PAE

Lew,

Hardly you will find somebody have both 😃, so I can't comment on UroLift, but can comment on my results with PAE. You find many long emails, comments,and argumentative notes written by me. I'm 71 yo, with severe BPH from at least age 55. Last 10 years first on Flomax (didn't like it low blood pressure effects and RE), then on Alfusozin, girst 10 mg at bedtime, then, additional 10 mg in the morning. Twice bladder neck obstruction with Foley catheter placed for 5 days. Since last December suffered from periodic bleeding from prostates varicose veins. Nothing dangerous with this, BTW. A few mild LUI in the past treated by antibiotics easily. Was offered TURP by my URO until didn't find from MRI scan that my prostate became 135 cc in size, probably with a median lobe. Urolift was out of question because local Uro and insurances limit the size of the prostate suitable for UroLift by 80 cc.Refused TURP and went for PAE on March 29 this year as a part of a clinical study at UCSD (they don't pay for it). Couldn't be better. First 3 weeks were very unpleasant, but painful and frequent urination only first week. Was able to work after first week. Don't get up at night at all (just before PAE every hour), noi urgency, can hold more than 1 hr after the first urge. Intervals between visit to bathroom at least 3 hours. Initially experience RE with now other sexual side effects. Now at 8 month even RE is gone, sexual functions improved substantially if compared to preop. Stream always overshoots the toilet like in my 30th. The downside is nobody knows how for how long it will last. So far the improvement continues but at slower pace. Also the radiation dose during PAE is substantial, but at my age it's not that important, lifetime probability of any abdominal cancer, according to the online calculator, increased only by 1%.

All discussed procedures:TURP, GL, GoLEP, UroLift , and PAE have their specific patients and not much competing, if considered by a well educated doctor. All UROs, naturally, are the worst enemies of minimal invasive PAE., performed by very skilled Interventional Radiologist. Mine was PErFeCeted PAE with embolization of some small arteries inside the prostate itself. Possibly that help to shrink the median lobe that usually obstructs bladder's neck. There were no additional after PAE scans, so I have no idea what percentage of prostate is gone. According to some publications, it could continue up to two years. The only objective factor is that I measured, is the flow rate. It improved from 7 cc/sec to almost 20 cc/sec. My IPSS went from 24 to less than 10.

I hope that helps.

also had PAE done at UCSD a month ago with favorable results so far. strong stream and off my Rapaflo med now . still waiting to hear my results if any reduction in size but seems to have improved flow. good luck

I had it done Oct 29 and the doctor said it could take a month for any improvement. Too date, the only improvement has been a stronger stream., but the nocturia has not improved. I had a follow up visit today and the doctor said that in some patients, there is improvement in all the areas except for the night time issue. I previously have had two urolifts done and the first one lasted about a year. I went for a second one and I still was faced with frequency and nocturia. So, I had a urodynamic done and it was Ok and the

urologist said he thought it could be just that my bladder had shrunk but nothing was conclusive. Thus, the PAE could have been performed all for naught. I am going to another uro for a second opinion.

Anyway, with both procedures, I had absolutely no side effects whatsoever. I've know people that have had success with both of the procedures.

So, its quite obvious that each patient may not experience favorable results as it is just a very individual matter.

Also, it's crucial that you find a Urologist/Radiologist that has a stellar record and has done the procedure many times.

Good luck!

Yes, I had it done in Poland at end of June 2018. I have had no other procedures. I am 76 and was getting up 5 or 6 times during the night

The procedure, to block arteries feeding blood to the prostate, took 2 hours under sedation. I was in the clinic 3 nights.

MRI before and CT scan in October 2018 (after the procedure) showed my prostate had reduced from 130mg to an estimated 100mg . I plan to have another measurement in February 2019. I now get up once or not at all during the night,

I have no flow measurements before or after.

I was prompted to have the procedure because tamulosin was a passion killer, and no longer working for me.

After the procedure I had some weak blood coloured pee but it stopped after the first week. Occasional RE initially but ok. Suspect my age is a factor!

I now take no medications at all

Hope this helps but we are each different. I have never used a catheter. I weigh 71Kg

Dear Lew,

I have no experience with urolift but I recently (seven weeks ago) had PAE and would recommend it without reserve. There is no meat grinder, burning tissue, or any such traumatic solution. There was no pain, it was simple and quick, literally done one day, stay one day in the area in case of problems, and fly home the next. I flew from Washington State to Virginia and it was well worth it. I began seeing the results quite clearly by three weeks. I could not find a urologist to refer me but Dr. Bagla at the Vascular Institute of Virginia accepted my self-referral. I no longer strain to go and my nights have gone from five to seven times up to pee to about three times per night. I can sleep now. I still have some problems with urgency and find myself dealing with wet pants when I can't find a place to go, (only one time since PAE) and it is much easier to manage. I had been diagnosed with a "watch and wait" prostate cancer (Gleason 6) and thought I was now without alternatives in my search for BPH answers. But Dr. Bagla said he could target the MRI-found and biopsy-verified cancer area. I just had my PSA tested yesterday and am waiting to see if it has gone down. PAE does best for those wishing to preserve their sexual function and those who have large prostates. It also helps if you have a good vascular system. I am very active and a no-oil vegan (after Dr. Michael Greger, nutritionfacts.org) so my vascular system was in great shape. My prostate was 127 CC and I am newly married at age 71 after my wife died of cancer. Things still work, not like 20 years ago, but at least not worse! PAE is a very good first procedure as it does not keep you from doing any other procedure later. My second choice would have been HoLep, but if things get worse again I could redo the PAE or have HoLep at any time.

Lew

Mine was done in January this year,in Durban SA

Nocturia - reduced to 2 maximum trips to the toilet

Sex function - back to normal - except delayed ejaculation - so my lady gets LOTS of orgasms, and I still produce lots of semen (unlike with Silodyx and Flomax - both caused RE and impotence)

Capacity - 250 ml every 2 to 3 hours

Urologist wasnt in favour of the procedure done by a radiologist, and said urine stream was no different to before the op.He was almost rude when I asked for a remeasure of the size- he said scan was too rough and an MRI would be a waste of money.I suspect he favoured doing a full scale op on me (with all the fees..)

I do feel the benefit of the op , although I must watch fluid intake 2 hours before sleep

My PG was 100ml per MRI scan

Kind Regards

Mr President

I had PAE at St. Louis University Hospital in St. Louis, MO on July 1, 2015. Total cost $44,000 - $7,000 from me and $37,000 from my insurance. I improved somewhat for six months, then was right back to where I started - 6x per night, weak stream. Turns out the Interventional Radiologist was only able to get to one side. He wanted to do it again, to get to the other side, but I didn't want to spend that much money, again, for something that didn't work the first time. My view of PAE is: 1. It is a highly technical procedure dependent on the skill and experience of the IR, and on the quality of his equipment. 2. It is not painless, but the main problem is the introduction point of the femoral artery, which is painful for about two weeks. There is also prostatic pain for the first month, which feels at times like a UTI. 3. In my case, the embolization on the treated side was in the perimeter of the prostate, not the core. (my prostate looks like the apple logo, but the urethra is still blocked.) 4. I won't be doing it again.

I just had a UROLIFT in Maryville, Illinois at Anderson Hospital, October 18. Total cost about $10,000 - $2,000 from me and $8,000 from my insurance. The Urologist (note the different specialties) put in 5 clips. About eighteen months after the PAE, I developed severe retention and had to go to the ER. The Uro put me on self catheters. At the time of the urolift, I was up to 3 per day. I have not had to cath since the procedure, so that is a big improvement. I had severe pain for about 5 weeks, but it is diminishing. I still have frequency/urgency issues, but a better flow. If I have to, I'll do another urolift.

I live near Tampa General and am considering PAE Does anyone know the rating of that hospital for PAE as I cant find any thing on Dr. D or Tampa general on there proficiency on PAE.. Don't want to put in Dr. full name as I don't think its proper . I have a urologist in same hospital as this DR. (Radiologist) and this is a help as my records for the uro is all in the same system. trying to find out how many times this dr has done pae and will ask and post as soon as I find out...

Dear Lew,

I think it really depends on the interventional radiologist you use. I was not able to find one in my area that had much experience. The one I first found had done about twenty procedures. He insisted on having a referral from a urologist. We even picked one out together. The urologist refused to refer me to him. That is when I went to the one in Virginia, Dr. Bagla who has done hundreds, maybe thousands of them. As for the cost, Medicare paid for it and my cost was zero except for the plane ticket. I had no pain at all except for a little burn on ejaculation about three days after the procedure. I am about seven weeks post op and am very happy with PAE.

Bill

Can you provide contact info for Dr. Bagla?

Thanks