My PAE at UCLA April, 2019

There are also 2 other good results that I forgot to mention.

1. Before PAE, I was involuntarily leaking small amounts of urine at random. I would be sitting at my desk or standing and talking with someone, I would feel a little release...and when I looked down there was a wet spot on my pants. My Uro prescribed Myrbetriq, which I never took. But since PAE, there has been NO LEAKING!
2. The other is stronger erection, which is always a bonus!

Happy 4th of July !

Just a quick update for the silent readers out there ( like I used to be ) - 10 weeks post PAE. I read this forum for 5 years before doing anything.

My results are nothing short of a miracle! I have ZERO side effects! I have not had a single BPH symptom in 10 weeks. My stream is not like a teenager, but more like when I was in my 40's...but the greatest improvement in quality of life is that I no longer have extreme urgency followed by extreme hesitancy! This used to be a daily occurrence, now I can hold it for as long as I need to and easily void when I get to it!

I feel sorry for those of you who have had poor results from the procedure, but for me it has been better than I ever expected!

BobCats and BlackForestTerp,

Thank you for sharing your experience in such details. I wrote probably more posts on this forum than anybody of you. I'm a relative veteran of PAE, currently 15 months post-op. I have absolutely identical experience as you both have, with exception that I'm much older (almost 72, albeit in fairly good physical shape), and suffered from the whole spectrum of BPH syndrome roughly from the same age of 54, due to the inaptness of my Uro and PCP, who didn't advise anything beyond TURP or Robotic RP. I was advised against any of these procedures by my fiends, who went through any of this radical medical surgical procedures, which usually have a long recovery time with almost inevitable consequences, which many on this forum chose not to disclose or were lucky enough to get the most modern variants of them from the the best trained Uro surgeons. My prostate was 125 g at the time of PAE and it was missed by any of my doctors who performed GRE regularly, but never ordered at the an MRI, TRUX or even looked at the existent abdominal CT scans made for a different reasons. My case just reflects the state of art of our "best in the world" for profit medical services which is very little oriented to the welfare of the suffering patient but rather follows "safe" routine for the doctors, who follow the recommendations of different medical associations created by medical malpractice lawyers and voted by the narrow circle of outdated medical professionals, who stopped reading research literature 20 years ago.

I also like BalcForest had a huge median lobe, obstructing the bladder neck, thickening and diverticula of the bladder wall, bleeding from prostate arteries into urethra when straining, voiding 50-60 ml every half hour, and extreme urgency each time. I was warned by my experienced PCP and URO (both in their 60s) that PAE is pre experimental and can have dire complications.

I took my risks at UCSD with a young professor with only 13 PAE under his belt but trained IR, who learned the best PAE techniques under Dr. Ari Isaacson from NC.

My results are pretty similar. No side effects, whatsoever, my state of the urinary system is close to what it was at 40th, if not better. I don't use any meds, albeit, contrary to numerous unsubstantiated statements on this forum, there is a whole literature of improved sexual functions in BPH patients using 10 mg per day of Alfuzosin, an alpha-blocker of the last generation that help to relax the bladder neck muscles together with the muscles of the prostate's capsule, which is the main cause of BPH side effects.

My PSA dropped from 4.6 ng/ml pre-op to 1.2 ng/ml at 45 days after PAE and is in the range of 1.6-1.8 ng/ml 12-15 months later. Due to the relatively high free PSA -30% before PAE, which puts the probability of the PC around 16% at my age, we have decided not to pursue any PC studies like biopsy or 3T MRI due to the "absence of the medical needs". Probability of the low grade PC is still high at my age, but given the absence of symptoms, low PSA reading for a prostate which is still probably in the range of 70-80 g, my chances of aggressive PC are fairly small.

According to my IR and my own calculations, my total dose of radiation experienced during the PAE and previous required CT angiogram of my iliac arteries was around 90 mSv, which is a substantial dose of radiation. That is not including the approximately 120 mSv from the lifetime CT scans, X-Ray fluoroscopies, and different unneeded nuclear medicine studies ordered by different doctors in the circumstances when a low dose X-ray picture would suffice.

Regarding the perceived risk of the radiation exposure during PAE, I will address this again and the last time. Yes, it's substantial, if compared to the natural dose of 3 mSv per year in USA from all sources, including medical diagnostic and therapy irradiation. It's equivalent to 30 years of the natural irradiation from cosmic rays and Earth sources, but post the age of 60-70 the probability of a lifetime lethal cancer grows only from 52% to 54% for the US male. Very little for one person, but translated to much more death from cancer for the entire population of hundreds of thousands (if not millions) of patients around the country. 90 mSv is an exact equivalent of of 9 REM of cumulative life time radiation, which is being put into prospective is roughly 5% of the lethal dose of the exposure, or in other words, 50% of adults will die within a few month after exposure to 250 rem of X-ray of gamma radiation. Maximum radiation exposure for the workers dealing with hazardous radiation at US Government nuclear facilities is 5 rem per year or 50 mSv. Last 10 years, nobody in US Government Labs received more than 2 rem per year (or 20 mSv). Nuclear industry workers don't have elevated risk or number of deaths from radiation related cancers. I hope that analysis will help everybody to make their own decisions regarding radiation exposure risks related to any (including PAE) IR procedure. For instance, frequently used CT scan of heart and surrounding arteries for assessment of the calcium score and blockage bears 16 mSv exposure. It's a lot but compared to the chances to have a second fatal heart attack appears to have a bearable amount of internal cancer risk.

I took my chances and only future will tell me whether TURP or SRP could be abetter choice for me.

I will you all luck and never have this experience of extreme BPH symptoms again.

Personally I still hold a strong opinion that given radiation risks and difficult first weeks after PAE, when part of the organ is dying and causes us an excruciating pains around rectum, and inside during the first post-op week, it's the least invasive procedures preserving most of the functions. The success is due mostly to modern techniques and extremely well trained IR doctor (most often a professor with years of experience), rather than "for profit" operating URO surgeon.

It's not much experimental anymore, rather very sophisticated procedure performed under the control of the most advanced X-ray and computer equipment with special expensive catheters and plastic beads. Available not everywhere.

Hi Bobcats,

My brother is considering a PAE. Would it be possible for you to give us another update on how you have done since this one on April 26, 2019?

Thanks a lot and best of luck.

Thank you very much, Bobcats. I'll pass that on to my brother - who lives in Santa Barbara and is hesitant to come East to Dr. Bagla as well (I live in DC). I'm happy for you!