PAE Sept 30th

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!

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.

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.

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.

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. 

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.

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" 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.

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

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. 

That's great David! 

I was wondering - did you have an enlarged median lobe ?

Thanks a lot.

Rich

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.

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