PAE for IPP/Median Lobe
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Can a PAE successfully treat a IPP/median lobe condition?
I've seen both yes and no answers.
If you've had a PAE, did you have a median lobe?
If, so did you have good results?
How was your experience; Positive, Negative, No change?
I've had a Urolift (2yrs ago, no improvement)which is intact and working. My issue is a large median lobe which acts as a ball valve cutting off my Urine flow. I'm on daily coumadin, so bleeding is an issue with the other BPH procedures. Ultra Sound indicates prostate size at 55g.
Intravesical prostatic protrusion (IPP) is a manifestation of benign prostatic hyperplasia marked by overgrowth of the prostatic median lobe into the bladder, producing bladder outlet obstruction and related storage and voiding symptoms.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896862/
Median Lobe addressed on Pages 7 (table 1) - 8
0 likes, 2 replies
1rphguy bill24813
Edited
I had Median Lobe elongation with symptoms at 35 yrs old. Struggled on medications for years. At age 50, something had to be done. I was having to cath. At 50, I couldn't bear the idea of the side effects that every procedure that was offered me would likely cause, so I researched.
My prostate on measured about 40+ but was pushing into my bladder. I found Dr.Bagla. I had the procedure 10 years ago at age 50. It helped only enough to postpone my problem. I still took BPH meds or I wouldn't have been able to urinate at all.
About 5 years passed and all my problems came back even worse. At 57, I still did not want retrograde and I sure didn't want incontinence or impotence. I researched a lot and my choices came down to aquablation or a prostate laser procedure. I chose the latter.
That procedure worked fantastically because you are inside an MRI machine while it's being performed and the median lobe can be targeted and the parts necessary for continence and normal ejaculatory function can be spared. I am able to urinate like I was 30 again and no sexual side effects at all.
To answer your question directly, most PAE results show that it's not very effective with median lobe enlargement, no matter how big or small the prostate is.
My last PSA was 0.46 and doing well.
I hope you find your healing.
rph
bill24813 1rphguy
Posted
Thanks for the Reply,
Aquablation has been at the top of my list. The issues I face are daily coumadin (anticoagulant), which I can only be off of for 3 days, bleeding and 6 hrs one way to the doc. Next is an ejaculation preservation HoLEP. This procedure can been done as a median lobe only, which results in a 2-3% chance of retrograde or full which includes the lateral lobes, resulting in a 10% chance of retrograde. The difference between HoLEP and ejaculation preserving HoLEP,from my understanding, is the preserving method leaves the tissue (1-2cm) around the verumontanum (near ejaculation ducts) untouched. Still a possibility of retrograde or dry ejaculation. The Last is the Prostate Artery Embolism (PAE) which doesn't require me to stop my coumadin, no retrograde or significant bleeding issues, it requires 5 hrs to the doc as does the HoLEP.