My Recent PAE Experience
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60cc prostate. 2.2 PSA. No median lobe. 78 years old. Excellent health for my age. Had PAE done 2 1/2 days ago in Miami. Went through the left wrist. I was completely awake. No "twilight" sedation that I could tell. The only discomfort was when he injected the dye and my penis got warm for a few seconds. Booked a hotel for 5 nights total, anticipating side effects. In reality, could have gone home the same day. Not one side effect. No pain. No burning. No frequency. No constipation. No nothing! Just urinating normally. 2 1/2 days post op. So the only med I'm taking is the antibiotic. No ibuprofin. No codeine. No bladder spasm medication. No colace. Just took off the wrist bandage. Can hardly see the pinhole entry point. No bruising. This interventional radiologist is a genius-doing such a complex procedure and finishing it with hardly a trace. He has done over 1000 of these procedures and he answers to the name, Dr. Bhatia. The hotel stay is a minor inconvenience considering the extraordinary results at this point in time. Thanks to ProstatePete for his comprehensive review of his procedure with Dr. Bhatia that convinced me to go with him! If anything changes, I will post it here. As of now, 2 1/2 days out, I am elated! I highly recommend this elite interventional radiologist!
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howard26683
Posted
16 days in. Urine flow a bit better. Nothing to close the banks for. But "sneaky" progress. Still awakening three times at night to urinate-just like before the procedure. Slow starting the flow, same as before the procedure. The doc said the next two weeks should demonstrate noticeable improvement.from BPH symptoms. Dr. Bhatia phoned me twice, concerned about my little ulcer or blister. He told me to put corticosteroid cream on it a few times a day, which I now am. He insisted from my photo that this lesion did NOT come from errant microbeads. How many MDs would call me back once, let alone twice? I had heart surgery(mitral valve repair) last July and had some questions during recovery. Voicemail went completely unanswered: both regarding the surgeon and his nurse. Still waiting a year later. Lol!
howard26683
Edited
4:17 PM, day 16. (Previous post was morning urination at around 7:15 AM.) Urinated very well late this afternoon without that constricted, squeezed feeling. It's only one really good time. We'll see what happens going forward.
howard26683
Edited
Orgasm this evening was fine, more intense than pre-procedure, BUT, looks like I have retrograde ejaculation. Nothing there. At my age, only just a drop or two of semen anyway, pre-procedure, now nothing. So I went from almost no semen to no semen. Not a huge adjustment. 20-40% have retrograde ejaculation, post PAE, depending on the study. Name me a BPH prostate procedure where this is NOT an issue, Those who have a normal volume of ejaculate after any of these prostate procedures are really lucky! So, weigh this as a potentially permanent(?) side effect if thinking about this procedure and you are in your 40's-50's with a nice volume of ejaculate. As stated, the tradeoff is my orgasm was really, really intense!
howard26683
Edited
I just read a post on another PAE thread in which the poster stated that well-known IR Dr. Isaacson said that there's a good chance that semen ejaculate may return over time after a PAE procedure. That would be nice. I have a telehealth visit with Dr. Bhatia in 2 weeks, and I will certainly be asking him about that. Sounds logical that semen is reduced or eliminated due to prostate shrinkage. So, not your typical RE. It also sounds logical that semen would be regenerated after the prostate starts growing again when new arteries take the place of the old ones and begin supplying blood again to the prostate.
howard26683
Edited
I had orgasm today, 18 days post-procedure, and actually HAD ejaculate; a few more drops than pre-procedure, so who knows? Glad to see it. I was kind of down in the dumps over potential RE, but now it appears to be better. Orgasm strong. My research shows a 30% reduction in ejaculate, post-PAE for about 40% of patients. Judging by my performance today, I'm not one of them. Strange how the previous orgasm seemed to be unaccompanied by semen. Am I crazy? Nope! Just honestly reporting my experiences. Today was a really, really good day!
howard26683
Edited
20 days in, ejaculated again with semen present. So those RE posts, don't pertain to me. The only downside I can see from the PAE procedure, assuming one does their homework and chooses an elite IR, is it could take 1-3 months to get really good improvement of BPH symptoms. No instant gratification. The prostate will slowly shrink; although I must admit my orgasms are faster and more intense than pre-procedure. Other guys have experienced the same.
howard26683
Edited
23 days in: Slept 4.5 hours straight last night (2AM-6:30AM) and just finished a 3.5 hour daytime interval without urinating. Followed by a 4.5 hour stint which just ended at 9 PM, EDT. So, BPH improvement from the PAE, seems to be finally beginning. It must be at least 30 years since urination was an occasional daily chore accompanied by 8 hours of uninterrupted sleep and not the torture it gradually became. Still some straining to get the stream started. Not 100% cured. It was an inconvenience to me to fly to Miami, a city I would never visit on my own. Seems it is finally showing to be worth it. Telehealth with my IR next Friday.
howard26683
Edited
So, as a final post, to sum it all up, for a painless, minimally invasive technique that is the only procedure that does not directly butcher the prostate, and leaves no permanent irreversible side effects, there is PAE. Supposed to take 1-2 months before noticing improvement, but there is no pain or temporary sexual side effects involved while one waits for the prostate to shrink. None of these procedures, including PAE, are forever, but for 2-3 years of potential tranquillity, definitely worth it for me. At 78, that may be all the time I need. Lol.
Disclaimer: I do not work for any MD and never have. Completely unsolicited log. Just a geezer looking for BPH relief surveyed as "severe", AND a good night sleep. The IR MD mentioned in my posts was recommended to me by another poster on this forum, and he indeed performed the PAE procedure on me in Miami, Florida at the Sylvester Cancer Center in July, 2023. Good luck in undergoing whichever procedure you choose!
howard26683
Edited
Three months post-PAE and urination much improved. 2-6 hours in between bathroom visits the norm now. 7.5 hours, my best. Urgency is rare. This is like my 20's all over again!
Averaging 2 night time visits which is acceptable, down from 5-7 when I was a zombie last year, Best of all, my PSA went from a not bad pre-PAE 2.2 to an astonishing 1.3 after 3 months post PAE procedure. I'm happy! Follow up three month post PAE procedure prostate MRI, this Monday to measure my new prostate size. Was 59.3 cc. pre-PAE. Will report the new prostate size after I get the result. The lower PSA bodes well for a significant prostate size decrease.
howard26683
Posted
Yup! Had the MRI today. Prostate went from 59.3 cc to 36.1 cc in three months. Very happy!