PAE Sept 30th

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I had mine about 10 days ago with Dr. Isaacson at UNC.  It is all very professional and caring.  No delays.  My only complaint is having to fly in from the West Coast.

The procedure is a game changer for me already.  I improved every day post proc and awoke a new man on day 8.  I am pretty stunned by how well this worked.  Post proc there were a few nights of urgency which was handled with  pain meds.  I slept like a baby.  I flew home on day four post proc and had a bit of urgency but less than pre proc. I would strongly recommend at least 3 nights in local hotel post proc.  I had sex for the first time on day 8 and just a bit of discomfort ejaculating but otherwise normal except that my erection was stronger than ever.

I can't say enough positive about Dr. Isaacson and the staff.  I was into radiology at 9 am and out of hospital at 1:30.pm.  I am still in stunned disbelief about how easy and effective this was.  Dr. Isaacson said I was a good candidate with a prostate size of 123cc.  Honesty this should scare the crap out of  the medieval practictioners called Urologists.  This was $6500 self pay and the hospital will work out payment plans.  Men who have BPH should look at this as a first option.  Let's work to get the word out to put the uros out of business.  Having read posts about their attitudes they shouldn't be practicing medicine. 

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  • Posted

    I should have added that I chose Dr. Isaacson due to his experience with the procedure.  He has performed over 130 which makes him the go to guy.  He went into the femoral artery which concerned me a bit but it is no problem at all.  He is using improved catheters which dictated this decision.  I rode my horse today on day 10 with no problems at all.  Normally riding gives me an urgency sensation but no problem today.  The unknown is how long this will last.  If I had to do it every 3-5 years it would be worth it.
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  • Posted

    David - fantastic news - so happy for you! My prostate is about the size of yours; I've been seriously considering flying to UNC. (I'm also from the West Coast). Good advice regarding not flying back right away.

    Did/Do you have an enlarged median lobe? Thanks.

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    • Posted

      Thought I'd jump in here :  I do have a large median lobe but prostate less than half that size.  I had the PAE w/ Dr. Isaacson about a year ago.  He is great; however, it only helped me about 5% (probably because of the large median lobe).  He was very upfront about this possible outcome.  I decided it was worth a shot anyway.  I also had gone into acute retention and was dependent on self cathing (still am).  This may have further decreased the chance of success.  Just wanted to give you more grist for the mill.

      Good luck!

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    • Posted

      I did not have a median lobe.  I had an RSI-MRI in late 2015 which outlined everything including an assessment of low cancer risk.  This newest diagnostic is done at UCSD in San Diego.
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    • Posted

      I live in San Diego - my home is very close to UCSD.

      UCSD's Andrew C. Picel, MD, is a board-certified diagnostic radiologist. From his bio: "Clinically, Dr. Picel also has a special interest in interventional oncology, uterine fibroid embolization, ovarian vein embolization, occlusion balloon placement for invasive placenta, [u]prostate artery embolization[/u], and vascular imaging." I wonder how many PAE's he has done? I am going to look into it.

      FYI, my uro told me I have an enlarged median lobe. Though I have been peeing on my own for just over a month since having the foley removed, I think it's time to be more proactive about my BPH. I do not want to experience AUR ever again. My uro says my only choice is simple prostatectomy, but I have told him on more than one occasion that prostate surgery will never happen, so he can stop suggesting it.

      PAE is at the top of my list of "non-surgical" choices. Currently I can't decide if I would want to go to UNC like you did where they've done more than anyone, or stay local and have it done at UCSD, where I'm sure they haven't done near as many as UNC. But being able to recover just a few miles from the hospital in my own home is very appealing.

      Good luck on your continued successful recovery.

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    • Posted

      What is simple about a prostatectomy?  They remove the entire thing and you're screwed for life. Many men are incontinent and most have ED.  I really can't believe the surgeon is so desperate for business that he says go there first.  That should be a last resort when you're 85 and not having sex. I would question Dr. Picel closely.  Since this is a new procedure the more an IR does the more they learn.  Not many trials written up so I would recommend whomever has the experience.

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    • Posted

      Dr Sandeep Bagla at the Vascular Institute of Virginia has also done many, many PAEs.
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    • Posted

      Just to be clear, my uro is recommending simple prostatectomy, not radical prostatectomy. Simple prostatectomy is a procedure to remove the inside part of the prostate gland to treat an enlarged prostate. Radical prostatectomy is a surgery to remove all of the prostate and some of the surrounding tissue, usually in some severe cases of cancer.

      My uro described the simple one as slicing into the tough outer skin of an orange, peeling back that skin, scooping out the insides, then sewing the skin back together over the hollow core. The prostate, though completely scooped out, is left intact, so to speak, along with all the nerves and sexual parts. Permanent, almost dry, retrograde ejaculation is almost 100% guaranteed. Of all the surgeries one could have on the prostate, the simple prostatectomy is by far the most invasive, requiring cutting through the abdomen from the navel down to the pubic bone. Hospital stays of almost a week are not uncommon.

      I agree with you that for something as important as this, experience is a must. If Dr. Picel hasn't done more than 100 PAE's, I will look back towards the East Coast.

      Thanks.

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    • Posted

      One further thought:  experience is particularly important with PAE as it can be a challenging procedure .
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    • Posted

      The uros may make a distinction but the body does not.  Retro is assured but look at the percentages of men ending up with ED or incontinence.  I think much higher than you would like unless you've tried everything else out there.  I actually had a uro tell me that potentially losing my ability to have sex was no big deal at 68.  I will never return to that DR. 

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    • Posted

      Yes, I totally agree with you, and that's why I will never have prostate surgery. Besides, I don't think my symptoms are bad enough where I need to gamble on my sex life! At this point, I will either have a PAE or I've even considered learning to self-cath as insurance for a low probability AUR.

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    • Posted

      If anyone is interested, Youtube has some decent animations on quite a few urologic surgical procedures.  For example, I just watched a short animation of a TURP procedure. ("Animation Turp Procedure"wink Maybe if we knew what we were getting into, we could at least be better informed about our options and their potential outcomes. Hope this helps, guys.

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    • Posted

      Why even expect to stop having sex at 85? Exercise and healthful diet will keep one going 'till 100!  I'm only 10 years from 85 and sex is getting better and better.  I'm into gymnastics, now.

      Harvey

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  • Posted

    Great news, David. Thanks so much for your post. Would you give us all updates as things progress?
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    • Posted

      I will give an update at 30 days which is when Dr. Isaacson will next contact me.  He called me the day after the procedure( a Saturday ) and had the dept call me the following day as well to check on me. 
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    • Posted

      Well, I'm about 38 days out from having a PAE procedure with Dr. Isaacson in North Carolina.  I am extremely happy with the result.  I can drink a little alcohol without worrying about urination.  I can also travel long distances in the car or on an airplane without worry.  Just when I think it can't get any better, I realize I continue to improve.  I would highly recommend this procedure as a first step for anyone suffering symptoms and try to do it before you need to cath.  The only issue I had for a few days post proc was urgency especially when trying to sleep.  That gets better fast. I haven't completed the questionarre yet but would guess I will be in mid single digits versus the 20's before. 

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    • Posted

      no median lobe that I'm aware of.  The more the IR's get experience I think they will start to get success with men with the median lobe.  Hang in there.

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    • Posted

      Thanks a lot, David.  I'm considering having a second PAE w/ Dr. Isaacson if no other viable options present themselves.

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