My Prostate Artery Embolization with Dr. Bagla, Jan 2017
Posted , 28 users are following.
I appreciate some of the detailed threads on this site about the PAE procedure - and after reading them, that became the deciding factor in me choosing to go with a PAE procedure rather than Holep laser. It seemed like the PAE was so much easier and less invasive...why not try it first, right?
I'm fortunate that I live fairly close (about 2 hours away) from Dr. Sandeep Bagla, one of the top IR guys in the country for this procedure (if not THE top guy). I can tell you first hand that Dr. Bagla is a first class doctor and all around nice guy as well. Very professional, courteous, answers all your questions, and just gives off that vibe like you know everything's going to be fine if this guy does my procedure. After driving down to meet him in person and do the initial consult at his office, I left there thinking - YES, this is the procedure that I'm going to have.
My urologist in Winchester, VA is actually a very good guy (doesn't do any in-hospital procedures himself, only does in-office procedures) and when I asked him about the PAE, he knew about them and had read about the procedure, and thought I'd be an excellent candidate. He encouraged me to go foward with it.
There was some difficulty getting my insurer to pay (they initially denied the pre-authorization) so Dr. Bagla had to do some follow ups with the insurance company doctors in order to get them to pay for the procedure.
Dr. Bagla and his team at Vascular Institute of Virginia is just top notch. There's no other way to describe them. Very friendly, easy to work with, and very professional. There wasn't one minute that I didn't feel like I was in good hands. My procedure was in mid-January, I got there at 7:30am, they started my IV of solu-mederol since I'm allergic to IV contrast, and within about 45 minutes I was on the table in the surgery suite. The sedation they use is excellent - fentanyl and versed I believe. Enough that I was aware of what was going on (I remember thinking geez are they done yet...? during the procedure), yet I was still off in a cozy, dreamy happy land. Weird but cool.
The proedure was a success, took about 90 minutes. Laying flat on my back for 2+ hours afterwards was miserable. By far that was the hardest part of the entire procedure. Killed my back having to lay flat on a very hard mattress, if I ever had it done again I'd bring a nice memory foam topper to have them use, lol.
Anyway, I was out of the office by about 1:15pm and on the way home. I passed a little blood in my urine while there at the office. Nothing uncomfortable, no burning or anything like that. I can't take nsaids so I didn't take any prednisone following the procedure, no ibuprofen or anything like that. I took one Celebrex in the morning and one in the evening for several days afterwards. This was by far one of the easiest medical procedures I've ever had done. No problems at all. Again the only discomfort I had was laying flat on my back for two hours after the procedure. Other than that it was a piece of cake.
It's been nearly two weeks and I've had steady improvement. Not a night & day difference - but definite improvement. I'm not peeing like a racehorse yet, but defintely peeing better. No dripping afterwards. Getting up less at night, so my sleeping is better. You don't realilze how much your sleep is affected because it happens so gradually over the years - but wow, sleeping for 2-3 hours at a time rather than getting up every hour or so is so much more restful. I still get up about 3 times per night...but that's much improved from 4-5 times per night. And it's only been two weeks so I'll still get more improvement.
I can say that without a doubt, I highly recommend Dr. Bagla and his staff. And I highly recommend the PAE procedure. If you are having doubts....I'd say just go ahead and do it. It was so much easier that I had imagined. Very happy that I had it done.
3 likes, 168 replies
j12080 bcb1
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bcb1 j12080
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I didn't have MRI imaging before my procedure so I can't really say if I had a large median lobe or not. I remember him commenting to the other doctor and his nurses as they were finishing up that my prostate wasn't huge (I guess they can tell the size of the prostate from the fluroscope).
In my case, I had been on prostate medicines for 10+ years. They worked very well at first but decreased in effectiveness over the years. I was up to two Flomax every day and still had to go quite often.
Even after just two weeks I feel better about my symptoms. I'm going less during the day and at night. If I continue to get improvement for several more weeks like Dr. Bagla says I should, then I will consider it a huge success.
joel39110 bcb1
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It's been a year now how you doing 1 to 10 with 10 being best?
j.d.83438 joel39110
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Hello Joel. Everything continues to be wonderful. I have NOT had the awful urinary retention problems. I am off ALL the meds the uro doc insisted I take. I like beer... If I over indulge (6 or more), urgency becomes an issue and I do need to get up a couple times at night. But that would have been the case when I was 20 years old. With only 1 or 2 beers, I can "hold it" for 30 plus minutes. Could not be more pleased overall.
BTW, Br. Bagla also did the same procedure on my knee and that has been a complete success. Life changing! I can walk, hike backpack without pain again!
mark23925 bcb1
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bcb1 mark23925
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Dr. Bagla advised me that while some guys get very quick results (like 5 days afterwards), that is the exception - not the norm. Most guys get a slow but steady improvement over about a month, and then continue to get some additional improvement up to about three months.
It's only been two weeks for me but I can say that yes, I definitely have seen improvement already.
don30615 bcb1
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Thanks very much for this detailed descripion of your experience with PAE. Your uro is unusual--in my experience, most uros either don't know about PAE or actively discourage the procedure.
I'm curious about one thing. I've heard that Dr, Bagla is quite selective in choosing patients he thinks will benefit from PAE. Was that the case with you? And what were the criteria for selection?
Thanks again for this very useful information, and keep us posted. Best of luck.
Don
bcb1 don30615
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Don, my urologist is Dr. Geib in Winchester VA. Really nice guy. He was at least familiar with the procedure - though he hadn't had any of his patients actually get one yet. I was the first, and he was very supportive. He wanted me to follow up in a month to see how I was doing.
Regarding patient selection - Dr. Bagla has a questionaire that you fill out and send in to his nursing staff. It's fairly detailed and it gives him a good idea if you would be a good candidate or not. They get back in touch with you - in my case it was the next day - to let you know if Dr. Bagla thinks you would benefit from the procedure. Since I'm not too far away from Woodbridge, I elected to drive down to their office and meet with him for a consult, but I imagine that a lot of guys would elect to talk to him via phone and/or email.
My PSA's had always been low. As far as selection criteria goes, it was based on my history, how well the medicines had worked for me (but were no longer working very well), and perhaps the fact that my urologist was supportive of me having the procedure. Dr. Bagla mentioned that prostate size alone is not the only thing they look at - it's a combination of factors, which I guess is what the long, detailed questionaire is designed to tell them.
j12080 bcb1
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mark23925 bcb1
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j12080 mark23925
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Mark I can tell you what I was told by Dr bagla in my visit to see him. He told me Medicare would pay for the procedure if it was coded and turned in as another procedure other than BPH treatment. I think it has to do with blood loss and if he is treating a patient for blood loss it is a different code than the true BPH insurance code which Medicare would pay for. I was also told by him the procedure would be $12,500 if it was not paid for by Medicare. I'm sure the pricing could be flexible as I have heard a variety of price quotes on this website and he may have done it for a different price point than what I was quoted.
I then went to see Isaacson and he quoted me $ 7,500. The price did not and does not matter to me. Alll that matters is results. The procedure I had was more expensive than either of these and I would pay many times more than that for the results I got if I would have known that I was going to get this good of results. I went with focal laser ablation. I believe both procedures work. I did not realize at the time I selected FLA that it could possibly be this good or this quick.
kenneth1955 j12080
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Yes payment is the way the codes are put in. If 1 number is off they they don't pay. Take it easy... Ken
don30615 bcb1
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richp21 mark23925
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Hi Mark,
I spoke with Dr Bagla's insurance person a few weeks ago, and she said that they have never had any trouble getting it approved by Medicare. When I pressed her on what it would cost if it didn't get covered, she said "self-pay" cost is $ 8,000. I would suggest calling the office if you would like this confirmed.
Rich
jjsmnow mark23925
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I had the good doctor Bagala do mine almost 3 years ago when he work out of Inovia Hospital. They accepted medicare then.
When I had it done my prostate size was 100. 4 months latter it was down to an 82. It has now slowely gone back up to 98 and my old problems of peeing 3 to 5 time a night have come back 2 to 4 days a week.
Same as before I had the first 1 done.
So I am hoping I can go back for another 1.
I would never consider getting scrape (Turp) or burnt (Laser) to many things to go wrong that cant get fixed after wards.
I dont under stand why any man would want to gamble on his sexuality destroyed and wearing dipers for life.
BCB1 description was just about the same as mine. Very easy to go through.Except for the first few days I had to pee every hour. After a couple of weeks it was down to 1 or 2 per night.I you want your sleep back go get the PAE by Dr Bagula.
joel39110 j12080
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