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Prostate Artery Embolization (PAE)

Posted , 39 users are following.

fiora
fiora

Hi All. Wondering if anyone had complications after the PAE procedure. Thank you. 

0 likes, 165 replies

165 Replies

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  • felix2330
    felix2330 fiora

    Posted

    Hi all,

    Thank you all for your contributions. I have decided for PAE close to home ( Florida) with Dr Kably at University of Miami/Jackson Memorial Hospital since my insurance is accepted there, no copay. He said he has done around 200, has good reviews, he does it from the wrist, will be seeing him soon for a prelim visit before hopefully getting it scheduled. It's easier for me than flying somewhere else.

    Thanks.

    FM

    • newzev4
      newzev4 felix2330

      Posted

      Please share your results with the rest of us. Good Luck!

    • spr
      spr newzev4

      Posted

      Hi

      I am going to do a PAE procedure at UTSW in Dallas on the 20th December.

      I will let y'all know how it goes.

      My prostate was 190 gm in 2016 measured from MRI. I have lost weight 25 lbs and that improved my symptoms- I have only one bad night a week vs 7 before. For the past couple of weeks I can sleep from 10pm to 5am if I do not drink any fluid after 7pm, do a long walk before sleeping and take my saw palmetto and beta sisterine . I still have to go at least once an hour during the day. Sexual function is ok now.

      I am excited to get this done. I am scheduled for a CT scan 3 days before the procedure and the IR doctor (Dr. Shah) will monitor while doing the procedure with a spinning CT scan. He will do the procedure under anesthesia and keep me in the hospital for a day. This is because he has not done many PAEs, but he will also have other IR doctors watching the procedure.

      Yes , I know everyone says get an experienced guy. Dr. Shah has experience in IR but not PAE. He seems like he is being very cautious, but his confidence level is high and seems like a very bright guy. His success rate is 100% getting improvements and his motto is the Hippocratic oath- do no harm.

      Yes, i am a little nervous.

  • ed70868
    ed70868 fiora

    Posted

    good luck.. lets us know you results. I live in Florida, what insurance is paying for your  PAE> thanks ed

  • mike03369
    mike03369 fiora

    Posted

    Wish you well. I'm glad I tried PAE 2 times down at UNC. Didn't work so I am now deciding between holep or traditional turp. love the dr that does turp but holep has less side effects. I really looked at rezum, but looking at my bladder from the latest cystoscopy it really is getting damaged from the 2 lateral lobes encroaching on either side of the urethra into the bladder. Looks like 2 tennis balls on either side of the opening. I've noticed that for me PAE did kill a lot of my prostate, just not the part that surrounds the urethra- and lets face it that's the area where it causes the most problems. I would do it again but now i need to get back to giving up a lot in order to reclaim my life.  2 years of wondering each time will i be able to pee is exhausting. I'm tired and hope that by doing one of the procedures it will give me relief.  Good luck on your journey

    • mike03369
      mike03369 hank1953

      Posted

      Thanks. I did but My PAE’s killed the same areas that the FLA would work on.  My problem is right by the urethra on either side.  I wish it would work but I feel it would not get the encroaching prostate that is squeezing my bladder.  Mike
    • hank1953
      hank1953 mike03369

      Posted

      I don't think PAE has the precision of FLA, which you need, since you seem to know where the problem is. Hank

    • sam19736
      sam19736 hank1953

      Posted

      When I asked my doc about FLA, be was very clear to say it’s never been shown in randomized studies to work for bph and he knows complications from FLA like impotence and incontinence. There are places that advertise zero rates of problems and 100% success and you should be weary of these magical solutions!
    • hank1953
      hank1953 sam19736

      Posted

      All procedures have potential complications, including FLA. The one with the least post op problems is PAE, which you already had. From what I've read on this forum, FLA is the next best. The worst complication of FLA is the $20000, because insurance is not paying, yet. Hank

  • gene97713
    gene97713 fiora

    Posted

    No, it's impossible to cut all the blood supply to prostate. Moreover, it will be dead and rotting right away inside your body. Only major arteries blood supply is blocked, sometimes only on one side due to the atherosclerosis of patients vessels. The lack of oxygen supply (so called ischemia) creates an infarction  of the prostate (literally man's second heart) and it shrinks by itself. Also, less blood supply, means less pressure from inside and less dihydrotestosterone, the only powerful steroid that stimulates prostate growth and baldness. It's a product of so called aromatization of testosterone. Testosterone by itself doesn't stimulate prostate growth or hair follicles to die.  Additional blood supply comes from the badder and urethra capillaries and keeps part of the prostate and all the nerves and spinkers alive. Body itself decides what part of the enlarged prostate it can sacrifice and self-absorb. Sometimes due to relived bladder neck obstruction, many small stones from the bladder (and prostate itself) can be relieved  through urethra.  That was reported in several patients.   

    Unfortunately, with time the body can restore some blood supply to the prostate and it can grow again. Tah happened in some patients (~10%), then procedure can be repeated again by a skilled radiologist. There are only 5-7 years long results. The procedure is new and experimental, required a skillful vascular trained radiologist. 

    I believe that it should be the first option for the patients with a large prostate, in which invasive surgery is almost always has complications.        

    • kam04201
      kam04201 gene97713

      Posted

      Hi gene97713,

      In what circumstances and how long after PAE precedure it can be repeated??

    • ktmxc-f
      ktmxc-f gene97713

      Posted

      Gene,

      That's a really good description of the procedure..My Mri revealed a 6cm necrosis on one side the other not so much. Dr believes a second Pae on the right side could improve even further,

    • gene97713
      gene97713 kam04201

      Posted

      I've read in the literature and on this site that there are few cases, when PAE was repeated in a few month(years). Also, if the prostate shrinked to less than 80 g,  FDA  approved Urolift procedure could follow PAE if needed. It's minimal invasive and preserves all sexual functions. Most insurances will pay for it. It's an 8 min procedure in the urologist's office.   

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