times after a bowel movement but never during urination.  My pain level was minimal even right after the procedure but I was taking Naproxin for the 10 days after the procedure.  By one month I felt normal again but have had only marginal improvement in flow.  As of today 1/6/15,  I still need to take .8mg Flomax every day but I can almost sleep through the night getting up only once so things are better, but not as good as I have hoped.  I really wanted to be off the drugs.  I don’t know how long it can take to get the full effect of the procedure so maybe it will still get better.

    I should note that my stream slowed very suddenly at age 25.  Literally overnight I had a 25% reduction in flow.  I saw urologists for two years, had a meatodomy and a complete urodynamics test.  It showed a constriction at the bladder neck but none of the doctors could explain why.  The only drug at the time was minipress and I didn’t want to take it. and I figured I could just get used to peeing slower.  It was fine until I hit my 50’s when it started to get worse and I go to the point where I could barely pee at all, especially late at night.  This is what drove me to try the PAE procedure. 

    I sincerely hope all of us get better.  I am willing to talk to anyone who has questions about my experience.


    Emis Moderator comment: I have removed the link as it was to a site unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.

    • t90373 t90373 bruce19007

      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.

    • bruce19007 bruce19007 t90373

      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...


    • t90373 t90373 bruce19007

      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.

    • william79680 william79680 t90373

      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.


    • t90373 t90373 william79680

      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?

    • william79680 william79680 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. 


    •  nealpros nealpros t90373

      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.


    • t90373 t90373 nealpros

      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.

    • t90373 t90373 bruce19007

      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!

    • bruce19007 bruce19007 t90373

      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.

    • t90373 t90373 bruce19007

      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.

    • caringbah caringbah t90373

      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. :-)

    • bill80656 bill80656 caringbah

      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.