Post-PAE at UNC report

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Hello everyone,

My Dad had PAE done by Dr. Issacson at UNC 2 weeks ago yesterday, on Aug. 17. I've been meaning to check in to our own report; this community has been invaluable in our research and it's important to keep the flow of information going. 

My Dad is 77ish years old (75 on paper, but that is a longer story) and has a 80g prostate that his urologist wanted to perform a simple open prostatectomy on. We researched and met with a surgeon who could perform HOLEP, but decided PAE sounded like a better first option to try. He was getting up 4-5 times/night with urgency and the start/stop/start feeling he describes (I'm sure there is a better term for this). 

We flew in to Raleigh the day before the procedure, which was on the morning of 8/17. Everyone we interacted with was great. While my Dad was in the procedure room, I took his Rx scripts over to the pharmacy to have them filled so we'd be ready to go. 

For him, they entered through his femoral artery. Said it was a bit twisty, but not unexpected with someone his age, as the body shrinks a bit. I thought it was interesting that the punture hole was treated by applying pressure for 10 min (by the nurse presumably, as it was done before he was wheeled back into the recovery room, where I was allowed to stay - adding that info so your loved ones know they will have a private area to hang out. There is also a larger, public waiting area. But back to the puncture hole: I was told that they do it that was because it saves us cash patients money. If insurance was paying, they have a plug device that they insert in the puncture wound. I just thought that was interesting (and like that they were looking out for our bottom line).  Tegaderm bandages applied once bleeding stopped. 

Because it was the femoral artery, he had to stay supine for a period of time. 2 hours, maybe? I'm forgetting. He had frequent urgency to urinate and had to use the plastic container they give. 

The urgency continued. He hung out in the hotel room the following day. Urinary pain was pretty bad, so Dr. Issacson called in a Rx for phanzopyridine, which is also available OTC as Uristat (I think). He also had blood in his urine, which can happen, but it sounded like that was unusual for Dr. Issacson. 

We flew back to CA the on Fri 8/19. I bought Depends for him, as as were worried about his urgency/need to go during take off and landing. He did OK. It would have been good to stay at least 3-4 days post-procedure, I think, and I did recommend to Dr. Issacson that they change their instructions, which currently say it's OK to fly 2 days after the procedure. I booked our flights based on that and would have stayed longer had I known up front. (We did consider changing our flights after reading some reports here, but it would not have been without difficulty and great cost, so we decided to risk it).

Upon arriving in CA, my Dad started experiencing right leg pain (the side they entered), with swelling/a couple of large veins popping out and/or looking like there was bleeding, on his right foot, near the ankle/top of foot. It was concerning, but turned out they were superficial and likely from flying(?) My Dad is in decent health and goes to the gym every day: walks 5 miles, lifts weights, and attends workout classes, so it was highly distressing for him to find that he couldn't walk more than 1/3 of a mile a week out from the procedure. 

Two weeks out now, the swelling has gone down. Still some leg pain, but he's walking daily and back up to 3.5 miles today! He reports that his stream is much stronger than before PAE, but he still has the urgency and start/stop/start experience. He's only getting up 1-2 times/night though! 

So, so far, so good! 

Apologies for being long-winded...trying to add any details I could think of which might be helpful. Please feel free to ask questions!

 

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6 Replies

  • Posted

    thanks for your report on your dad. I agree it would be helpful for anyone going through this procedure to stay 4-6 days before travelling a long distant. I hope he continues to improve and the procedure works for him as well as it did for me to this point.. It has been a little over 10 months since I had PAE and so far so good. 
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  • Posted

    Your Father's experience doesn't sound like it is unreasonably different to "normal". My own experience was a little easier than his but I was 58 when I underwent PAE so that may be a factor. At two weeks it is certainly early days and I would caution reading too much into his recovery in the first 3 months. Once he is past that milestone he should have experienced some significant change. If he is already only getting up once or twice a night he can feel reassured that things are working.

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  • Posted

    Thanks for the info. Please be cautious as some of the meds your dad got post op (prednisone) also help urine flow, and general wellbeing. Don't be upset if things regress a little for him in a week or so, then expect them to get better again.

    Please keep us informed of progress.

    Neal

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    • Posted

      I should have written, "...in a week or so when that medication wears off. The process actually requires tissue to die and be resorbed, and that takes some time."

      Neal

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  • Posted

    Thank you for that report. That's the kind of real information men need to know. Great job. Looking forward to an update. Don't worry about being long winded. The more details the better.

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