PAE proceedure not working

Posted , 12 users are following.

had the proceedure on August 6th 2014 at UNC hospital. I had been experiencing bhp since my mid 30's and am now 60. I have been on uroxotrol    for the last 10 years or more. My local urologist had recommended the turp proceedure because of infections primarily from bladder retention. I read about the pae proceedure and decided to try this because of reduced side effects. The proceedure took much longer than expected (4 hrs.) because the right side of the prostate had much smaller blood vessels than the left. I was releasd that day to go home with a catheter because of retainege and with no meds for pain. The pain was much worse than I thought it would be and lasted for the first week. I had experienced some mild incontinence ( occasional dribbling) before the proceedure but afterwards it has gotten worse. It has been five months and after some improvement initially I seem to have regressed. Currently I am seeing a urologist at UNC for the incontinence problem who is telling me I am going to have to have the turp because the pae proceedure did not help my problem. Has anyone out there had similar experiences.

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14 Replies

  • Posted

    Hi Rudy;  I had the PAE on Sept. 10th, 2014.  The first thing I want to say is I can't believe the Doctor/Hospital sent you home with NO pain meds.  Unbelievable.  When I was sent home they included in a sack for me 4 different meds to take for 10 days.  Pain meds, anti-inflamatory meds, anti-biotics, and I forget what the 4th one did but I was told to take all 4 meds for 10 days.  Iam still getting up nightly on average about 3 times.  It use to be 4 times so I guess I will say I have had a 25% improvement.  The big thing with me is I was able to completely get off the Avodart and the Tamsulosin so now I truly enjoy a nice sex life again for the first time in over 2 years.  I hated those two drugs for how they killed my sex life.  I have not experienced your problems as of yet.  Where are you located???   Iam in the USA.
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    • Posted

      Hi Chuck, thanks for the response . I also have enjoyed an improved sex life but the increased incontinence issues are putting a damper on it at this time. I am located in Virginia. I go back for tests the 26th of January and will give an update.
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    • Posted

      If you are in Virginia Iam going to take a "wild guess" and say you had the procedure by Dr. Sandeep Bagla at Inova Hospital in Alexandria.  Thats who I used too!!!!!   Small world isn't it???  I was his number 116 PAE patient.  I like him, as he is a very good highly intellectual man.  Iam just dissapointed that Iam still getting up 3 times a night.  But as we all know "life has no guarantees".   Just ask Steve Jobs who had multi billions of dollars but couldn't buy good health.
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  • Posted

    Hi Rudy, looks like Pae is at best a mixed bag. Most patients post-op report much better sex lives compared to most any other procedure except probably urolift. 

    I think your decision to use a urologist at a large university medical center is a wise choice. Those institutions plus clinics such as the Mayos and Johns Hopkins  are where the best doctors af all disciplines are found and you much more likely to receive the best care. Good luck, keep us posted. Thousands will read your posts.

    Ron in Texas 

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  • Posted

    Hi Rudy,  I had my PAE on November 21st.  I agre with the "mixed bag" comment.  I know of one other person who had serious pain for 5 days after, but had a vast improvement about two weeks after it.  IPSS score of 2!  My results are a slight improvement in bladder emptying so I only get up once or twice, but I still need the Tamulosin at the max dose.  It can take up to six months but it looks like you are already there.  I started having BPH in my mid twenties.  It was an overnight development for me.  I literally woke up one day and had to wait for the stream to start and when it did it was slower.  This led me to a series of diagnostics that only showed a constriction at the bladder neck so the urologist jumped to the prostate conclusion.  I was skeptical that my prostate could "jump" in size in 12 hours, but that's all urologists know how to diagnose.  To them there are no other causes.  Very frustrating for me dealing with them.  So now that Im 57, it had gotten much worse and my prostate has enlarged a bit.  So I went for the PAE.  I am hopeful that I will continue to see improvement but time will tell.  I also had a long procedure due to the right side blood vessels.  15 minutes on the left and 2.5 hours for the right.  I was originally going to have the PAE at UNC, but found a IR doc in California in my HMO so went that route.  The doc at UNC seemed very knowledgeable and was very helpful with information but I also am suprised they didn't send you home with Meds.  I had Naprosin for pain and swelling for 10 days and Cipro antibiotics for 10 days.  Best of luck to you with treatment.  We all gotta pee.
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    • Posted

      Prostatitis needed to be ruled out when you had the sudden jump in symptoms.  I wouldn't doubt that many BPH patients also have some prostatitis.  Prostatis will cause inflammation and some swelling.  
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  • Posted

    My experience was similar in that I started suffering, what I now know to be BPH, starting from age about 38 though not diagnosed till 58, then went for PAE age 59.

    My procedure took longer than expected, around 1hr 45, due to acute bend in one artery. I was released 6hr later, no meds but no pain, just tightness around catheter insettion point for about a week.

    So far, at 10 weeks, I've benefited from the procedure. At 4 weeks scan, my prostate size had reduced 17%. Was told that any size reduction would be over the first 6 months, so from that would think your chance of any improvement from the PAE are slim.

    I went to Prof. Pisco in Lisbon, who probably trained the UNC people. Hespoke about a paitient 80 yr old smoker with (seen on CT scan) tortuous (small, very branched) arteries, who still wanted to proceed despite low chances of success. So it seems strange that, in your case, theey had not expected it to be a long procedure. Did you not have a CT scan, or |MRI, beforehand ?

    Were you told if embolism had been sucessfull on both sides?

    In Lisbon, if procedure was not a success, they will repeat after 12 months provided your arteries are suitable - not too tortuos/

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  • Posted

    My experience was similar in that I started suffering, what I now know to be BPH, starting from age about 38 though not diagnosed till 58, then went for PAE age 59.

    My procedure took longer than expected, around 1hr 45, due to acute bend in one artery. I was released 6hr later, no meds but no pain, just tightness around catheter insettion point for about a week.

    So far, at 10 weeks, I've benefited from the procedure. At 4 weeks scan, my prostate size had reduced 17%. Was told that any size reduction would be over the first 6 months, so from that would think your chance of any improvement from the PAE are slim now.

    I went to Prof. Pisco in Lisbon, who probably trained the UNC people. Hespoke about a paitient 80 yr old smoker with (seen on CT scan) tortuous (small, very branched) arteries, who still wanted to proceed despite low chances of success. So it seems strange that, in your case, theey had not expected it to be a long procedure. Did you not have a CT scan, or |MRI, beforehand ?

    Were you told if embolism had been sucessfull on both sides?

    In Lisbon, if procedure was not a success, they will repeat after 12 months provided your arteries are suitable - not too tortuous

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  • Posted

    I have gone to Dr. Pisco's website and entered contact information.  I haven't received a response.  How were you able to contact the office?  Was it reasonably affordable?  I don't know what the prices are like in Portugal.  
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  • Posted

    I also had the PAE , I don't regret it ,things are better but still have UTI's and an still on alpha blocker.

    I still need a solution to this issue.But I have much better urgentcy symptons,now can hold on for up to 4 hours or so since the PAE.

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