PAE w/ Dr. Bagla 9 Days Ago (Nov 2019)
Posted , 16 users are following.
I used the experiences a several men who posted on this site to make my eventual decision to have PAE done and have Dr. Bagla do it . I thought I would recount my experience in hopes it might help someone else.
I am 55 y.o. and I've had gradually worsening BPH symptoms since my early to mid-forties. While I was never in as bad shape symptom-wise as many stories I read here, it affected my quality of life and I wanted something done. For instance, I could always urinate on my own, never had to cath, I just had a weak stream and a frequent urge to go. Sometimes when I hit that bathroom, I would pee out literally a couple of cc's of urine and that was it. Other times, it was a "normal" amount. I could never tell how full the bladder was based upon how the urge felt.
I highly endorse Dr. Bagla. Professional, courteous, competent. The staff is efficient and competent. Like another post I recently read, I really felt like I was in good hands.
Because of my height (5' 10"), Dr. Bagla gave me a choice of having the catheter inserted in my wrist versus my groin. He said it made zero difference to him in terms of difficulty or effectiveness. But the benefit to me was a better recovery. Less restrictions on walking post-procedure. I chose the wrist. Side note: I was at the upper end of the height range to choose the wrist because of the length of catheters available.
Day 1, I walked out of the office and felt more normal, not groggy or drugged, than I have with any other surgical procedure. They use a 'twilight' sedation versus a general anesthetic. Didn't feel much, if anything, day one except I was winded, out of breath, walking back to the hotel after dinner. I had to stop 3 times to catch my breath.
Day 2, I began to notice my urine stream was noticeably stronger. Not working with high pressure yet, but definitely an improvement.
Days 3 and 4 were the worst, recovery-wise. I had an unrelenting urge to pee, even if there wasn't anything in my bladder. It was worse sitting than standing. So, I stood for 3 - 4 hours in the airport waiting for my flight. I ran out of pain meds for the urination Day 4 (Sunday) and had to suck it up until Monday to get another Rx. This was the worst of it for me. In hindsight, it was not that bad. I may have had a little blood in my urine initially but it's hard to say because the pain meds turn your urine a deep orange-ish yellow.
I am now 9 days post procedure and I feel normal. Stopped taking the pain meds day 6 though I could have done without starting day 5. My stream is stronger but I still get up at night a couple of times to pee. I do believe I evacuate more urine from my bladder during the day so that is an improvement.
Why I chose PAE: Every other procedure I read about mutilates the prostate and requires a catheter. No thanks.
Also, I may change urologists. My former urologist retired so they assigned me to a different doc in the practice. He's really young. Probably a smart, knowledgeable guy. But he was really negative on the PAE. He really tried to persuade me not to have it done. He kept pitching Rezume. My assumption is he pitched PAE as a negative because he couldn't do the procedure and make a buck off of it, not because it was best for me or what I wanted. Being more charitable, maybe he's just not knowledgeable about PAE? I don't know which it is, but I don't think my well being and my wishes were upper most in his mind. He would have happily mutilated my prostate with a laser if was willing. Again, no thanks.
I am happy to update this as I put more time post-procedure behind me. Also willing to answer any questions.
Mark
0 likes, 60 replies
stome mark770
Posted
It all depends on the quality of the surgeon. Prevention is the main issue as BPH gets no respect as no one knows abought it unless you get it.I should of stoped it but now have to live with the let's try not to make it worse.Less sexual activity is better as you keep your prostate from working to hard to make sperm.ZInk is a reluckterbase against DHT.Look at the BPH food guide on what to eat and not.THere is so much more.
gene97713 stome
Posted
Stome,
BPH can't be prevented by diet or supplements. Stop believe in this BS. There is not a scintilla of scientific evidence behind these claims. I used Saw Palmetto for 15 years and ate pretty healthy, using vitamins and zinc, but my prostate has grown to 120 g. The only scientifically proven method of BPH and cancer prevention is castration at early age. Helps to stop growing at later age but doesn't shrink it. Helps to stop growing the cancer, which becomes more aggressive afterwards.
Only early radical prostatectomy prevents late stages of BPH. So, stop wining and dreaming. Take care of it with one of approved procedure and become happy or miserable. Sexual activity doesn't cause BPH ot PC. It's other way around.
Dogs get it too.
derek76 gene97713
Posted
Why have you let yours grow to 120 grms without getting something done about it. The longer you leave it the less options you have. That is the problem that the majority of posters especially American ones seem to have. I find that strange as you have access to more choice than UK NHS patients. I had to fight each time to be referred to a Uro in another region who did the procedure I wanted rather than TURP.
stome mark770
Posted
It all depends on the quality of the surgeon. Prevention is the main issue as BPH gets no respect as no one knows abought it unless you get it.I should of stoped it but now have to live with the let's try not to make it worse.Less sexual activity is better as you keep your prostate from working to hard to make sperm.ZInk is a reluckterbase against DHT.Look at the BPH food guide on what to eat and not.THere is so much more.
stome mark770
Posted
It all depends on the quality of the surgeon. Prevention is the main issue as BPH gets no respect as no one knows abought it unless you get it.I should of stoped it but now have to live with the let's try not to make it worse.Less sexual activity is better as you keep your prostate from working to hard to make sperm.ZInk is a reluckterbase against DHT.Look at the BPH food guide on what to eat and not.THere is so much more.
gene97713 mark770
Posted
Saw palmetto is not homeopathy. I don't know how homeopathy works when it's less than one molecule per barrel. Never been a Prince, even less a Queen, so can't tell you about their experiences with homeopathic medicines. Well, as we know the Princess could feel a pea through many layers of mattresses, so I can believe that homeopathic medicine can help royals, but a layman? No way, Jose.
Saw Palmetto allegedly decreases conversion of testosterone to a more potent form of dihydrotestosterone, which is responsible for libido and erections.
Saw Palmetto can cause ED
derek76 gene97713
Posted
I was classifying Saw Palmetto as being a remedy that perhaps was all in the mind like homeopathic remedies. You native Indians used saw palmetto along with other herbal medications.
gene97713 derek76
Posted
Indians lived short lives, and died long before their BPH had a chance to develop. So, Saw Palmetto if used, probably not for BPH treatment. Although, herbal medicine is old enough, modern pharmaceutical companies studied all these remedies and the ones that were promising, converted to expensive modern drugs. In my view that excludes the possibility to find an effective herbal supplement in Chinese or Ayurvedic medicine. As George Hegel, the founder of dialectic principles once said"Everything that makes sense already exists..."
I don't believe in quite common notion that a amateur medicine can be better than professional pharmaceutical research performed under the guidance of very knowledgeable MDs and PhDs.
derek76 gene97713
Posted
It was used by them I believe for urinary problems.
How do you feel about traditional Chinese medicine ?They have huge herbal stores there even with modern medicine. Last time we were there we met a very smartly dressed young couple. She did accupuncture and he did Chinese medicine. They asked if we needed any treatments while we were there 😃 We also met a a doctors son who was a college student who spoke perfect English that he said he had perfected mainly from listening to the radio. He did actually sound very like Prince Charles and that made his day when I told him.
But do the herbal ones have the multiple side effects of our manufactured ones ?
gene97713 derek76
Posted
Of course, natural remedies have side effects. If something works on one organ, it will have side effects on other organs or functions. Natural could have even worse side effects while being almost obsolete as medicines. I experienced that many years ago in Chinatown Vancouver, BC when buying a stomach medicine from a Chinese pharmacy prescribed by a doctor present at the site. Gave me horrible nausea and vomiting. It was supposed to work with my duodenal ulcer. Eventually antibiotics killed my helicobacter and healed my ulcer once and for all.
Yes Saw Palmetto is known to influence the lining of the urinary tract and slightly (in some men only) prevent the conversion of the testosterone into DHT, which is similar to castration. If you want castration, you would like a stronger medicine which is avodart (dutasteride). Is much more effective and shrinks the prostate in 60% of patients. In most cases the effect of castration is irreversible (depends on age and duration of the course). If that's the price one is willing to pay for "prevention" of BPH, so be it. Saw Palmetto is known to give ED and decrease PSA as well.
derek76 gene97713
Posted
I used Saw Palmetto for years without ED. My PSA went up during that time but large prostate equals high PSA. In 1994 when my BPH was first diagnosed my PSA was 5.1 and I had two negative biopsies. Prior to my GL in 2004 my prostate was 75 grms and my PSA 9.8. Post GL my PSA was back to 5.1. I tried Finasteride briefly when my prostate started to grow again but not for long as it started to give me ED and put my heart rate up. By 2013 when I had my second laser procedure my PSA was about 7.8. It was 0.74 after the procedure. Now its 0.70 when checked last year.
gene97713 derek76
Posted
Just for comparison. After PAE my PSA went from 4.5 to 1.2.
Regarding beta sistosterol discussed on this forum, I found a following statement on:
Beta-sitosterol is LIKELY SAFE for most people when taken by mouth. It can cause some side effects, such as nausea, indigestion, gas, diarrhea, or constipation. Beta-sitosterol has also been linked to reports of erectile dysfunction (ED), loss of interest in sex, and worsened acne.
In my view avodart is more effective with the same side effects.
You cannot have it both way, lowering your DHY and preserve a steel erection. ED is almost inevitable . Reminds me about some young women rather having an abortion than using some type of protection.
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Marty02 mark770
Posted
I had PAE several years ago. It is a wonderful procedure. Gave me 50% improvement in terms of nocturnal urgency problems, but not enough to make me stop looking for bathrooms wherever I went. Unfortunately, my large median lobe was the culprit. PAE is not always effective on median lobes.
HOWEVER, there is a new surgical procedure called Aquablation. I had it done at Winthrop Hospital in New York ten days ago by Dr Chris DiBlasio. I am already feeling the benefits of a normal happy bladder. i can empty, have a strong stream and go for three to six hours between feeling any need to urinate. Still a trickle of blood comes out once in a while, so I am still healing. Its only been ten days!
Aquablation uses high velocity saline water jets to remove prostate tissue with the "Aquabeam" robot. No heat, vapor, laser, etc. Same outcome as TURP without sexual side effects or long recovery.
My advice: no large median lobe, do PAE first; otherwise do Aquablation. Google it!
derek76 Marty02
Posted
Article on Aquabeam.
The Patient
Since my 50s, I’ve had to get up in the night to go
to the loo — it could be four or five times if I’d been out for a drink.
After about three years I sought help. It was
getting annoying and disturbing my sleep. My GP said it was probably benign
prostate overgrowth, which happens as men age: the prostate, a walnut-shaped
gland surrounding the urethra (the tube which carries urine out of the body)
grows and can block flow. He examined me and referred me to a specialist for
tests.
A few weeks later an ultrasound scan showed my
prostate was very large — they didn’t give me a measurement but called it a
‘monster’. They said it was pressing on my urethra, so I couldn’t empty my
bladder properly, which is why I had to keep going to the loo.
My consultant recommended transurethral resection
of the prostate (TURP), where they cut away overgrown prostate tissue. But the
risks included erectile dysfunction. I couldn’t bear the thought. I didn’t want
the physical side of my relationship with my wife Susan to end.
Instead, I was prescribed a drug, finasteride, to
shrink the prostate. But it, too, had side-effects. It made me grow breasts and
I couldn’t produce semen, so my sex life was affected anyway.
I had fewer erections, and my wife started wondering if I
had another woman. After three years of this, I stopped taking it and just
lived with the frequent urination, getting up at night for the loo and going
around 15 times a day. As a result, it was hard to sit through anything and I
stopped going to the theatre or cinema. Did you know? Stress at work can cause
painful joints. A new study in the journal Cogent Psychology, found that out of
200 people, those who reported having the biggest workloads also had more pain
in up to 12 areas of the body. One theory is that high mental workloads lead to
fatigue and poor sleep, which in turn causes musculoskeletal problems. I’d take
ages at the urinal as my bladder would never fully empty. But I didn’t want to
be seen as loitering, so I started using a cubicle in public loos instead.
I’d take ages at the urinal as my bladder would
never fully empty. But I didn’t want to be seen as loitering, so I started
using a cubicle in public loos instead.
I was referred back to the consultant. Again, they
suggested TURP but I still couldn’t face it.
I did some reading and heard about a new treatment
being trialled at Frimley Park Hospital in Surrey.
Called Aquabeam, it uses a high‑powered water jet
to remove excess tissue. It was less risky than TURP, so I could retain my
sexual function.
I wrote to the consultant running the trial and
pushed my GP for a referral. I had an appointment with the surgeon, Neil
Barber, in September 2017.
After scans, he said I’d be suitable for the next
trial. I couldn’t wait. I finally had the hour-long procedure under general
anaesthetic in May 2018. I was woozy afterwards and had a catheter for two
days. But when it came out, I could empty my bladder properly, just like when I
was a boy. It was amazing!
Now I can enjoy a few pints and still sleep through
— and our love life is better than ever.
The surgeon
Neil Barber is a consultant
urological surgeon at Frimley Health NHS Foundation Trust in Surrey and
Weymouth Street Hospital in London.
Benign prostate growth affects
most men from their late-40s onwards, when the prostate, a gland which adds the
‘carrier’ fluid to semen and surrounds the urethra, enlarges with age.
This can cause increased urinary
frequency and urgency, which greatly affects quality of life.
We can offer medication which
relaxes the prostate and bladder muscles, or those such as finasteride which
block testosterone. These can reduce the size of the prostate by up to 30 per
cent, but they all have side-effects, the latter impacting on libido and erectile
function.
We also have minimally invasive
options such as UroLift, where we pull the prostate aside with tiny implants.
This is not suitable for larger prostates, though, as the implants aren’t
strong enough.
Or we can offer transurethral
resection of the prostate, passing electricity through a loop to remove
prostate tissue.
While TURP is well established,
it causes bleeding; and 40 to 80 per cent of men will have a permanently dry
ejaculation, meaning nothing comes out on climax. There is also a 5 per cent
risk of erectile dysfunction, as the electricity and heat can damage nerves.
We have been trialling Aquabeam,
which uses a high-speed jet of saline to ‘wash’ excess prostate tissue away.
Marty02 derek76
Posted
Yeah, I avoided the dreaded TURP for decades as well. it was decades of suffering for me waiting for less gruesome procedures. PAE and Aquablation are the best ones out there right now IMO.
There are other new BPH procedures: Urolift is effective but requires leaving hardware in your prostate and is not very good for enlarged median lobes. Rezum is also a good procedure, but Aquablation has it beat - faster recovery, no heat is used and no surgeon skill is involved (it is a robot based procedure).