Miraculous treatment for BPH, PAE or prostatic artery embolization

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I have been suffering from BPH symptoms for quite a while. I began seeing a urologist due to rising PSA values which turned out to be low risk prostate cancer which is being managed through Active Surveillance. To treat the BPH symptoms I was taking two Flomax a day plus Gemtessa which is an overacitve bladder drug. Even with medication my BPH symptoms were annoying at best. My urologist suggested that the next step in treatment was either Urolift or TURP.I have heard mixed results for Urolift and the spinning blades, blood, pain and catheters associated with TURP weren't attractive.

Through some research, I learned of a procedure called PAE or prostatic artery embolization where an interventional radiologist inserts a catheter through a vein in the wrist or groin and blocks the two arteries that deliver blood to the prostate, causing the prostate to shrink. I had this procedure about 3 1/2 months ago and the results have been amazing. It is done as an outpatient procedure; you are in the hospital for about 5 hours including prep and recovery. It is done under sedation, not anesthesia, it is entirely painless and there are no aftereffects. I began to see results after about a week, and now I am peeing like a teenager, my urgency problems are gone, my nightly bathroom trips have gone from 4 or 5 to 1 or two and I am no longer taking any medications for BPH.

You won't hear about this procedure from your urologist. It is done my an interventional radiologist so the urologists don't make any money doing it. It is covered by Medicare. If you aren't yet on Medicare, be sure your insurance will cover it because it is expensive.

1 like, 14 replies

14 Replies

  • Posted

    Dr. Christopher Grilli of ChristianaCare of Delaware

  • Posted

    I also had a PAE done about 6 months ago. Like you, my procedure was painless. First couple of days afterwards had extreme urgency but once that subsided the urine flow starting getting better at about 5-6 days. Now at 6 months I'm still thrilled with the results. Wish more guys knew about this procedure. If it's done by an experienced IR, it truly is miraculous.

  • Posted

    Agree with what doug said about PAE. I had PAE done 9/1/2021, with initial prostate size of 140mL. Went for check up 12/8/2021, via MRI prostate had shrunk to 65mL. My median lobe went from severe to moderate. My IPSS score went from 25 to 9. As per doctor the prostate will continue to shrink for about a year, and probably last for about 10 years. I am pleased with these results.

    Now on to the other half of the urinary issues, the over active bladder. Luckily this problem is mild compared to the original BPH symptoms. I tried Myrbetriq and a host of other drugs to quiet the bladder, but nothing relieved my original BPH+OAB problems. Now with the BPH minimized due to PAE, I will maybe try Myrbetriq again, and also the Oxytrol patch (works for men too, as per PENN urologist.)

    • Posted

      I also had problems with OAB. Took Myrbetriq but it didn't really seem to help. Switched to Gemtessa, (originially $450 per month, down to $250 per month). Results with it weren't outstanding either. Now I take nothing for OAB and the PAE seems to have helped that as well.

  • Posted

    Doug,

    Have you had additional imaging. There are. few studies showing necrosis of the tumor.

    • Posted

      Not at this point. I usually have a 3T MRI every 2-3 years as part of my active surveillance protocol.

  • Edited

    Did any of you fellas have erectile dysfunction caused, in part, by your BPH? Did the problem improve after PAE?

    • Posted

      So far mine did not improve after PAE (3 months post), though more importantly, it did not get worse, i.e. absolutely no RE at all.

    • Posted

      This procedure sounds really interesting.

  • Edited

    Not everyone has such glowing results. My PAE resulted in little improvement in flow (I am still on flow meds), internal bleeds that still happen two years out, decreased ejaculatory volume by 50% (a proven side effect now 2021), acute kidney injury (AKI) from hospital prescribing high dose Bactrin and Ibuprofin to fight off high fever after operation which was probably sepsis introduced into my blood during the procedure. No erectile disfunction or retrograde ejaculation though.

    And, two years out, the small benefits are gone.

    I believe if my surgeon had been informed about large medium lobe contraindications, that he would have advised me not to choose this path.

    It was VERY profitable for Lovelace hospital.

  • Posted

    I had PAE done a couple of years ago, and though it seemed to help for a few weeks, by three months out it was clear that I was back to baseline.

    My prostate was 40cc which is generally considered borderline for this treatment. It works better on larger prostates.

    On the other hand, there were no negative side effects and the treatment was painless, so worth a try.

    The only caution is that you will be exposed to radiation for a while.

    BTW, I followed this with iTind last year, and had similar results. Back to baseline within a few weeks.

    • Edited

      I had a UroLift a couple of years ago which resulted in no improvements. Recently went for a 2nd opinion, which was suggested by my UroLift Physician. He indicated he is out of ideas. Couldn't see anything wrong (Cystoscopy). Everything looks good.

      2nd Opinion: Physician said; The 1st thing that came to mind was, UroLift intact and working, we are looking in the wrong place. He suggested a possible bladder neck issue.

      2 cystoscopies -- I have no scaring, median lobes, narrowoing, no spinal injuries -- In other word all looks normal.

      My Mother had her urethra and I assume bladder neck opened 2 times (1970's). She said at the time her back was hurting, had to go multiple times to empty. She had the procedure done in the hospital the 1st time and at her follow up in the office the 2nd time. Out the 1st time, awake the 2nd, she said it was very painful. Sounded like the use a spreader type of forceps to spread the Urethra and bladder neck. She hasn't had a problem since. Could this be hereditary?? Mentioned this to the 1st physician, 3 year earlier, but he indicated it wasn't a possibility.

      I'm going in for my 3rd Cystoscopy and prostate ultra sound in a couple of weeks.

      Unlikely he will find anything different on the Cystoscopy, but the Prostate size will be useful information. 1st doc didn't record the size in his records, that would have been nice to know.

      Bladder neck or external sphincter(mainly in spinal injury patients)?

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