Preemptive PAE to prevent BHP?

My Urologist obviously does not like PAE because he can't do it. He is an old school chop it up kind of guy and that's all he likes

I've had multiple preemptive surgeries in the past, waiting until my prostate is the size of an apple makes no sense to me, it's like as if Id waited for my skin cancer to hit stage 3 before removing it, or until my hips were so destroyed I couldn't walk before I had corrective surgery to remove the bone spurs

Bubba,

There are risks with PAE. The biggest risk is non target embolization. If the beads go into a wrong artery you can have an ichema to an unintended organ. It doesn't happen often but does happen. You should ask the radiologist what the probability of that happening is.

Thomas

my stream is weak and it takes forever to finish, I also feel like I want to pee all the damn time which as you know drives you crazy

I'm on TRT so concerend with prostate enlargement because the side effect of TRT get worse as you get older

Sounds to me like you need surgery, meds, or cic now. How old are you? Are you on medicare and have a medigap policy? The reason I ask is because getting the new hydrophilic catheters through a provider could be an option if you want to try that. Intermittent catheterization protects your kidneys and keeps the bladder from getting more stretched that it probably is by now.

I would say that it is hardly pre -emptive in that case. Obviously the TRT is not helping the prostate situation.

Then which do you believe ?

ultrasound to measure it, is that accurate? I don't know the exact number but he said it was increasing every time we measure it and these symptoms are pretty recent, but it was still in normal range

can even smaller prostates cause issues?

It really depends on which way it grows. Mine was measured at 125 gr I've been on finasteride for a couple of years. Best case scenario my prostate measures a bit below 100 gr. Yet, on a good day my flow is 25 ml/sec. On occasion its been up to 30 ml/sec. My prostate is nothing but contradictions anyway. At 125 gr my PSA should be somewhat elevated so I've read. My PSA level in April was .5

BB99:

Has your uro mentioned anything about an enlarged median lobe? It sounds like you have not had a 3T MRI, so have you had a cytoscopy, which I'm told would be able to determine whether or not you have an enlarged median lobe. A large median lobe could easily cause severe LUTS even with a not overly enlarged prostate.

Uncle:

Since you are on finasteride a raw PSA level of 0.5 would be doubled to 1.0. I also have a 100 gram prostate (103 grams recently confirmed by 3T MRI) and my raw PSA is currently 2.0. But I'm taking dutasteride so doubling the reading yields 4.0. 1.0 seems very low for the size of your prostate, which I guess is great news. Do you also get your free PSA measured?

How was the flowrate measured? A peak flowrate of 25 to 30 mL/sec is unbelievably high for someone with a 100 gram prostate. That's a flowrate of a young man. When men are selected for BPH clinical trials, the cutoff for not accepting men is typically a peak urinary flowrate of 15 mL/sec. If 25 to 30 mL/sec really is the flowrate, then what urinary problems do you have?

rdemyan,

Yes, I am aware my actual PSA is 1. Free PSA? I don't know how the Dr. measured it. The flow rate I mentioned is actually average flow rate. I imagine my peak is higher flow rate is a bit higher. I have an accurately graduated scientific 500 ml beaker. I pee in it and measure the time. Granted its seat of the pants but gets me a ball park figure. Now the problems. I had very bad bleeding episode in 2015. I would pee blood for 10 days straight. I was peeing blood, not pink/red urine, real blood. Prior to that I guestimate my flow was 15 ml/sec. After a year of sporadic bleeding ( Thank God)it stopped. I had a cystoscopy and CT scan done. There was no reason for my bleeding. I'm guessing I have a very vascular prostate. I was taking Krill at the time. My theory was the Krill oil thinned my blood and had a hand in my bleeding. I could be way wrong. Night time peeing is all over the place. Some nights flow rate is the same as during the day, other nights I get just dribble. I do think the finasteride has done wonders on my prostate size. Someday, I'll get it measured again.

Uncle:

I've had blood in my semen and it certainly caused me a lot of concern. I can't imagine what you went through seeing red blood in your urine. Glad it stopped.

I've mentioned a few times that there is a device you can buy on Amazon for measuring peak flowrate. It's crude but much more accurate than trying to time it just from flowing into a graduated beaker. If you are interested, PM me and I'll give you the details.

Uncklefester,

the medical review of the typical urine flow for males and females without BPH provides the following datum, which I also cited once on this forum.

**The median centile rankings for their maximum and average urine flow rates were 21 and 11 (male) **

So, for a man with BPH and UTS symptoms the average number of 30 cc/sec means one of two things, either your are the brother of Gulliver or you have a race horse and used her for measuring your flow rate. Typical average will be 15 ml/sec. Young man have maximum 22-24 ml/sec.

Perhaps like the racehorse he is on Lasix 😃

Well, Lasix is a diuretic and won't relax the prostate capsule or bladder neck. Maybe he has a pump installed inside the bladder. Only few women can achieve 30 ml/sec rate. With roughly 5 mm stream diameter, the speed of the stream from urethra should be 1.6 m/s at 1 m height, it will result in overshooting any toilet. Never seen it in 60 years old.

rdemyan,

I bought that funnel like device if thats what you're referring to. I filled it up to the top then over the edges

I'll video it .......kidding. I know what you're saying. Unless there is a flaw in my process that I'm overlooking. As mentioned, waking in the morning or middle of the night it can be reduced to a dribble.

No I'm not on Lasix

Just a little clarification, 0 ml/sec is not the normal flow. 20 - 25 ml/sec is pretty normal during the day.

Thats 30ml/sec