My PAE Treatment Experience on 07 July 2016 by Prof. M. Pisco at St. Louis Hospital in Lisbon

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I had my PAE treatment procedure done two weeks ago on 07 July 2016 by Prof. Martins Pisco and team at St. Louis Hospital in Lisbon, Portugal. I am 47 years old and was the 1056th PAE treatment procedure patient.

I encountered acute urine retention and associated BPH symptoms and was catheterized in a hospital number of months ago. By then, the ultrasound result showed a very large prostate problem. The medical doctor in consultation with a general surgeon recommended an immediate open surgery. I instead resisted and demanded to think over it. The next day, I visited Urologist while under a catheter. His diagnosis confirmed the same problem of very large prostate. He recommended immediate open prostatectomy and suggested if I could be admitted in the hospital right away. Again, I resisted and demanded to think over it. The Urologist has stated rather gloomy remark that the only solution would be immediate invasive surgery. So, he prescribed Alfuzosin [Xatral] 10mg/day until I make up my mind and recommended to remain under catheter. I began taking the prescribed medicine. However, I instead went back to the previous hospital that catheterized me and my catheter was removed after the third day.

As a process to make up my mind for the open prostatectomy, I continued reading and reviewing literation on the conventional BPH treatments [particularly on Open Prostatectomy]. Unfortunately, my review showed many severe disadvantages and complications such as risks of bleeding, impotence, erectile dysfunction, urinary incontinence, loss of ejaculation, retrograde ejaculation, stricture formation, long hospital stay and recovery period, urinary retention, and many other side-effects that critically reduce my quality of life. The possible prospects of the latter severe side-effects put me under serious stressful dilemma with a sense of hopelessness whether to whether I would undergo the surgery or not.

Nevertheless, I continued my literature review on recent BPH treatments. Just over a month ago, I google searched with ‘BPH treatment 2016”. Then, I suddenly came across with PAE treatment procedure discovery as a breakthrough treatment by interventional radiologists than urologists. It was a turning point to begin getting away from my hopelessness situation. I continued reviewing the PAE treatment literature voraciously and enthusiastically with great interest.

The review led me to discover Prof. Martins Pisco’s ‘International Prostate Medical Centre at St. Louis Hospital’ with detailed broad highlights of PAE treatment procedure [pre-, during, and post PAE], publications, patient testimonials, pictorial photo and video documentation. Almost over 1000 patients were treated under Prof. Martins Pisco by the time I discovered his website. Using the contact address, I immediately sent an e-mail, for which I received prompt reply. I replied to the e-mail by completing the necessary forms plus enclosing supporting documentation. Following receipt of confirmation on my eligibility for PAE treatment procedure, I immediately travelled to Lisbon and began my pre-PAE preparatory diagnosis. Prof. Martins Pisco’s examination and diagnosis included PSA and related blood test, Angiography-CT Scan, Urine-flowmetery, and MRI, which were completed from 04 - 06 July 2016. A day before the actual PAE treatment, he re-confirmed my eligibility for the PAE treatment procedure based on the outcomes of the different diagnosis.

On Thursday 07 July 2017, I underwent the PAE treatment as a 2nd patient out of eleven scheduled for the weekly procedure. As I was undergoing the treatment, the procedure began with a local anaesthesia around my right side femoral artery with a small needle. Then, a 1.5mm needle was used to perform my PAE treatment with a minimally invasive procedure, which was rather painless except minor feeling of discomfort as Prof. Pisco and the professional team performed the procedure. After 30 minutes, I was informed that the embolization of the right side was completed. After another 30 minutes, I was again informed that embolization of the left side was completed. The entire procedure was completed within one hour. Since it was not as such painful, I was interacting with Prof. Pisco and his professional team, requesting them to take memory photos [which I possess them now].

I was moved to a recovery room where I was told to stretch mainly my right side foot where the catheter was inserted. After two hours, I used the wash-room on my own. Since I was alone, Prof. Pisco recommended me to spend the night in the hospital instead of returning to my hotel, which I accepted. In the late afternoon same day, I was already walking inside the hospital’s small nice garden. The next day morning, Prof. Pisco checked me and I returned back to my hotel walking alone a distance of more than 10 minutes alone. The slight feelings of discomfort were all gone within two days and then I was walking in the city centre and around, visiting many nice sight-seeing places in Lisbon.

Overall, my PAE treatment in Lisbon brought me back my hope for a quality of life without any pain and blood loss as well as without any worries of severe risks, disadvantages and complications expected from conventional treatments. The PAE treatment transformed my hopelessness status to one full of hope to enjoy a quality life. I have already begun witnessing the early highly promising positive results. Currently, I stopped taking the medication, including Alfuzosin 10mg. My urine flow has shown significant improvement. The frequency of night urination is limited only to 1-2 times on average depending on the volume of my liquid intake. My personal IIEF-5 function index issues have already begun showing noticeable improvement whereby I am witnessing a happy and healthy quality family life.

I have been witnessing fast improvement after the procedure because the PAE treatment may have contributed to the softening of my prostate tissues and relaxation of the urethra muscles alongside the expected possible reduction in the size of my prostate [which can be measured after 2.5 months]. Currently, I am on my full-time work in the office without much worry of the previously bothering BPH symptoms.  I am enthusiastically looking forward for the 3 months’ progress monitoring test after 2.5 months to support the current promising outcome I am feeling and witnessing now with quantified credible evidences of medical tests and examinations.

I am among those lucky ones who benefitted from this fundamental ground-breaking discovery of PAE treatment procedure by interventional radiologists with their accumulated knowledge, skills, and experience in arterial embolization. This break-through discovery has transformed my hopelessness to full of hope. I have no enough words to express by deepest gratitude to Prof. Pisco and his professional and administrative team for their extra-excellent professional and exemplary human qualities. He and the team members are gifted and blessed to do such a wonderful and fabulous PAE treatment as a simple out-patient procedure to alleviate the sufferings of BPH patients without pain and much worry about risks of complications. Without any sense of exaggeration at all, my PAE treatment was my rebirth, which has provided me back my quality life full of hope. Had I undergone the open prostatectomy as decided by the Urologists, my present life would have been miserable due to the obvious side-effects and complications. I have no enough words to express my gratitude to Prof. Martins Pisco, who saved my life with this effective discovery without any side-effects that I will remember you throughout my entire life

I consider the PAE treatment as a miraculously amazing foundational medical discovery to be nurtured and expanded widely throughout the world so promptly. This enables many BPH sufferers to benefit out of it before they end up risking their quality life under the risky conventional treatments full of irreplaceable side-effects, disadvantages and complications.

Based on my own first-hand most recent experience, I highly recommend to anyone suffering from BPH problems to undergo the PAE treatment procedure in under Prof. Martins Pisco in Lisbon [Portugal] or anywhere in the world where the BPH medical breakthrough service is available. For example Prof. martins Pisco has already treated over 1050 patients from over 75 countries in the world [as learnt from his own words]. All patients, including myself benefited immensely without worries of risks, side-effects, disadvantages and complications of expected from the conventional BPH treatments.

Once again, the above account is from Prof. Martins Pisco’s 1056th patient who underwent PAE treatment procedure on 07 July 2016. I recommend for the prompt expansion and promotion of the risk-free PAE treatment procedure across the world so that all BPH patients benefit out of it.

WSAD-1056

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  • Posted

    Thank you for that exceptional report. I am very happy for you, and hope that the procedure's improvements continue.

    It is possible that it could take some years for this process to become widely available. For example, in my country, the UK, as far as I can tell, only one centre performs PAE. We are subject to the vagaries of NICE, our approval body, which so far regards PAE as 'experimental', so one is likely to have to pay for it oneself, as well as travel to Southampton.

    The obvious drawbacks of the procedure are that urologists do not get involved and the training and need for experience is considerable. There can sometimes be a lengthy exposure to X-rays whilst trying to follow convoluted veins, and individuals vary considerably in their internal structures and reactions to the procedure.

    On the other hand, part at least of the prostate is killed and re-absorbed into the body, and the continuing blockage of blood flow possibly prevents prostate re-growth (this remains to be established), whereas all the other forms of treatment - cutting, vaporising, pinning aside, boiling away and so on, presumably do not prevent eventual regrowth. They are all of course more invasive as well, except urolift.

    We live in interesting times !!

     

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    • Posted

      Dear gbhall,

      Thank you very much for your insightful appreciative reply to my PAE treatment experience under Prof. Pisco in Lisbon. I considered this break-through medical discovery as miraculous against my hopelessness. Unfortunately, my dilemma on either accepting the instantly recommended open prostatectomy by my Urologist or opt to face the consequence has intensified the more I continued reading and reviewing the side-effects of the conventional BPH treatments. Before discovering prof. Pisco's webpage, I have no idea about PAE. Since I have only one choice to undergo what was recommended by the Urologist, myself and my wife continued with our prayers to God to give us exit as believers. Because I was seriously scared of the long-list of risks, disadvantages and complications of all types of the conventional BPH treatments. At times, I even spent sleepless nights with worries of the consequences open prostatectomy. On top all, I have a relatively young family. I have no idea about the existence of a PAE treatment. I simply got access to it through my pure web search. That is why now I feel very much hopeful and consider that I got back my quality life with this risk-free procedure compared to conventional treatment.

      In my view, if the urologists are attempting to interrupt this miraculous PAE treatment, I consider their reasoning not scientific at all. Instead, I imagine, any act of preventing the expansion and promotion of this ground-breaking fabulous effective BPH treatment discovery throughout the world would be rather subjective, unwelcome, weak, and illogical behavior. Based on my pre- during-and post- PAE treatment procedure with fresh memory plus its early impressive result I am already enjoying, I am among the witness on this excellent scientific discovery's effectiveness. The non-/less- invasive PAE treatment discovery can revolutionize and transform for good the problems of all suffering from BPH the world over if the treatment is promoted and expanded promptly without delay. Instead of engaging in any unhealthy polemics, the urologists should acknowledge the effectiveness of the PAE miraculous and game-changing positive impacts in the medical discovery and appreciatively join hands with the interventional radiologists in alleviating the sufferings of BPH patients. Those of us who benefited out of this break-through discovery would like many others suffering from BPH to get immediate and fast access to the PAE treatment services before their quality of life would be reduced with the obvious adverse effects of the conventional BPH treatments. Let the two come together, join hands, and accelerate the speed in alleviating the human sufferings with this and many other new scientific medical discoveries.

      The PAE treatment procedure discovery should be approved by the necessary recognized approving institutions for its fast expansion and promotion. The practical evidence based testimonies of those of us who benefited could be considered well as guaranteed witness. Thanks be always to the almighty God that provided me a chance to come across with the PAE treatment. Otherwise, by now my quality of life would have been miserable and ruined had I undergone open prostatectomy as urgently recommended by my urologist.

      Best wishes,

      WSAD-1056

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    • Posted

      Does anyone come across any figures on the incidence of non-traget embolization? I understand it is skill dependant. Could it interfere with the function of the ejaculatory duct ( I am not talking about retrograde ejaculation) rendering it less vigorous or weaker or cause bladder neck necrosis. 
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    • Posted

      Dear NBCP,

      So far I did not come across with the problems you indicated. Yes, you are full right that this procedure is highly skills dependent. Given the technological advancements of imaging/scanning the arterial structures coupled with  excellent knowledge and skills of interventional radiologists and other related specialists within the PAE treatment performing team, the risks may not be very high in my view.

      Best wishes,

      WSAD-1056

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    • Posted

      Skills of the radilogist is everything in this procedure. Since everyones circulatory system is different to some degree which has created a few cases when the neck of the bladder has been damaged by PAE and in several cases required surgery. It seems these are very rare and better imaging has probably reduced this concern. The US was way behind in getting this procedure into clinical trials. 
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    • Posted

      "Quote:" part at least of the prostate is killed and re-absorbed into the body, and the continuing blockage of blood flow possibly prevents prostate re-growth (this remains to be established)"

      I had the procedure done in 2014 by by Prof. Martins Pisco and team at St. Louis Hospital in Lisbon. I asked quite a few questions, but didn't get real answers to "what happens to any necrotic prostate tissue" and "how the blood flows stays cut off after the embolism beads have dissolved".

      Anyway, my initial prostate size was 163ml, usually 5 toilet visits per night. I found immediate improvement in flow on first visit to toilet in recovery room. I guess the immediate change could be due to the prostate 'deflating'  when the incoming blood flow is stopped.

      After 1 month it was down to one or zero night visits (over about 7-8 hours). 

      At 3 months check, volume was 136ml (done in Lisbon as cheaper with flights than cost of TRUS in UK).

      At 5 months I started to need more night visits again, so was not suprised at 6 month check that volume had gone back up. It was now 156ml.

      In Lisbon, if the PAE does not work, they offer to repeat the procedure at reduced cost (materials price), providing you did not have "tortuous" arteries (which is most frequent in smokers and older patients) and that you send in checkup results at 3 and 6 months.

      I was told, before having procedure, that my arteries were straight forward ,not tortuous. So afterwards I paid to get the checks done, just in case there should be any problem.

      Unfortunately, at my appointment with  Prof. Pisco, I was told that the procedure couldn't repeated, due to having an acute turn in one artery which required longer on the radiologist's table. I am quite upset about that, as I felt that Prof. Pisco should have made that clear at the post procedure meeting (a few days after, attended by my wife and myself). So, for me, the money spent on visits to Portugal for tests at the two checkups was a complete waste!

      Asked why a failure after 5 months, Prof. Pisco said no one fully understands why it sometimes doesn't work.

      Unless cases of failure are followed up, then no one's going to improve their understanding.

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    • Posted

      Hi - I had the same experience as yours with Dr.Isaacson at UNC. He said I was a perfect candidate for the PAE but also could not explain how it worked. Anyway, after 3 months mine has been a complete failure and Issacson has shown zero interest in why it failed.

      I started another thread for PAE failures so maybe we could see a trend - certainly the IRs have no interest. Maybe put your posting there too - it would be much appreciated:

      https://patient.info/forums/discuss/pae-disappointment-journal-534612

      I have 2 theories why PAEs sometimes work and sometimes fail. One is the placebo effect and the other is aggressive tissue regrowth due to prostate stem cells which are among the most abundant of any organ.

      Good luck. Neil

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  • Posted

    Dear WSAD-1056...very happy for you ....may I ask the total cost of this treatment?
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    • Posted

      Dear David53853,

      The detailed PAE cost-breakdown is presented under Prof. Martins Pisco Prostattic Artery Embolization Clinic webpage with a title: "International prostate Medical Center at Saint Louis Hospital - PROSTATE ENLARGED - Safe and Effectiv New Procedure Shrinks Enlarged Prostate without Sexual Side Effects..."

      Just to share you the cost I paid as follows"

      [1] PAE Treatment - 4450 Euro [at St. Louis Hospital];

      [2] PSA and related blood teste - 150 Euro [ at St. Louis Hospital;

      [3] Angiography CT Scan - 150 Euro [diagnostic clinic in Lisbon city];

      [4] MRI - 150 Euro [diagnostic clinic in Lisbon city]; and

      [5] Urineflomerty - 20 Euro [St. Louis Hospital Clinic at different location in the city.

      So, the overall cost I paid for the medical diagnisis and PAE treatment was 4920 Euro.

      Most importantly, I noticed living cost [hotel accomodation & food] in Lisbon is relatively cheaper compared to other big cities in Europe.

      Best wishes

      WSAD-1056 

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    • Posted

      Dear WSAD-1056....Thank you so much for that breakdown of costs ...thats all sounds great.....how are you feeling now at this point in time....Ihave read a lot on this proceedure ...and it sounds the best treatment for our complaint.
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    • Posted

      Dear David53853,

      I am feeling quite alright now and resumed my office work right after my return from the treatment. That is why I felt amazed and and very pleasant of this procedure as amazing medical breakthrough, which I wish all others suffering from elalarged prosate problem to benefit out of it. I already presented a detailed account on my pre- during- and post- PAE treatment procedure by Prof. Martins Pisco in Lisbon.

      I am optimistically looking forward for my future test results at different intervals to support the impressive improvements I am currently enjoying with quantifiable credible evidence. Given my previous hopelessness and desperation, I strongly recommend the PAE treatment, which is predominantly risk free even if the scale of positive results may differ from one person to the other.

      Best wishes,

      WSAD-1056

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  • Posted

    Thanks for this excellent report.  It gives me a very good image of what Dr. Pisco's treatment would be like.

    My concern would be after-care or emergency care.  Dr. Pisco has an excellent reputation and much experience but did you consider what you would do if, you had a problem once you are back home?  You'd have to rely on a much less experienced dr?  Or what if you cannot travel for awhile after the procedure?

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    • Posted

      Dear JJJ57989,

      Yes, I had open discussion with Prof Pisco on my post-PAE teatment issues. Right after the completion of the PAE treatment, he gave me his private cell phone number. My original plan for a return trip was on Sunday after the actual PAE treatment on Thursday. When I discussed with Prof. Pisco the flight hours of my return trip, which takes around ten hours with one stop-over, he suggested if I could postpone my Sunday flight for one round of check up before my departure as a safe precaution. So, I postponed my Sunday flight to Wednesday [three days after] and visited him on Tuesday for a check-up before departing Lisbon the next day. After my return, I already contacted him to inform my good progress via his cell phone. In case of any incidence, he confirmed me his availablity so that I can call and inform him for remote guidnace and advice.

      Best wishes,

      WSAD-1056

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  • Posted

    My Dear WSAD

    I am highly delighted to know the result of procudure u have gone under and knowing as first hand knowlege from a gent like you who has given detailed report for the benefit of so many sufferring from this condition. I too had accidently discovered Dr MP name and his skills and on top of it his reputation and preparing myself to travel to him in near future. I congratulate u and wish you well for quick and full recovery and pray  it is long lasting one. 

    Could you kindly suggest any nearby hotel with reasonable rates located in close proximity ? There may be many but share you experience if possible

    Best Regards 

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    • Posted

      Dear jag21,

      Thank you very much for your appreciative reply. I can happily recommend you to stay in Hotel Botanico, a 3 star hotel. I found it excellent for my stay. It is only 8-10 minutes walking distance from St. Louis hospital. The three reception staff at different shifts possessed excellent qualities. they speak very good English. The rooms are slightly small but well furnished with a big safe inside  a capboard where you can put your valuables, including a big laptop.

      I suggest you book a room on the 5th floor [if available, I suggest room numbers 53-55 whereby I stayed in one of them], and had an excellent view. I enjoyed seeing an excellent view of the attractive Lisbon city as the hotel is in a hilly area. Additionally, the hotel is located very close to the city center, easy to reach to all service areas.

      Infornt of the hotel, you can find excellent vegetarian restaurant if you are a vegetarian. Otherwise, you will find many restaurants and services of your choice around. The hotel is very quiet and located on a hilly area for sight seeing. the hotel room cost varies even on daily basis based on market price. In my case, I negotiated and paid $65/day, inclusive of breakfast. The same price may not be guaratnteed but it may vary according to seasonal demands. Their public contact phone number is: +351213420392. Kindly note that cost of living in Lisbon is relatively cheap compared to major cities in Europe, including taxi fares.

      I wish you all the best in your efforts to get PAE treatment procedure at St. Louis by Martins Pisco.

      Best regards,

      WSAD-1056

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