Trilobal Prostate and PAE questions
Posted , 4 users are following.
I'm scheduled for a consult for PAE, for a 42 cc prostate, with IPSS =22. I'd like to be prepared with the right questions when I go in, about how effective the treatment is likely to be for me.
There is a lot of discussion about a large median lobe being contra-indicative for PAE (Prostate Arterial Embolization).
My urologist didn't say whether my median lobe was "large", but he described my prostate as being "Trilobal". I think all prostates have three lobes, so I'm not sure if that means the median lobe is large or just "normal" relative to the rest of the organ. (I sent him a message asking about PAE, but he hasn't replied. He was pushing TURP.)
And I read lately that PAE can be targeted at that median lobe now too, which didn't seem to happen in the beginning.
Does anyone have any experiences that can shed light?
Of course I'll ask these questions during the consultation, but the more info I have going in the better.
0 likes, 2 replies
kenneth1955 daryl54162
Posted
Hey Buddy
I had to look up what a Trilobal was. It is one of the lobe pushing into the front of the bladder neck. It is blocked. It is the enlargement of the lateral lobe There are many medications that can take care of it but they do have side effects. Most of them cause retro ejaculation and orgasms can be a 3rd less of what they have been. One that I do know that has no sexual side effects is Vesicare 10 mg
Stay away from a Turp.That must be all he does so that is what he is going to try to get you to do. PAE can take care of that. The doctor that does the PAE will explain it to you. They do have some go results with smaller prostate.
Have you look at any other procedure. What about a Urolift or a Midlift. This would open you up and will cause no side effects. I had my Urolift done over 7 years ago still open. If your lateral lobe is the problem with the Midlift they can pull it to one side to open you up
It is up to you what you do but stay away from anything that cuts at the prostate.
God bless,,,,,Ken
TKM daryl54162
Posted
Daryl,
Don't expect a Urologist to be supportive of PAE. The PAE is done by a different group of doctors, Interventional Radiologists. Many Urologists see them as competition taking away some of their work.
An enlarged median lobe was considered contra-indicative in the early days of PAE, but now some Interventional Radiologists say they can reduce the median lobe, by targeting the median lobe blood vessels. I communicated with Dr Bagla, one of the most experienced PAE doctors, and he said he has been effective with enlarged median lobes by targeting the appropriate arteries.
The way you can tell if you have an enlarged median lobe is by MRI, or Cystoscopy. They may also be able to see it with an abdominal ultrasound, ask a urologist about it.
Thomas