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My Prostate Artery Embolization with Dr. Bagla, Jan 2017

Posted , 28 users are following.

bcb1
bcb1

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

168 Replies

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  • TasmanianDevil
    TasmanianDevil bcb1

    Posted

    I wish I'd found this site earlier. I had no idea what BPH was until it hit me. I tried some drugs to alieve the symptoms and I felt chemically castrated. Retrograde ejaculation is a pox on men. I almost ended up with TURP as that was my uro was pushing. I then looked in the side effects and thank God I did.

    Long story short I ended up having PAE done last week. I ended up having it done somewhat locally in Minnesota. The IR was doctor Jafar Golzarian. I didn't find anything negative about him online in my searches and most things seemed pretty positive. He didn't seem to quote any unrealistic success rates.

    So now I am in the recovery process. Went through the femoral artery. He didn't advise any other. From my perspective it would seem like close to the problem area the better and less of your body being irradiated. Immediately after the surgery I felt pretty good. It did take longer than expected. Apparently I was a bit more difficult than planned.

    I've kept a diary of everything so far and I'll post a new thread at some point. My BPH was to the point I've point on about 60 pounds in the last 2 years as I could almost never sleep. I was waking up minimum of 4 times a night to up to 11 or so. I can never easily go back to sleep and once light out I am up to stay.

    So I am hoping the effects will kick in pretty soon. Most of the drugs did little to help me but the side effects were crippling. Two days after my surgery I was up 12 times for the night. I was a zombie for sure that next morning. I've started taking Tamsulosin again and helpfully it will help until the PAE kicks in.

    Overall I was very pleased with how I was treated by the doctor and his staff. He has a nurse coordinator Mary who was an angel and very responsive. 

    One thing I am experiencing that I didn't seem to read anywhere else is I almost feel like I have a wedgie near my prostate. Maybe it s the prostate complaing its blood supply is reduced but I almost feel a mild pinching in that area. The recovery has been a little bit more than I anticpated. They put me on CIPRO in advance of the surgery. Likely it was a good move and I am still taking it. Day 2,3 and 4 after the surgery were pretty rough for me. Today is day 6 and I am feeling pretty close to normal.

    • kenneth1955
      kenneth1955 TasmanianDevil

      Posted

      I am glad you found someone to help you.  What did the doctor tell you about Retro with PAE.  Do you know you can lose it all together because the prostate get to small and it does not make the fuild anymore  Good Luck  Ken
    • richp21
      richp21 kenneth1955

      Posted

      Hi Ken,

          Where did you hear this from? I've been following the PAE threads and researching PAE for a long time now, and this is the fisrt time I have heard anything about this.

           Thanks.

      Rich

       

    • TasmanianDevil
      TasmanianDevil kenneth1955

      Posted

      First I've never heard of that as well. Dr. Golzarian has been doing them for quite some time from what I understood. I think he has been doing it since 2011 or maybe sooner. He never mentioned that as a possilbe side effect that the prostate would shrink too small.

    • kenneth1955
      kenneth1955 TasmanianDevil

      Posted

      The doctor should have told you something about it.  They say that there is a 4% chance but we have found out that it is more like 10 to 15%.  Doctors do not feel that we need it after we are done having kids.  They do not consider the ejaculation a sexual function.  I wish you luck.  Take it easy  Ken
    • kenneth1955
      kenneth1955 richp21

      Posted

      Hey Rich.  I got a letter from one of the nurse. I can look it up and tell you from were.  But she said that PAE does not cause retro?  This is what she said but if you make the prostate smaller it makes less fluid and sometime you can lose it all together. So it does.  It all depends how much they put in the veins. Ken  
    • richp21
      richp21 kenneth1955

      Posted

      Hi Ken,

         I sure would like to see whatever you have. As I mentioned, your post is the first I time have ever heard of this. I've had several phone conversations with Dr Issason and Dr Bagla, and have been following the PAE discussions on this forum for some time now.

      Rich

       

    • kenneth1955
      kenneth1955 richp21

      Posted

      That is about the same time that I was e-mail some people because we could not get a straight answer.  does it or not.  I will let you know  I have 2 accounts it is on my other.  Talk later  KEn
    • richp21
      richp21 kenneth1955

      Posted

      Hi Ken,

         Did you ever look into where you came up with that information?

         Thanks.

      Rich

  • vigneron
    vigneron bcb1

    Posted

    Thank you for the post.  I am considering PAE.  I went to Inova in Alexandria on the 15th for a consult with Dr. Sterling.  j12080 said that he trained under Bagla.  I was not able to see Dr. Sterling because he was with a patient in pain and could not keep his appointment with me.  I consulted with his PA and we went over a lot of things.  I said I still wanted to talk to Dr. Sterling if I decide to go through with the procedure.  On the 24th I am having an MRI in Frederick; Alexandria is a little too far to drive just for that.  Luckily J12080 told me to make sure I got a "3T" MRI because they are more detailed than the open MRI machines which are not "3T" - at least the place I called initially.  I am glad to read that you did not use Prednisone afterwards because I have SEVERE problems with that drug and can not take it.  Inova is pretty insistent on using it but that is a deal breaker for me if they insist.  I will try motrin or something else.  The side effects for me to use Prednisone would be worse than any pain or discomfort I can imagine from the PAE.  John has done a LOT of research on the various procedures and he chose FLA, which from reading, researching and talking to him, might very well be a better option but the cost seems prohibitive to me.  My BPH is not as severe as some of the posts I have read.  In fact, if my condition did not get worse, I could probably live with it - EXCEPT - my BPH caused me to develop Urinary bladder stones.  I just had Ten of them removed two weeks ago at the VA hospital.  They busted them up with a laser and irrigated them out.  I was warned about the painful urination afterwards for a day or two and they were right - very painful but I was only in pain when urinating. They must have use a very large tube up my penis during the procedure.  At least they are gone and I have not experienced any more hematuria.  I was having hematuria at least once a week for the last couple months before the procedure.  CT scan with contrast before procedure did not find any problems with kidneys or other lower abdominal body parts.  Keep us informed of your progress

  • jjjj57989
    jjjj57989 bcb1

    Posted

    BCB;  Forgive me if I'm missing it, but I just searched through this thread and could not find any updates in the last 6 months.   Please tell us how you are doing now.

  • j.d.83438
    j.d.83438 bcb1

    Posted

    Good Morning Everyone!  I am becoming somewhat "anxious" about Tuesday's PAE procedure at Dr. B's.  My normal squeamishness...  No food or drink after midnight!  I have to drive ~ 100 miles that morning WITHOUT coffee!!!  Barbaric eek !

    I will post my adventures this coming week.

    J.D.

  • j.d.83438
    j.d.83438 bcb1

    Posted

    Update 48 hours:  Hello!  Home and feeling pretty good after PAE procedure with Dr. Bagla.

    Up at 3:30 AM Tuesday (08/29), drove over 100 miles, checked into hotel, and called Dr. B's office at 7 AM.  They had UBER try to get me, then LYFT.  Finally got to their offices about 8:10 AM.  They quickly had me in a hospital gown and in a reclining chair to check vitals and stick the IV in my arm.  As each of the nurses and aides fussed over me, I explained to each and everyone of them that they needed to check all my forms and charts for the message in BIG CAPS:

    "HIGHLY ALLERGIC TO PAIN"...<g>...  And, explained that I was needle phobic, scared, and very grouchy from lack of coffee.  "Maria" was very cool and asked if I would like a Valium to relax.   I asked her for 5 or 6 Valiums and she did bring me 2 !!!

    Next, I was on the gurney, into the room. hooked up to the happy juice.  I continued to joke and asked them to crank open the valve for that stuff.  Out Cold!  Guess they just wanted to shut me up...<g>...

    Didn't feel / know anything until I was in the recovery room.  Maria brought me a coffee and small sandwich.  Laid there for an hour.   Initially, I figured I could tough it out and drive home that same day.  WRONG!  I was totally out of it!  Probably the combo of Valium and the twilight juice.  Dr. B came in and talked with me a bit; hardly remember any of that.  Except that my prostate is 130 grams.

    UBER back to the hotel.  No restaurants within easy walking distance...<sigh>...  VERY very nice lady at the front desk suggested take out AND said she was about to leave for the day and would fetch me something.  She got me some Chinese stuff AND brought it to the room!!!   How nice was that...?!?!?

    In the hotel room, ate a bit, napped for an hour or less and had to pee - urgently!  Had to pee urgently every couple hours all night.  They did have me hooked up to a saline solution which probably added a couple quarts to my system.  Some tolerable pain when urinating - nothing severe.

    NO OTHER PAIN NOR COMPLICATIONS!!!  Except for a minor lower G.I. "ache" that continues.

    08/30 - I showered and checked where they went into my groin.  Nothing there except a teeny bit of a bruise; took off their dressing and put on a tiny band aid.   Left the hotel about 9 AM.  Stopped about half way home for lunch with a good buddy.  HAD (!!!) to stop to pee three (3!) times just getting there.  After lunch drove another hour home and did NOT have to stop!  Got home and napped...  Just kinda passed out.  Still tired from not sleeping well last night.

    All in all, a piece of cake!

    So...  Here I am 48 plus hours later feeling pretty damned good with no complications.  Hoping that all this works!

    J.D.

    • j.d.83438
      j.d.83438

      Posted

      Update Day 14 after PAE procedure with Dr. B:

      W_O_W!  At Day 6 - 7, I was already feeling some great results!  My flow increased dramatically from the weak dribble of the past years.  Unbelievable!  Now getting 3 - 4 hours sleep vs. 2 -3 hours before.  According to Dr. B it usually takes 6-8 weeks before improvement kicks in with better outcomes at 6-8 months.  I am so happy thus far and cannot imagine how it can get better; but, I'll take it...<g>...

      My only "complications" were some very weird dreams from the darned meds; probably the steroid used for possible inflammation or infection.  I had none of those.

      Anyone with BPH and complications NEEDS to investigate PAE.  Go for it!

      J.D.

    • don30615
      don30615 j.d.83438

      Posted

      Happy to hear your success story, J.D. I've got a question for you. Did you mean to write "6-8 months" above? I thought I recall Dr. B telling me that  I shouldn't  expect any more improvements after Month 3.  But I'm 4 1/2  months post-procedure, and I continue to slowly get better. So maybe I heard wrong, and your numbers are right. I hope so! My improvement is not as dramatic as yours, but I'm definitely doing better. The main issue these days is occasional episodes of nocturia. (which, I know, can be caused by things other than BPH). 

    • j.d.83438
      j.d.83438 don30615

      Posted

      Hello Don,

      As best I remember...  Somewhat of a haze from the twilight drugs.  "Most" do not see the rather immediate improvements that I have experienced; i.e., days vs. a few weeks.  YES, more good stuff to come at 6 - 8 months.  I have read that some see great improvements at month # 5.  This kinda makes sense to me b/c that darned prostate is being deprived of blood flow (it deserves that too!) and will continue to shrink.

      "nocturia" is a word I will try to use more often now that I know what it means.  Yes...  My own nocturia is probably caused by other things than BPH.  Such as my love for a good beer or two cheesygrin

      J.D.

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