My Uro's response to my inquiry of PAE

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From my Urologist when I asked his opinion of PAE:

"I have three patients who have had PAE, none of them got any improvement. However, there are certainly patients out there that have improved. "

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  • Posted

    That's consistent with the information on this forum. It helps some but not others. I did a survey here several months back and the results pointed to it being not very effective on recipients that had a median lobe.

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  • Posted

    Hey Buddy

    That seams like the standard answer from a urologist. But we all know not all treatments work on every one because we are all different

    Some of the men on here that have had it only got maybe 20 to 40 % improvement. And if I remember it works better on bigger prostate.

    Have a good day.....Ken

    PS. Yes that is true it does not work on a median lobe

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  • Posted

    Yes I can confirm . May 2017 PAE in LISBON Portugal without any effect . I have had BEAsT median lobe protruding to bladder acting like pressure valve. And my l prostate was relativelly small just 45 ccm . But in case of standart regular y increased prostate even big ones PAE has positive effect about 80 % of success. Firstly you need to provide MRI scan to discover correct anatomy of your prostate and just then find solution. No other method can give such clear definition of prostate shape and structure. My solution was FLA in Houston - May 2018 - my life changer. Best wishes to brothers in arms. 😃 Stan

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  • Posted

    Had mine over 3 years ago. No median lobe problem so an almost 50% reduction improved my symptoms by a similar amount. 3-4 times a night to just once being the most significant, however nocturia is an issue that PAE is not guaranteed to improve. Still get occasional urgency and still more frequent than my 20's and most frustrating of all, I can go from approaching hose like voids to weak stream even in the same day. It is still way better than prior to the PAE.

    There is only one thing that I know effects my "performance" consistently and that is drinking alcohol. Drinking definitely "tightens" the prostate making the passage available for voiding reduced. I still suffer from PVR (post void retention for any newbies) but again this varies and alcohol is a factor, particularly in Beer form. 😃. I have had two bladder scans in follow ups to the PAE, one was zero the other about 10-20ml, it was so little that margin of error was mentioned. Answer is obvious, give up alcohol, but that isn't going to happen as it is still more than manageable, couldn't say that before the PAE. In my case, important to stress that, what the PAE has done is brought a major reversal to BPH and has bought me time, how much who knows, and hopefully taken stress off my bladder, that gives me the opportunity to wait for the next "big thing" in BPH medicine whilst enjoying my current levels of relief.

    PAE gives suitable candidates a relatively non invasive improvement in the symptoms of PAE and does so without precluding other options. In my view, if it is right for you it should be your first choice, even over drugs, which don't get a particularly good press on here. More invasive options tend to be a one way street so should be approached with caution if PAE is an alternative for you.

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  • Posted

    you need to find a URO that specializes in PAE. Mine does and I have excellent results after a failed Urolift with no RE.

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    • Posted

      That's unusual for a Uro to do PAEs. They are usually done by Interventional Radiologists (IRs). I would strongly recommend, if one wants a PAE, to have it done by an IR with extensive experience doing them.

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  • Posted

    My uro estimates 60cc based on DRE. how do i know if I have median lobe?

    I have reached out to DR Bagla and I am willing to fly from Los Angeles to him. Will he say do PAE regardless of my situation because he specializes in PAE?

    I don't drink alcohol.

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    • Posted

      PAE results are hard to predict because it is overall reduction of the prostate, not specific to the impingement. Some people have it done again to further reduce the impingement zone. The median lobe is embolized during PAE as are the other lobes. One IR told me when the enlarged median lobe acts as a ball valve into the bladder, PAE may not work. Maybe have an MRI done of the prostate. Have Dr. Bagla look at the anatomy of the prostate. Dr. Charles Nutting in Parker, CO has also been doing PAE for quite some time. Maybe he could give you a second opinion. I have talked to him and he seemed pretty straight forward and not a salesman. I have found Dr. Bagla to be straightforward also. No IR can guarantee you results. It is a non-invasive procedure that some men choose because it has little downside. It may or may not work. It generally does work on the majority of patients. After 5 years, about 75% success rate. Initially, about 80 to 85% success rate.

      If you choose to have a cystoscopy for more information, I would check into whether the camera on the cystoscope can record the procedure. I read of another patient recommending this so we have a record of the findings that can be shared with other doctors. Otherwise, each urologist would want to do his own cystoscopy. I'm going to contact Olympus who produces cystoscopes to confirm this.

      I have been waiting for some movement on intraprostatic injections directly into the prostate where the impingement is. I talked to a doctor who did a clinical trial for this and he said it had great promise. It works like PAE in a different way. The injectable fluid causes cell death. There is no cutting or burning. It is specific to the enlargement. It has been in Phase 3 clinical trials. I know of three companies doing this. It is also being tested outside of the U.S. It is done in the doctor's office under ultrasound. It is a short procedure. There doesn't appear to be sexual side-effects.

      Cam

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  • Posted

    Two different Uro. stated that PAE was experimental and does not work... I had it anyway in Oct 2015 and was able to get off two a day Flomax which was wonderful.. I had a 3T-MRI two years after the procedure since my PSA went back up to the same level it was before having the procedure. This led to a focused biopsy which was neg. I sent my MRI scan and ask the doctor who preformed the first PAE if another one would improve my flow since the MRI indicated a enlarged medium lobe. He stated there was room for improvement including the medium lobe. I had the procedure done again in Oct 2018 and four months late I have had very little improvement. It did lower my PSA level back down to 3.7, Still off Flomax which makes it well worth the expense, Hopefully I can continue as is for a few more years. Just like many individuals on this forum it is buying me time waiting for that silver bullet.

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