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I am 61 with 35 cc prostate. I have a small median lobe and high bladder neck. I could not tolerate meds. My post residual is less than 15 cc. Uro-dynamics is consistent with obstruction. I wake up about 4 times a night and it messes my sleep as I am still working. 1st urologist was recommending TURP, but I thought it was a drastic measure. PAE is not the best for a small prostate with high bladder neck. I looked into FLA but I asked two physicians from reputable medical centers who use the technology to treat prostate cancer and they say it is not as accurate as claimed by the doctors who use it and there is the risk of perforation. My urologist , who is a professor of urology, is now is recommending Rezum and he has done more that 100 of those. He has also experience with HOLEP, Urolift, TURP. I am scheduled Nov 20th but I am hesitating because messing with bladder neck can have risk of RE and incontinence and the fact that my prostate is small and most of it would be cooked considering that only a small portion of it is causing the problem, but I don't know if there are other options. Any response will be greatly appreciated. Ken have been very helpful in these posts.

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    I would recommend checking w/ interventional radiologists (Isaacson at UNC, Spies at Georgetown or Bagla in northern Virginia) rather than urologists regarding the PAE and the FLA (Karamanian in Houston). There seems to be a reluctance for urologists to recommend any procedures performed by radiologists.

    Keep in mind that if you have an enlarged median lobe then the PAE has a much lower succes rate (if any).

    Best of luck!

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      PAE is not the answer for small prostate with small median lobe and high neck bladder. FLA is not as accurate as they make you believe and there is risk of perforation and more tissue damage especially in a small prostate. I looked into those and spoke to the perspective doctors too and I spoke to doctor who does FLA for prostate cancer at University of Chicago and he recommended caution because it is not as accurate as it is claimed to be

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