My PAE didn't last and today I tried Urolift

Hi guys, I haven't posted in some time. I had a PAE in July 2019 and while it didn't ever give me a great stream, it got me off the drugs that didn't agree with me and my sex life improved to a level it had not been at for years. However, it seems that other small arteries increased their flow and 15 months after my PAE I was retaining ~150ml and my sex life was suffering heavily.

I opted for what I deemed to be the next best choice, Urolift. I found a urologist with lots of experience, it is her primary go to solution for BHP. I had a cystoscopy and rectal ultrasound Monday and 6 Urolift clips this morning (Thursday). She explained everything she was seeing during the cystoscopy and I was watching on the screen. I don't have a median lobe, or any kind of flap, but with the bladder filled with fluid and looking back at the exit, you could easily see what looked like a volcano dome, bulging into the bladder where my 63 gram prostate was extending the bladder neck inwards.

My outpatient time is the hospital was about 5 hours total, arrival to back in the car. Much quicker than my PAE when I spent 5 hours on the table in the surgical suite, and around 10 or 11 at the hospital.

However, my body's reaction is very similar in some ways. I've been home for a few hours now and I'm visiting the bathroom every 10 to 20 minutes.

Let me start with what I experienced right after the procedure, when I started remembering things after the "twilight" drugs wore off.

I felt like I needed to urinate, and of course they wanted to capture it. I can't pee lying down, so I suggested standing, when that didn't work I asked if I could sit on the toilet (elongated bowl) with the portable urinal in the bowl. 25 ml the first time, 100 ml the next, and a bit over 100 ml the third, all pretty bloody but it was enough for them to release me with no talk of a catheter.

Just before I left for the car I used the toilet a 4th time, without the bottle and I suspect it was even more.

I have six clips, 3 pairs (right across from each other left and right) somewhat evenly distant thru my prostate. The device reminds me, just a bit, of the pneumatic hog ring gun I used when I worked on a mink ranch at age 16. It's far more precise and hi tech but the overall process of adding a ring is a location to hold something without having to be shaped by the things you are holding, just by the tool is similar.

So over time, as the hours are passing, the amount of blood in my urine has greatly reduced, but there is still some blood at the beginning every time I start a stream so far, and I have passed a few small clots, and the amount of blood changes a bit when a clot comes out.

I was prescribed Phenazopyridine for pain and Sulfamethoxazole/Tmp (antibiotic). I was also told the I could take Motrin or Naproxen, I haven't yet but plan to before bed.

So, I'm pretty well caught up to current in my story. I'll start comparing to my PAE experience, with PAE there was no blood, but with both there was frequent urination in the hours after the procedure, and some significant discomfort with both. In both (for me) the pain is felt most when starting the stream, which is every 10 or 15 minutes right now. When I had me PAE, I didn't sleep longer that an hour at a time the first night, but my prostrate was larger and I was on Tamsulosin to reduce my retention from ~500 ml to less than ~150 ml. This time (Urolift) I had it done early enough to not restart the drugs that really bothered me in the past. I was never in a study or anything so my prostrate has only been measured a few times. About a year before my PAE it was (I think) 64 as measured by rectal ultrasound. I'm confident that it shrunk some after the PAE as my symptoms were greatly improved for several months. Monday it was right about back to about that size at 63 grams. This seems to be a size where I am greatly impacted, generally visiting the bathroom every couple hours day and night, 24/7. Always need to know where another bathroom is in the next two hours, makes travel a pain, except when we take our motorhome, of course with COVID, I haven't yet been willing to visit an airport, I have a couple outer issues and am considered immune compromised.

I'll see how I do tonight and provide updates. Our bodies and DNA are all a bit (or more than a bit) different and this is just my story of my experience as I found reading others experiences helpful in my decision making process. I also looked at data from a number of studies that influenced my decisions. I didn't read but I heard about a study that suggested that bad experiences are 30 times more likely to told online. I think my experiences may be closer to middle of the road or better. I have frequent and regular pain in my life, and tonight I'm clearly less comfortable than I've been for quite a few nights, but I'll rank it as less pain then when I fractured my foot (proximal metatarsals) several weeks ago. And I think less than that first night after my PAE, I put the PAE between this and the fractured foot.

-Dale

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