Will TURP be outdated and Will Prostate Artery Embolization be the accepted way to treat BPH
Posted , 19 users are following.
I ve had BPH for about two years and now it's getting worse. I'm only on alfuzosin and not anything else.
Alfuzosin effectiveness seems to be declining and I would be a candidate for TURP. However I am hoping and waiting for PAE to be offered in Canada. Hopefully in the next few years. Is this a strategy that anyone else has thought of?
0 likes, 52 replies
tony79404 johnny90372
Posted
HI Johnny, my wife was just reading up on this new PAE because it is the least invasive but it is not done by a surgeon but , I think , a radiologist. We have consultation this morning with a surgeon who deals specifically with BPH issues. However, one concern she had read was if you have median lobe. It could be the case that if you do, this alternative treatment may not be effective. We will be asking our doctor about that today during consultation though he may turn up his nose at this treatment (my wife assumes) because it is not performed by a surgeon although one could be on hand with the radiologist for any additional knowledge or guidance. Hope this helps. We know that here in America, research institutions like *University of Chicago * here in the U.S. is performing this treatment now. Dr Scott Eggner is the chief surgeon (PhD) and doing really innovative treatments for prostate issues but specifically for prostate cancer.
tom86211 tony79404
Posted
Tony,
PAE is not a new procedure - it has been done for years and many here, including myself, have had it. It's performed by interventional radiologists and not by urologists. It's done all over the country. There are many discussions here about PAE so this is a good place to get answers.
Tom
johnny90372 tony79404
Posted
Please, can you update on what the Uro says about that?
thank you.
gene97713 johnny90372
Posted
Johnny,
wrong question. According to AUA "PAE is not recommended for BPH outside the clinical trials" . It's anathema to any URO. The all will reject such an idea because it will never will be in their domain and deprives them from their main source of income: prostate butchering.
Wrong approach, Buddy...
Tom is right it's more than 10 years old. Just very few IR perform it. Very complicated technique. Like rotoblader plumber vs. cardiac-surgeon.
Practically non of the URO is involved in post-PAE study (except in well designed clinical trials).
tom86211 gene97713
Posted
Gene,
Absolutely right - some uro's "bad mouth" PAE because it takes away their business. The stats I have seen are that it works just about as well as any of the primary BPH procedures, but there is no heating or cutting of the prostate and it can be repeated. Mine didn't work particularly well because of a median lobe issue. Now, the IRs know about this and have better techniques to address this.
Tom
gene97713 tom86211
Posted
Тom,
You can repeat PAE every 3 years if are not afraid of radiation. It's still less than radiation received during prostate cancer treatment with radioactive pellets.
Modern techniques with a real good IR will produce results even with median lobe, which shrinks the most BTW during PAE.
dale75649 gene97713
Posted
Tony,
PAE was first performed in an attempt to stop bleeding in a non operable patient years ago and as a side effect it improved his BPH symptoms. Some years later there were some animal studies and then a decade ago they started performing it for BPH in Portugal, followed by Brazil, and later many parts of the world. The FDA approved this use for embospheres a couple years ago, which allowed the procedure to expand beyond clinical studies in the US. But there are not yet a great number of trained interventional radiologists. My PAE was performed at a teaching hospital (UW medical center) and I expect the fellow did must of the work under the instruction of the more experienced professor. I was just happy to get my insurance to pay for it and have it done so close to home. As mentioned, many urologists don't like the idea. My uro was at first interested, and later suggested that surgery would have been better. He likely talked with other uro's. What I know is that I haven't yet met a surgeon that I'd trust enough for a BPH procedure. However with PAE, the only cutting was a tiny incision to get the catheter into the artery in my groin.