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
scott95643 bcb1
Posted
Hi all. I am new to the site, but have been reading many old posts and threads here over the past week or two regarding PAE and FLA. I am a recent inductee into the Hall of Great Retention!!!! It came on suddenly around Thanksgiving, when I began having intense frequency and urgency, having to strain to pee and often requiring a 10 to 20 minute seated cycle of straining every few minutes just to get a little more out each cycle! I really could not leave the house. Luckily I moved my office home a year ago, so I was able to deal with this sudden nightmare at home for the first couple months. But 2 months later, I was completely blocked, and now have had a catheter for the past month, being imprisoned by my own body. For a relatively fit 61 year old who is/was very sexually active, it has been nothing short of a state of shock. I am actually scheduled to have a suprapubic catheter surgically put in on Thursday, because I could not bring myself to run in and do a TURP, as my Uro has suggested is the only option. I needed time to review all of the options, and of course now my head is spinning. I won't get into all of the frustration with the urological medical field in this post, as you all are quite familiar. Another post for that!! I have been looking at all the alternatives, and have mostly honed in on FLA and PAE . My additional complications are median lobe, and a prostate cancer diagnosis that had been in the watchful waiting category for a few years. My uro says TURP, and that given my low grade cancer, prostatectomy would be overkill and much more risk than is necessary. Part of me says just get it over with, take it out and be done with it all, but that's only because there did not seem to be any easy in between that didn't have a lot of the same risks. FLA and PAE seem to be the closest thing there may be to that "easy", or at least, not horribly difficult, in between procedure, with less risk of bad side effects. I've read a lot of your threads on your experiences with both PAE and FLA, and have reached out to Dr Bagla and Dr. Karamnian and have spoken to both of their offices, tho not yet to the docs directly (although each of them has called me). I am in Los Angeles, and also learned of Dr. Justin McWilliams , an IR who does PAE right here at UCLA. Of course, my own UCLA urologist did not even mention him or PAE or the fact that UCLA was involved in the PAE story and advancement!!!!!!! I've seen so much here about the docs at Vascular Institute in VA and the docs at UNC, and am wondering whether there is a thread for people who may have had the procedure with Dr. McWilliams at UCLA or whether anyone here is familiar with him. So far I have had a great experience talking with him, and he has been very available by phone and email, but am surprised I have not seen anyone here who may have done the procedure with Dr McWilliams. I've got a million other questions, concerns , fears, etc. that I'd love to vet with the FLA and PAE folks here, but I just wanted to start with the question of whether Dr McWilliams/UCLA has made it into the discussion of the main PAE guys and whether anyone has had the procedure there?? THANKS for any insight!!!! Peace, Scott
mark23925 scott95643
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kenneth1955 scott95643
Posted
Scott. Why are you having a Suprapubic Catheter put in. Why don't you just do CIC. That would buy you some time to do your research. That is not a easy surgery why have it done If CIC would give you the freedom for sex. Who talked you into that. Get a hold of JimJames he can help you. Stop and don't do it. Also don't rush into any surgery Please I'm 62 and I would never have anything thing done like that. Please think of what you are doing. Many men do CIC..Ken
scott95643 kenneth1955
Posted
Thx Ken, I am not a candidate for CIC. I just cant do it. Not sure how there aren't more in my situation when it comes to the enlarged prostate, but it is just too excruciatingly painful for me. Maybe it's because of the median lobe, not sure. It would literally be like torturing myself several times a day, more of a living hell than the one I am already in. In fact, it was attempts at CIC that resulted in the ultimate total blockage, because it caused so much irritation (lots of blood, even tissue, etc). It unfortunately just isn't an option for me.
luis55497 scott95643
Posted
Actually the PAE was not originated in the US but in Portugal by a humble Dr
Martins Pisco.
It amazes to me that after 15 years so little information has been disseminated on the scientific medical circles in the US.
kenneth1955 scott95643
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scott95643 luis55497
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Yes Luis, I know. That is how I originally learned about it. I was actually about to reach out to Dr. Pisco and was considering flying to Portugal. I then tracked down Dr Bagla here in USA, and ultimately learned that there was even a doc here in LA at UCLA, Dr McWilliams who has also been doing it for several years. It was unfortunate that I had to figure all this out on my own and that even the UCLA urologist did not mention it as something UCLA was doing and an option to at least explore. You would think they would work together to pursue the best course for particular patients based on the patient's concerns and lifestyle.
scott95643 kenneth1955
Posted
Thx. I have thought about Urolift, and did see a Dr here that does them. I have a median lobe problem, so Urolift is a little trickier, tho the doc I met said they have been trying some different techniques with the Median lobe. I haven't ruled it out. That is part of the reason I need the SupraPubic, so that I can continue to investigate all the options. Even PAE is probably an issue with the median lobe, but the doc I have been speaking to about PAE said that they have been having success with median lobe patients as well.
kenneth1955 scott95643
Posted
Scott that is a good Idea. I have read that they have had good results with the Urolift and the median lobe. In the trail they just pull it to one side and it stays out of the way. No Retro problem. Don't know if that is a concern of yours. I know I had mine done 3 years ago and I have had no problem with my orgasm or ejaculation. Rezum they have had some good result but they have had 10 to 15 % of men get Retro. PAE has concerns with retro to. But it is up to you. Good luck Thursday forget about everything and just relax Ken
scott95643 kenneth1955
Posted
Thnx Ken. Trying my best to relax, but I also hate the idea of having to do this, and am freaking out . But it's just a choice of two evils at this point. Yes, retro is a huge concern. That's why I am taking so much time. In fact, see my post to OldBuzzard, I think in the REZUM chain.
scott95643 kenneth1955
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PS, Among other things, one of my concerns with UROLIFT is that MRI's would be a problem, and I do have reason to need MRI's from time to time. Also, any issue going through airport scanner , lol ??? BTW, my urologist says to take UROLIFT off the table, lol. Like most traditional Uros, he is pretty much all about TURP. But he has blessed if I want to give PAE a shot (even though he doesn't believe it works). He's removed a few Urolifts I guess.
luis55497 scott95643
Posted
When I spoke to the urologist in Peru about his training with Dr Pisco in Portugal he was very honest to say that there is a conflict of interest.
He also said that that he learned a lot during his week of training with Pisco.
I sent a note to the American Urological Association to let them know that and I also I feel that what they are doing is unethical and misleading.
Even if it’s not for everyone they should make aware to the patients that the procedure exist instead of hiding all together.
scott95643 luis55497
Posted
I agree. I've written to a couple uros to say the same. Maybe we should form a group and sign a petition to the AUA ;-) ! I'd like to beg them to be less complacent about sticking with traditional urologist procedures and practices, which also makes them take for granted the consequences, like RE, that they feel we shouldn't be concerned about and they pass off as "no big deal". I've been snickered at for expressing how traumatic the thought of the sexual consequences, including RE, are for me. They need to work together with the other fields to come up with better solutions in the name of the best result for the patients suffering from this, and based on what are each patient's main priorities, concerns and fears.
kenneth1955 scott95643
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Scott. Sorry I am getting back to you so late went back to Georgia this morning will be here for 4 weeks. Who told you that a UROLIFT can't have MRI. I had 2 last MRI's last year there was no problem. It tell you all the information on it. It will do the same as any of the other procedures. It will make a tunnel. It is the easier of all the procedures and the quickest to heal from.Please look into it. Your doctor told you to forget it becausse he want's to do a TURP. Stay away from that. How was your procedure today. Just relax and give yourself a rest. Good luck Keni
scott95643 kenneth1955
Posted
Thanks Ken, True my Uro prefers TURP, but he's opened his mind to being OK if I want to give PAE a shot first. He is actually just not a fan of Urolift, because he's had to remove a handful of them that failed, and because he says many don't last long at all, or end up having the tissue grow around them. Its also because I have a median lobe. problem. Even the Urolift guy I spoke to acknowledged that It has not traditionally been the best procedure for Median lobe, but he said he has been doing a new procedure that he's had some success with where I think he makes an incision to split the lobe. Anyway, I read in some articles about it that there could be a problem with MRI's. I thought the clips were metal ? That would usually be a serious problem with an MRI, especially with a 3T MRI. Do you know if the MRIs you had were 3T? Also thought I remembered seeing something that they could even set off some airport metal detectors. lol.
scott95643 kenneth1955
Posted
PS, Also, surgery went ok. Sore now and some oozing...and back to a bag for a while instead of a valve, to keep the bladder from filling while the puncture is setting up. So that is a pain in the ass. But hopefully in the long run it will be more freedom. But once again a Uro was pretty complacent about the impact of things, as he told me b4 the procedure that he'd keep me with a bag for the first few days to let everything set before I start using a plug or valve again. Then after the surgery he tells me I'll keep it on for two weeks!!!!!! Yeah, I guess that's a few days !!!!! What the hell is it with those guys!!!?????