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

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

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. 

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.

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. 

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?

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. 

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.

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 .

http://patient.uservoice.com/knowledgebase/articles/398331-private-messages

Hi Icejohn, if you are still looking to speak to someone, private message me to exchange contact info.

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

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. 

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

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

Chris 

oh I forgot to ask ....How much was the PAE is it covered by medicare or a health fund ?  

thanks again

chris

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 . 

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.

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. 

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 )))

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...

Hi sorry you to have another treatment. Was your prostate size measurement for the first treatment if you know? I have a similar issue.

Thanks lou

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!

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

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. 

 

Where did you have yours done, and who was your doctor? That doc needs more business.

Thanks,

Neal

Ok thanks for the reply

Hope you continue to do well

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

Chris

Chris,

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.

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.

 

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

 

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

Chris😊

Where do you have the PAE procedure done?  You said that Medicare paid for it.  Does Medicare generally cover PAE?

Liverpool Hospital in Sydney. Call the radiology dept. and ask for an appointment with Dr Glen Schlapoff for a PAE. He is the only one in Australia doing it .....and Medicare paid for mine. 

Thanks.  I'm amazed that Medicare paid for a procedure done outside the U.S.  I'm located in Massachusetts.  It appears that Innova in Virginia is the closest place experienced in doing PAE.

I was told at Inova Hosipital in Alexandria Virginia that medicare will pay.

I had mine on June 2 and I have not seen a bill. Others have said the same.

That is Dr. Bagla's office at Inova.

He is a vascular surgeon not a urologist.

He has done over 200 PAE's

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...

Arthur, I live in Australia. Our healthcare system is called Medicare also. All Australians are covered by it. Sorry for the confusion. I was talking about Australian Medicare. 

Would you mind revealing the approximate costs of the procedure in Sydney? I'm strongly considering PAE and have a relative close by. 

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. 

PAE hands down.

Lazer is barbaric.

you will have reverse ejaculating which sucks!

I had the TURP 2 years ago and it was horrible and didn't work.

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  

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.

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

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.

Sam

Sounds good Sam. I'm seeing Dr Schlaphoff next week for the initial assessment (MRI & Angiogram) then go from there.

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

Sam

Thank you Sam. And the very best of outcomes to you.

Stewart

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?

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.

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?

I have PM'd you since the moderator may remove the email address etc.

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 

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. 

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

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. 

Hi Wandering.

Sounds like a success. Thanks for keeping us posted. 

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.

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.

Neal

Thanks for your comments, will help in taking an informed decision.

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.

Thanks Roseland, and Nealpros thanks again.

Hi, Sounds good ,PAE--Their is a clinical trial at Northwestern Hospital in Chicago doing this. Were you ina clinical trial also? 

thanks for your info.

Hi,Can you tell me were you had the PAE  done?

thanks

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>

Hi Kc, Were you nin a clinical trial for PAE?

thanks for the info??

How are things going since it has been over a year since your pae?

Hello Chuck are you getting better I have been following your story and I hope that you are still improving. I am scheduled to have the PAE done 3 weeks..

let me know thanks

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.

Jim

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?

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.

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

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?

Jim

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.

Jim

 

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..

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. 

Jim

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.

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.

Jim

Have you had PAE procedure done?

Or have you had another type of surgery ?

I think I would be ok with one trip at night

But finish all at once. that is better then 5,6 times. So that is a good sign thanks for the input ..

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.

Jim

I will thanks again

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.

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

Around..

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?

Thanks,Jim

frank,

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. 

Jim

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?

Thanks 

Frank

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. 

Jim

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.

Hi Bob, Thanks for that info. I was told by one URO that i was to old for surgery. At almost 88 years old. What kind of side effects did you get from Turp?

thanks 

frank,

Jim, My volume varies,most of the time it's under 400 ML.Being that it's under 400 ml should i ignore this urge that i get,and try to cut down to 5 times a day?

Thanks  Jim

frank,

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. 

Frank,

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. 

Jim

Bob,

Frank has complete retention.  No natural voids. It's all CIC. The question is whether his bladder is viable enough for a good surgical outcome.

Jim

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.

Rick

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

Richard,

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. 

Jim

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.

Hi Victor

from what I can see FLA is the way to go.

Can you inbox me with the details of where you had it done and contact details, thanks very much.

WHat was the cost by the way?

regards

Jeremy

Not sure about the PVR, the tech said it was okay my last urology appointment. My main problem is difficulty beginning urine flow when getting up once or twice per night.

Richard,

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. 

Jim