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I am having the PAE procedure on November 20th at Inova Hospital in Alexandria, VA. The procedure will be performed by Dr. Sterling. I asked Dr. Sterling if he trained or worked with Dr. Bagla when Bagla was at Inova. He cleared his throat and said "WE trained Dr. Bagla". I guess Bagla has the following but was not the first at Inova to do the procedure. Dr. Sterling said he used "Cone Beam Ct:" which allows him to precisely locate the location of the beads. I told him I have severe reactions to Prednisone and he said there was no problem and he would prescirbe other drugs post procedure. I will keep everyone up to date on my experience and results.
2 likes, 17 replies
ed70868 vigneron
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arlington vigneron
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Do you have an enlarged median lobe?
vigneron arlington
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Yes, my prostate is about 3X normal size. I have read all the post saying that PAE would not work with a prostate with a median lobe. I am not clear on why shutting off the blood flow to the prostate would be shrinking some parts and not others. Most of the literature I have read references prostate anatomy in "Zones" so I am still not clear on the distinction and how or if they relate. Hopefully with the Cone Beam CT, he will be able to locate the beads to be most effective. I chose PAE because if it does not work, I can always try another procedure. At least this procedure seems to have the least liklihood of adverse affects. I consulted with three Urologist besides the Interventional Radiologist prior to making a decision. Most of the old timer Urologist stick with the TURP. The last one I visited in Frederick, Maryland, a younger Dr., said "Yes, I think PAE is a good option for you to try". If it does work for me, then perhaps I can help debunk the "Median Lobe" mantra.
arlington vigneron
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The PAE docs I've spoken to all say their results are much less effective when there is an enlarged median lobe. I'm sure that doesn't mean that it's never effective in such cases. Good luck!
hank1953 vigneron
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vigneron hank1953
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Medicare covers it and I also have supplimental insurance. I had hematuria associated with the BPH. I don't know if this is a qualifier for Medicare payment or not. Of course, after the fact there are often some things that are not covered by by both.
david41064 vigneron
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arlington david41064
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Please keep us informed of your results over the coming months.
Best of luck!
vigneron arlington
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Ok, there is a lot of confusion (at least on my part) distinguishing "Lobes from Zones"
Here is what I found:
Name
Fraction of gland
Description
Peripheral zone (PZ)
Up to 70% in young men
The sub-capsular portion of the posterior aspect of the prostate gland that surrounds the distal urethra. From this portion of the gland ~70–80% of prostatic cancers originate.[13][14]
Central zone (CZ)
Approximately 25% normally
This zone surrounds the ejaculatory ducts. The central zone accounts for roughly 2.5% of prostate cancers; these cancers tend to be more aggressive and more likely to invade the seminal vesicles.[15]
Transition zone (TZ)
5% at puberty
~10–20% of prostate cancers originate in this zone. The transition zone surrounds the proximal urethra and is the region of the prostate gland that grows throughout life and causes the disease of benign prostatic enlargement. (2)[13][14]
Anterior fibro-muscular zone (or stroma)
Approximately 5%
This zone is usually devoid of glandular components, and composed only, as its name suggests, of muscle and fibrous tissue.
Lobes
The "lobe" classification is more often used in anatomy.The prostate is incompletely divided into five lobes:
Anterior lobe (or isthmus)
roughly corresponds to part of transitional zone
Posterior lobe
roughly corresponds to peripheral zone
Right & left Lateral lobes
span all zones
Median lobe (or middle lobe)
roughly corresponds to part of central zone
The Radiologist report on my 3T MRI says that my prostate measurements are:
5.9 cm in transverse diameter
4.9 cm in AP diameter
7 cm in SI diameter
Prostate Volume 89.7 cc
and states "The transitional zone is markedly enlarged and heterogeneous"
So, to me and the information above correlating lobes and zones, it seems as if my enlargement is in the "Anterior lobe or Isthmus"
Hope the above solves some of the anatomy confusion in case others are also having trouble distinguishing lobes from zones.
Paul
arlington vigneron
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ed70868 arlington
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sam19736 vigneron
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sam19736 vigneron
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david41064 vigneron
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