MY HORRIBLE PAE EXPERIENCE
Posted , 6 users are following.
I made a PAE one and half year ago.
First 30 days were horrible and very painful. Excruciating pain when begin urinating (no medicine was able to subside it), blood in urine and feces during 30 days.
Sometimes I urinated on myself (flow was released) and I passed a big chunk of something
like a piece of my prostate and which cause me great horror.
After 60 days I began to urinate very well (like a young, I´m 67) with strong and great volume.
After one year flow diminished a lot, but I´m stiill able to pass 200ml / 250ml more slowly.
Today I drink 1,5 lt of water until 1p.m to avoid urinate by night.
Worst symptom right now is great difficult in begin urinating. Don´t want to use alpha-blockers.
Prostate weight before: 120 and right now 95.
My doc said "new arteries have grown but no worries, we can make a second PAE".
I learn from a Dr. Pisco article that some arteries must be isolated during PAE so you won´t
feel pain after it (penile and proximal bladder arteries). Is that true?
I would like to ask you if you can guide me to an article which shows me success rate of a
second PAE and which strategies you use to fight pain after that surgery.
How can I protect my only one kidney from contrast dye during MRIs? I read that NAC plus
vit C just before the test can do the job. Any clinical trials proving it?
0 likes, 31 replies
dl0808 lrp1
Posted
For readers who are considering PAE, this post attempts to answer the questions
Disclaimer：not oppose to PAE, no interest in and knowledge of PAE. Did this research by google search trying to answer a question posted by a thread member. No personal attack, please. Let’s discuss only scientific evidence and proof.
When I googled PAE, came across the following two publications. My selection is arbitrary. Please google yourself and select other papers u like or support ur views.
(I) PAE Clinical Trial Results：
Title: Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity‐matched comparison with transurethral resection of the prostate (the UK‐ROPE study)
Authors: Alistair F. Ray John Powell Mark J. Speakman Nicholas T. Longford Ranan DasGupta Timothy Bryant Sachin Modi Jonathan Dyer Mark Harris Grace Carolan‐Rees Nigel Hacking
Date published: 12 April 2018
Link:
onlinelibrary？wiley.com/doi/full/10.1111/bju.14249
(Free access; in the above link, replace ? by a period that is a dot.)
One section of the paper discussed result for reoperation rate, given below:
“Reoperation Rates
The reported reoperation rate up to 12 months post‐procedure for PAE was 11/216 (5.1%). An additional 32 patients (14.8%) were reported as having, or awaiting, a reoperation outside of our 12‐month follow‐up period. Three of these patients received only unilateral embolization and nine had median lobe enlargement. Four had small prostate volumes, with two of these additionally having a high bladder neck. The remaining cases had late clinical failure with no clear cause identified. The total reoperation rate for PAE cases was 43 (19.9%). Table 1 shows these overall reoperation rates, across all procedural groups.”
(table 1 did not show up. plse read it from the original paper.)
Comments by DL:
1）not sure how long is ‘after 12 months’. Let’s assume is 24 month. If so, 20% of reoperation rate in 2 years is very high. In comparison, the reoperation rate for holep is about less than 5% within 10 years.
(II) A review of a clinical trial paper on PAE
Title: Re: Comparison of Prostatic Artery Embolization (PAE) Versus Transurethral Resection of the Prostate (TURP) for Benign Prostatic Hyperplasia: Randomised, Open Label, Non-inferiority Trial
Author: Stephan Madersbacher
Department of Urology, Kaiser Franz Josef Hospital, Sigmund Freud Private University, Vienna, Austria
Date: Published Online: August 03, 2018
Link:
europeanurology?com/article/S0302-2838(18)30533-5/full-text
(Free access; in the above link, replace ? by a period that is a dot.)
“Abt D, Hechelhammer L, Müllhaupt G, et al BMJ 2018;361:k2338
Expert's summary:In this open-label, randomised clinical trial (RCT) the authors compared the efficacy and safety of prostatic artery embolisation (PAE; n = 48) and transurethral resection of the prostate (TURP; n = 51). The primary endpoint was improvement in International Prostate Symptom Score (IPSS) at 12 wk. The mean IPSS reduction at 12 wk was 9.2 points for PAE and 10.8 points for TURP (noninferiority for PAE not shown; p = 0.17). No differences between the two study arms were observed for IPSS-quality-of-life, Chronic Prostatitis Symptom Index, and International Index of Erectile Function (IIEF) scores. Marked differences were observed for objective parameters such as maximum flow rate (Qmax) at 12 wk (PAE 13.0 ml/s, TURP 22.5 ml/s; p < 0.001), postvoid residual (PVR) volume (PAE 70 ml, TURP 34 ml; p = 0.003), prostate-specific antigen (PAE 2.3 ng/ml, TURP 1.3 ng/ml), prostate volume (PAE 41 ml, TURP 27 ml; p < 0.001), and the degree of obstruction (shift towards less obstructive category: PAE 56%, TURP 93%; p = 0.003). Fewer adverse events occurred after PAE (n = 36) than after TURP (n = 70; p = 0.003). The authors concluded that the symptomatic improvement after PAE is comparable to that after TURP at 3 mo. PAE is associated with fewer side effects yet has disadvantages regarding functional outcomes, which should be considered when selecting patients.
Expert's comments:
PAE is a promising minimally invasive treatment option for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) that is performed under local anaesthesia. Despite a number of studies published in the past decade, evidence is still limited [1,2]. There is clearly a need for high-quality comparative RCTs [1,2]. The few RCTs available to data have been criticised for severe methodological limitations.
Abt et al [3] should be congratulated on a well-designed, open-label RCT comparing PAE to TURP. From a methodological standpoint, this is the best RCT so far available for PAE. The subjective improvement in IPSS after PAE and TURP was comparable, although the IPSS at 3 mo was numerically lower after TURP (6.8) than after PAE (10.2) [3]. Marked differences were seen for all objective and urodynamic parameters. PAE had an advantageous safety profile. In contrast to many previous PAE reports, this (reliable) study showed a high rate of ejaculatory dysfunction following PAE (56%), while the IIEF score revealed no relevant changes in both study arms during the 3-mo follow-up [3].
Despite a favourable short-term symptomatic outcome, the main issue remains the durability of PAE. The rather poor outcomes for Qmax, PVR, and urodynamic data suggests that the long-term efficacy will be limited and ultimately a high number of patients, particularly those with obstruction, will experience failure and require additional treatments [3,4]. Prostate volume reduction following PAE is in the range of 25%, similar to that achieved with 5α-reductase inhibitors [2–4].
The UK-ROPE study, a propensity-matched cohort study comparing TURP to PAE, revealed similar data and trends as the Swiss trial [4]. The total reoperation rate after PAE (maximum follow-up 36 mo) in the UK-ROPE study was 20% [4].
Current evidence suggests that PAE might be a viable option for symptomatic patients with no or minimal outflow obstruction or those unfit for surgery; hence, the main competitors for PAE are medical therapy and devices such as UroLift. The myth that PAE is devoid of sexual side effects (in particular ejaculatory dysfunction) has been clarified by the Swiss RCT.
Finally, long-term data (follow-up >2 yr) from large-scale, high-quality, preferably randomised clinical trials are required to be able to determine the future role of PAE in the armamentarium of minimally invasive BPH/LUTS therapy. Until these data are available PAE has to be considered as experimental and should not be performed outside clinical trials.
Conflicts of interest
The author has nothing to disclose.”
Highlights (compiled by DL):
A) “IPSS after PAE and TURP was comparable” and “PAE had an advantageous safety profile”
B) “this (reliable) study showed a high rate of ejaculatory dysfunction following PAE (56%)”...... “The myth that PAE is devoid of sexual side effects (in particular ejaculatory dysfunction) has been clarified by the Swiss RCT.”
C) “Despite a favourable short-term symptomatic outcome, the main issue remains the durability of PAE. The rather poor outcomes for Qmax, PVR, and urodynamic data suggests that the long-term efficacy will be limited and ultimately a high number of patients, particularly those with obstruction, will experience failure and require additional treatments”
D) “Prostate volume reduction following PAE is in the range of 25%, similar to that achieved with 5α-reductase inhibitors [2–4].”
E) “The UK-ROPE study, a propensity-matched cohort study comparing TURP to PAE, revealed similar data and trends as the Swiss trial [4]. The total reoperation rate after PAE (maximum follow-up 36 mo) in the UK-ROPE study was 20% [4].”
F) “Current evidence suggests that PAE might be a viable option for symptomatic patients with no or minimal outflow obstruction or those unfit for surgery; hence, the main competitors for PAE are medical therapy and devices such as UroLift.”
G) “Finally, long-term data (follow-up >2 yr) from large-scale, high-quality, preferably randomised clinical trials are required to be able to determine the future role of PAE in the armamentarium of minimally invasive BPH/LUTS therapy. Until these data are available PAE has to be considered as experimental and should not be performed outside clinical trials.”
dl0808 lrp1
Posted
For readers who are considering PAE, this post attempts to answer the questions:
PAE durability (reoperation rate or longevity)
the concern of having enlarged medium lobe
How successful PAE can preserve ur sexual functions
the views of one urologist on PAE based on published clinical trial results
Disclaimer：not oppose to PAE, no interest in and knowledge of PAE. Did this research by google search trying to answer a question posted by a thread member. No personal attack, please.
When I googled PAE, came across the following two publications. My selection is arbitrary. Please google yourself and select other papers u like or support ur views.
(I) PAE Clinical Trial Results：
Title: Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity‐matched comparison with transurethral resection of the prostate (the UK‐ROPE study)
Authors: Alistair F. Ray John Powell Mark J. Speakman Nicholas T. Longford Ranan DasGupta Timothy Bryant Sachin Modi Jonathan Dyer Mark Harris Grace Carolan‐Rees Nigel Hacking
Date published: 12 April 2018
Source:
onlinelibrary？wiley?com/doi/full/10?1111/bju?14249
(Free access; in the above link, replace ? by a period that is a dot.)
One section of the paper discussed result for reoperation rate, given below:
“Reoperation Rates
The reported reoperation rate up to 12 months post‐procedure for PAE was 11/216 (5.1%). An additional 32 patients (14.8%) were reported as having, or awaiting, a reoperation outside of our 12‐month follow‐up period. Three of these patients received only unilateral embolization and nine had median lobe enlargement. Four had small prostate volumes, with two of these additionally having a high bladder neck. The remaining cases had late clinical failure with no clear cause identified. The total reoperation rate for PAE cases was 43 (19.9%). Table 1 shows these overall reoperation rates, across all procedural groups.”
(Please read the original paper for table 1).
Comments by DL:
1）not sure how long is ‘after 12 months’. Let’s assume is 36 month. If so, 20% of reoperation rate in 3 years is very high. In comparison, the reoperation rate for holep is about less than 5% in 10 years.
(II) A review of a clinical trial paper on PAE
Title: Re: Comparison of Prostatic Artery Embolization (PAE) Versus Transurethral Resection of the Prostate (TURP) for Benign Prostatic Hyperplasia: Randomised, Open Label, Non-inferiority Trial
Author: Stephan Madersbacher
Department of Urology, Kaiser Franz Josef Hospital, Sigmund Freud Private University, Vienna, Austria
Date: Published Online: August 03, 2018
Source:
europeanurology?com/article/S0302-2838(18)30533-5/full-text
(Free access; in the above link, replace ? by a period that is a dot.)
“Abt D, Hechelhammer L, Müllhaupt G, et al BMJ 2018;361:k2338
Expert's summary:In this open-label, randomised clinical trial (RCT) the authors compared the efficacy and safety of prostatic artery embolisation (PAE; n = 48) and transurethral resection of the prostate (TURP; n = 51). The primary endpoint was improvement in International Prostate Symptom Score (IPSS) at 12 wk. The mean IPSS reduction at 12 wk was 9.2 points for PAE and 10.8 points for TURP (noninferiority for PAE not shown; p = 0.17). No differences between the two study arms were observed for IPSS-quality-of-life, Chronic Prostatitis Symptom Index, and International Index of Erectile Function (IIEF) scores. Marked differences were observed for objective parameters such as maximum flow rate (Qmax) at 12 wk (PAE 13.0 ml/s, TURP 22.5 ml/s; p < 0.001), postvoid residual (PVR) volume (PAE 70 ml, TURP 34 ml; p = 0.003), prostate-specific antigen (PAE 2.3 ng/ml, TURP 1.3 ng/ml), prostate volume (PAE 41 ml, TURP 27 ml; p < 0.001), and the degree of obstruction (shift towards less obstructive category: PAE 56%, TURP 93%; p = 0.003). Fewer adverse events occurred after PAE (n = 36) than after TURP (n = 70; p = 0.003). The authors concluded that the symptomatic improvement after PAE is comparable to that after TURP at 3 mo. PAE is associated with fewer side effects yet has disadvantages regarding functional outcomes, which should be considered when selecting patients.
Expert's comments:
PAE is a promising minimally invasive treatment option for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) that is performed under local anaesthesia. Despite a number of studies published in the past decade, evidence is still limited [1,2]. There is clearly a need for high-quality comparative RCTs [1,2]. The few RCTs available to data have been criticised for severe methodological limitations.
Abt et al [3] should be congratulated on a well-designed, open-label RCT comparing PAE to TURP. From a methodological standpoint, this is the best RCT so far available for PAE. The subjective improvement in IPSS after PAE and TURP was comparable, although the IPSS at 3 mo was numerically lower after TURP (6.8) than after PAE (10.2) [3]. Marked differences were seen for all objective and urodynamic parameters. PAE had an advantageous safety profile. In contrast to many previous PAE reports, this (reliable) study showed a high rate of ejaculatory dysfunction following PAE (56%), while the IIEF score revealed no relevant changes in both study arms during the 3-mo follow-up[3].
Despite a favourable short-term symptomatic outcome, the main issue remains the durability of PAE. The rather poor outcomes for Qmax, PVR, and urodynamic data suggests that the long-term efficacy will be limited and ultimately a high number of patients, particularly those with obstruction, will experience failure and require additional treatments [3-4]. Prostate volume reduction following PAE is in the range of 25%, similar to that achieved with 5α-reductase inhibitors [2-4]
The UK-ROPE study, a propensity-matched cohort study comparing TURP to PAE, revealed similar data and trends as the Swiss trial [4]. The total reoperation rate after PAE (maximum follow-up 36 mo) in the UK-ROPE study was 20% [4].
Current evidence suggests that PAE might be a viable option for symptomatic patients with no or minimal outflow obstruction or those unfit for surgery; hence, the main competitors for PAE are medical therapy and devices such as UroLift. The myth that PAE is devoid of sexual side effects (in particular ejaculatory dysfunction) has been clarified by the Swiss RCT.
Finally, long-term data (follow-up >2 yr) from large-scale, high-quality, preferably randomised clinical trials are required to be able to determine the future role of PAE in the armamentarium of minimally invasive BPH/LUTS therapy. Until these data are available PAE has to be considered as experimental and should not be performed outside clinical trials.
Conflicts of interest
The author has nothing to disclose.”
Highlights (compiled by DL):
gene97713 dl0808
Posted
Let me add something to that very thorough and excellent analysis. The mention review is only one, albeit teh latest and seemingly comprehensive review but doesn't use very many cases.
Let me add some of my personal comments
High reoperation rate for PAE is skewed and is mostly due to the one side embolization. when another side arteries are not suitable due to the atherosclerotic narrowing and small size of the prostate. Large median lobe is a questionable obstacle because the way each prostate will shrink and what part will die is unpredictable. Recent PerFected PAE which targets median lobe is much more successful. Here is the abstract from from a Publication of year 2014.
Prostatic artery embolization requires a refined technique to achieve good imaging and clinical success. The PErFecTED (Proximal Embolization First, Then Embolize Distal) technique has produced greater prostate ischemia and infarction than previously described methods with clinical improvement of lower urinary symptoms and lower recurrence rates. The microcatheter should cross any collateral branch to the bladder, rectum, corpus cavernosum, gonad, or penis and be placed distally into the prostatic artery before its branching to the central gland and peripheral zone. This technique allows better distribution of embolic material in the intraprostatic arteries and reduces risk of spasm or thrombus. Because benign prostatic hyperplasia develops primarily in the periurethral region of the prostate, the urethral group of arteries should be embolized first. Subsequent distal investigation and embolization completes occlusion and stasis of blood flow to the prostatic parenchyma. Since we added the second step to the PErFecTED technique, we have observed infarcts in all patients submitted to prostatic artery embolization.
My IR Dr. Picel told me that he used PERfecTed PAE at least on one side of my prostate. He doesn't believe in median lobe theory. Maybe my procedure was a relative success due to that innovative approach.
I would also like to comment to a few of your statements:
“IPSS after PAE and TURP was comparable” and “PAE had an advantageous safety profile”
*That feature was the most important for me. Except for the UroLIft, any other procedure has more side effects and possible lifelong complications. The older the patient, the more are the chances of the complications. *
“this (reliable) study showed a high rate of ejaculatory dysfunction following PAE (56%)”...... “The myth that PAE is devoid of sexual side effects (in particular ejaculatory dysfunction) has been clarified by the Swiss RCT.”
3.**I I don't know where this number comes, but all the previous clinical studies of PAE showed very low rate of lasting sexual and ejaculatory dysfunctions. If we are talking possible RE, 56% is much better than almost 90% for TURP and HoLEP.
“Despite a favourable short-term symptomatic outcome, the main issue remains the durability of PAE. The rather poor outcomes for Qmax, PVR, and urodynamic data suggests that the long-term efficacy will be limited and ultimately a high number of patients, particularly those with obstruction, will experience failure and require additional treatments”
4.**As most table shows Qmax, PVR and other numbers are similar in PAE and TURP (with 20-30% advantage for TURP). Word "particularly with obstruction" are senseless. Nobody will resort to any of those procedure until they have partial or total obstruction. Whether this additional 20% improvemnt are worth the risk of ED or incontinence, I don't know. Should be a matter of personal decision, not even your URO **
“Prostate volume reduction following PAE is in the range of 25%, similar to that achieved with 5α-reductase inhibitors .”
5.**Who cares about volume reduction, if symptoms are mostly gone. **
“The UK-ROPE study, a propensity-matched cohort study comparing TURP to PAE, revealed similar data and trends as the Swiss trial. The total reoperation rate after PAE (maximum follow-up 36 mo) in the UK-ROPE study was 20%”
Possibly, but this is a new technique, very advanced, requires 10 years of IR experience, ans still pretty safe.
“Current evidence suggests that PAE might be a viable option for symptomatic patients with no or minimal outflow obstruction or those unfit for surgery; hence, the main competitors for PAE are medical therapy and devices such as UroLift.”
6.***Another nonsense. Qualification and insurance coverage in US for UroLift is less than 80 g prostate , while for PAE it's preferably greater than 80g. Most of the patients of PAE(me included) had partial of full obstruction and used alpha-blockers and 5-alpha-reductase medicine first. *** Somebody who wrote this never performed PAE ar studied all the literature. It's based on one summary study.
“Finally, long-term data (follow-up >2 yr) from large-scale, high-quality, preferably randomised clinical trials are required to be able to determine the future role of PAE in the armamentarium of minimally invasive BPH/LUTS therapy. Until these data are available PAE has to be considered as experimental and should not be performed outside clinical trials.”
Well outdated and based on personal opinion only. Many medical centers in US offer it, in many countries it became a standard treatment for these who qualifies of course. Such an opinion makes it unreachable for many qualified patients and becomes a reason for most US insurances to deny related CPT codes for the coverage. The question with Medicare coverage is still open, albeit many doctors claim it;s covered by Medicare.
There is no ideal approach and no silver bullet when it comes to the treatment of sever BPH. If it's not severe, carefully adjusted dose of alpha-blockers is the best. It's a fallacy that some patients can't stand them. Unless you are allergic to them, or have very low blood pressure for other reasons, a good physician will always adjust the medicine and the dose. It's much safer than any invasive procedure. Uroxatral (Alfuzosin) doesn't cause RE and generally well tolerated even in doses twice a day 10 mg. I used them successfully for 9 years with reasonable quality of life, experiencing no related ED or RE. The downside of alpha-blockers is taht your prosatte continues to grow and at some point you are obstructed and not a good candidate for many surgeries, except for open abdomen radical prostatectomy.Personally I'm a strong opponent of 5-alpha-reductase prescriptions, unless you are 80 years old and are already disqualified for any other surgical methods. By design Avodart (dutasteride) is an inhibitor of production (conversion to) of Hydrotestosterone, which the almost only hormone in males body responsible for libido, erections and other seual functions. Yes, in some men, particularly with very large prostate and preferably unobstructed bladder neck, it cam shrink teh prostate by 10-20%, not 25-28% that PAE achieves. It doesn't create infarctions in teh prostate as PAE does, which alleviates the obstruction by the median lobe. The cost of using Avodart is grown scalp hair and total loss of libido and erections. It differs from man to man but 3% claimed by Big Pharma is a total fallacy. I tried it 10 years ago, when it was new and no research was published on how it causes permanent ED and total loss of libido. After two weeks I stopped using it and took me two years to recover from these side effects.
So comparing the effectiveness of dutosteride to PAE is to me similar to comparing experiments of Nazi Dr. Mengele on human survival in icy water and people practicing swimming in cold water.
There are plenty of well documented recollection of Avodart users on this site. Anybody who tried themselves still suggests to replace PAE with Avodart because they have similar effects?
Her is quote from the recent Web Publication (2017)
In fact, approximately 1,370 lawsuits have been filed against Merck, which markets finasteride. A class-action lawsuit against the company will examine the pharmaceutical giant's culpability in the multitude of reported sexual side effects potentially associated with the drug. Merck did not respond to a request for comment.
Keep in mind dutosteride is roughly 10 times stronger than finesteride.
Still want to recommend as a good alternative to PAE?
So much for that independent and impartial review written by a URO doctor who hates IR taking his "birthrite jobs" of performing TURP or prescribing dutosteride.
The best way to keep them at bay and within small clinical trials, which most HMO will never cover as out of network services.
I wish good to all you suffering from a standard ailment of an aging men. Doesn't deserve the attention of our governments how 90% of our old men suffer in public and private restrooms from inability to pee and are ashamed to ask for a better life.
The problem is so pervasive in my observation that it deserves public attention and public financing of the research on minimal invasive treatments of BPH.
Sincerely,
Gene
dl0808 gene97713
Posted
hello gene,
to avoid being moderated:
delete https//
delete www.
use ? for '.' and ask the readers to reverse the signs.
dl0808 lrp1
Posted
U are the most knowledgeable and well read member of this forum. To do the point by point rebuttal surely had taken u a lot of time. It could only come from a person who wants to help others. Ken is like that too. He is very enthusiastic and willing to spend a lot of time helping other members and and answering their concerns. I remember that when I first looked into aquablation as a surgery candidate, Ken actually called and emailed the equipment manufacturer to ask them questions on my behalf, called a urologist and corresponded with an UK expert on aquablation.
You , Ken and other members with similar attitude are people who make this forum different.
Like i said, i know zero about PAE. The only thing I could help in this debate was to present results from recent clinical trials. Interestingly, the results from them are different than your overwhelmingly positive view of PAE.
I believe that we presented the best information on PAE to readers who are considering PAE. They have both the diametrically different positive and negative views. Knowing all the facts will help them make a decision that they will not regret later as oppose to being uninformed.
gene97713 dl0808
Posted
dl0808,
Thank you for the words of appreciation. You are right . I do it exactly for that reason to educate men who suffer in silence and don't know what to do with their BPH or what method to choose. I set my mind long ago when read in the literature about research and studies of a group of Israeli doctors, who operated on PM Netanyahu, treating his BPH, I have that paper with some calculation of hydrostatic pressure in the prostate and theory that in many men with BPH, concentration of DHT (dihydrotestosterone), a derivative hormone of testosterone that is responsible for libido, erections, and early balding is dozens of time greater than in venous blood. That discovery totally contradicts common opinion that exogenous application or injection of testosterone by hypogonadal men can aggravate BPH or cause(accelerate) cancer. They proved that this total fallacy. Unfortunately most of our URO docs with all their certificates and memberships are very poorly versed in endocrinology and physiology of main organs.
My major point was and still is that the judgment about PAE shouldn't be left to URO doctors who will never perform it and consider it as a personal assault on their "birthright" territory of prostate surgery. They don't care about advances in prostate surgeries achieved in the developing countries like Brazil, Russia, China. This country use HoLEP for successful early stages of PC, develop more advanced PAE techniques, which can make PAE the primary care for BPH.
If the moderator will allow, here is the reference to the Web page of a Brazilian doc who explains in details what PErFected PAE is. This page has link to another two papers appealing to PAE as a possible primary choice for BPH treatment as a frontier of fight against BPH quality of life decrease and possibility of treatment with least (and temporary self-healing) side effects. Most of the URO doctors will deny this results (like my URO) and call it pseudoscience which makes a necrotic mess of the prostate and surrounding organs and prevents the patient from later "gold standard" surgeries. Nothing could be farther from the truth.
https://interventionalnews.com/the-perfected-technique-for-prostate-artery-embolization/
PAE is slightly less effective than TURP (which can also fail in 3-5 years, dependent on patient's hormonal profile and rate of growth) and is much more safe. In all the cases of side effects of bleeding or accidental embolization of the neighboring arteries, it was sel-healed in a few weeks or repaired surgically in very few cases. Nothing irreversible like in TURP, HoLEP or UroLift damage to important nerves prolifirating the prostate's capsule.
BTW te patient who suffers from ED after UroLift shouldn't despair but try a vacuum pump, rubber ring around pennis or as a last resort insatll a pump in teh scrotum. It's affordable and isused ny many post TURP men in their 70th who have younger parters. Their no place for sexual despair in teh 21 centuray.
I wish you all teh best sexual health and high quality of life.
Gene
kenneth1955 dl0808
Posted
DL Thank you for saying that. We are born in a time that we have the internet and this site to help us with all the procedure out there. In our Father's time and before men did not talk about there prostate or urine problem. That is not what you talked about over a beer. With this site and other we can share our thought's and our procedures to help our fellow men. We on here are all different and we come from all over. But one thing we have in common is we are all built the same and have the same problems and concerns. I have made many friends on here. We may never meet but we all have a bond. God bless Ken
dl0808 lrp1
Posted
sorry, the previous post from me was for Gene97713 not Irp1.