What's the criteria for eligibility for prostate artery embolization procedure

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My prostate is around 64 ml free void volume of 621 mL and post void residual of 492 mL. In the ultrasound I had there was a mention of a 0.7 cm hypoecholic nodule in the peripheral zone.

However my urologist has said I'm not eligible to receive this treatment. What is the criteria for the eligibility to get a PAE procedure done?

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  • Posted

    Hi. In terms of eligibility why don't you ask the same Urologist? He should be able to explain more. Not just simply stating that you are not meeting criteria.

    How long do you have problem with your prostate gland? Have you ever had semen culture test done? or Stamey's? Or do you know if your urine culture test came back as "no significant growth "?

    I'm aware that our prostate is getting little bit bigger as we getting older but some people at this forum are not old at all and some of the prostate sizes are massive.

    Also in my opinion any nodule should be removed before it turn cancerous. We had similar situations with my wife regarding cyst. NHS told us to wait for it to disappear. 3 years later and it was still there 3 times the size. Eventually we have paid for private consultations and Consultant written for us the letter stating that it must be removed ASAP. We been referred very quickly and it was removed through NHS despite them claiming not long time ago that my wife didn't qualify.

    Best of luck

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  • Edited

    That is Great advice! Thank you!

    Regarding the nodule, I did not realize that it could turn cancerous or that it should actually be removed at some point.

    I've been getting regular PSA tests done and they say that it is always within the range 2.5 to 4.5 and that there's no need to deal with the nodule

    Also that makes a lot of sense to ask more about why I'm not eligible for a PAE they're insisting that I should just go for green light or TURP procedures. Or the other option is to take more finasteride. Not taking the 5 mg dose recommended I'm taking 1 mg.(Just for hair preservation)

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    • Edited

      Also, remember that PAE is not performed by urologists, so there may be an incentive to discourage it. Definitely get clarification from your urologist, but also consider talking to an interventional radiologist who has extensive experience with doing PAEs.

      Rich

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    • Posted

      Hi mate. You welcome.

      One more thing. PSA is not 100% accurate in terms of picking up cancer or even infection. My PSA is 0.33 . Despite that during semen culture test and Stamey's test the bacteria is found (prostate inflammation/ Infection). PSA suppose to be raised above the norm during infection but in my case in was not.

      Also go private and do so called "Free PSA" ratio test. This one is much more accurate then ordinary PSA test performed by average Dr Smith. NHS will not do it for ya unless your ordinary PSA is above norm.

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  • Edited

    Urologist does not do the PAE procedure, that is done by an interventional radiologist or IR.

    I have had PAE procedure done twice! I am very happy with results. 1st time lasted about 2 years, and still going strong on my second procedure done April 2021.

    Eligible? That is a strange way to phrase it. The procedure is done through your arteries, does your urologist have some knowledge of a problem with your arteries?

    Anyone is "eligible" ! A better question is "are you a good candidate for positive results"?

    My IR did a CTSCAN of my pelvic region / prostate to see if my arteries feeding my prostate were in good shape for him to do the procedure. He determined that yes, he thought he could help me. He made no guarantees , but he thought he could help me.

    How did your urologist come to the conclusion that you are not eligible?

    What city do you live in?

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