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As a health professional, I was worried about the effects of a TURP procedure. Although my urologist was against doing a PAE, saying he did not know about it and that it was experimental, the research I had seen suggested it would be a good approach with no effects on sexual function and fewer complications that a TURP.
Since PAE is a relatively new procedure, the effects of it have been measured for a space of 3-5 years post-procedure in the research currently available.
I went ahead and had the procedure done 4 weeks ago. The results have been simply wonderful. All symptoms of BPH have dissappeared.
Prior to the procedure I had painful urination, weak flow, frequent urinary urges, around 100 ml of urine output each time I voided,and the ultrasound revealed that my bladder was almost full after urinating. I was concerned that it could lead to hydronephrosis in the future.
I now get up 2x a night to urinate. I measure my output at home, and my nightly volume exceeds 300 ml each time I go, sometimes to 400 ml or more. My daytime urinary output is approximately 250 ml at each urination with no urges, no spotting, no burning sensation or a need to push using a valsava manuever. It just flows out naturally with no effort.
The research on it show that results are operator-dependent. That is, the more experience the doctor doing as, the more successful and less complications.
I flew from the west coast to have the procedure done at UNC Chapel Hill since their team, and Dr. Isaacson, have been doing well over a hundred of them. Great staff.
Please note that the PAE is a procedure that urologists do not perform. It is done by interventional radiologists. I have noted in a commentary that I read in a urology magazine, and in the attitude of my initial urologist, that there can be some prejudice about exploring a PAE since it is a procedure that would be done by someone who is not a urologist. It's outside their turf. My urologist insisted that I needed a TURP - while guarranteeing me that I would have retrograde ejaculation for life afterward if I did the TURP. That is not an issue with a PAE. I positive side effect is that the interventional radiologist discovered during the procedure that I had a venous shunt from my penis to the prostate, which had an detrimental effect on maintaining blood flow when erect. He sealed it off during the procedure. It turns out that a number of men have this without knowing it.
It feels like when I was urinating 25 years ago. I am so relieved and happy about it that I wanted to share this with you in case some of this information is helpful.
I had the advantage to access to a number medical journals on the procefure, but google scholar on the internet will have good info.
A recent systematic review of PAE is titled:Short- to Midterm Safety and Efficacyof
Prostatic Artery Embolization:
A Systematic Review
Ziga Cizman,MD,MPH, AriIsaacson,MD, andCharlesBurke,MD
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