My family doctor was all for PAE until she checked with another doctor in the practice when she changed her mind. She says there is a large danger if blocking the wrong arteries feeding either the bladder, rectum or both, obviously leading to very serious issues. This could lead to surgery possibly having major consequesces.
Has anyone encounter such issues and did the doctors performing the procedure address the possibities beforehand.
I was ready to have the procedure but am now also looking into MRI guided prostate ablation----has anyone had that performed?
Hello Richard - I had PAE in August by Dr. Isaacson at UNC in Chapel Hill. I have a very prostate (280gm) with no median lobe so I was considered the ideal candidate. The doctors who perform these procedures are well aware of the risks you mention which is why they stay away from the transitional zone near the urethra when they embolize. But it is a risk though a very small one.
My PAE went well and my prostate was reduced to 175gms after 3 months though my symptom improvement is not there and I still have to self cath.
I had a 3T-MRI a month ago to see if the PAE was effective in reducing blood flow to prostate. Apparently it was but the MRI also showed a suspicious lesion near the capsule which is thought to be cancerous. I will be having an MRI-targeted biopsy with Dr. Karamanian in Houston in 2 weeks. The lesion is very small (7mm). But I mention this because there is some evidence that the PAE procedure can "awaken" otherwise indolent tumors because their blood flow has been cut off. So these otherwise quite lesions suddenly start aggressively looking for blood vessels. I don't know if that is what happened with me and I don't mean to scare you but it is something quietly talked about which you wouldn't hear from the doctors.
Regading FLA for BPH, that is Dr. Karamanian's expertise and I will discuss it with him when I see him but I am quite satisified with CIC (self Cath) into the future.
I asked dr bagla who did mine about this and this seems to be mainly a scare tactic by urologists. It's rare to have a complication from pae and you should see someone experienced
I think the reason she don't what you to have it is because a urologis does not do it. If that is what you want go for it. A lot of men on here have had them and they are fine.. Ps. Not into women doctors. Talk with some men that have had a PAE done. Ken
I have to agree with Sam on this. The chance of the wrong arteries being embolized are very remote. Any procedure can go wrong, but the odds are as good or better than any of the surgerys where nerves, arteries or other can be nicked by mistake. I am going on 20 months now since my PAE and my results are still outstanding. It was the best decision iI ever made.
I had all the symptoms of a enlarged prostate and I was considering the PAE procedure but then found out I also had prostate cancer. My urologist recommended a radical prostatectomy but after my research I decided to have the HIFU procedure which took care of both the cancer and the symptoms associated with having a very large prostate. I am totally back to normal and can urinate with no issues. I Sleep through the night also.
The urologist who did my procedure used to do the laser ablation but found the HIFU procedure to be more controllable and accurate. Downside is the procedure is not covered by insurance and cost $25,000 which is way more than the PAE procedure.
I have not heard of the issues you have mentioned actually happening in a PAE procedure but I'm sure it is possible. Just go to someone with a lot of experience. Also checkout Urolift.
You need to match your symptoms with the best procedure for your specific case.
If you have a competent doctor, that should not be a problem. In any surgery, you want to find a surgeon who has done many many of them successfully, e.g. get. the best, most experienced person you can find, even if you have to travel a significant distance to get to where they practice. I don't know about Britain, but here in the States, that would be Dr. Bagla in northern Virginia, or Dr. Isaacson at UNC.
Remember that the PAE is performed by an interventional radiologist, not a urologist, so it will seldom be recommended by a urologist, since they make no money on it. Urologists make their money doing one, or another, kind of TURP, so that's what they usually recommend.
Good Morning Richard. Get all the information you can before you pick a procedure. Listen to men like ES28567 or William79680 and a few more that have had the procedures you are talking about. They did not have any of the problem that your doctor told you. Yes there are risk in any procedure but if it will help you they go for the one that you think will be the best. PAE is a very good procedure and is done by a Rasiologist like Dr Bagla. There are reports on the procedures on the internet. The HIFU is a very good procedure that is use for cancer and it does help with BPH. Do you have cancer. Like I said before get all the information you can. Why have one if you don't did to. Talking about any procedure you have and trusting the doctor is very wise. I had a Urolift all most 2 years ago and it done very well. I trusted my urologist to know what he was doing. I will be having a Atrial Fibrillation Ablation on Monday November 28th The doctor I have I only met 1 time but I was very at ease with him he seam very nice and know what he will be doing. He told me that it will take 3 to 5 hour to burn parts of the heart I have A-Fib and have had 5 attack in 11 months. He has been a Electrophysiology for 20 years. Im scared but it's something I have to do. If the PAE is what you want do it. Radiologist know what they are doing and the test before hand will give them the picture of the artery that they need to block. PAE have very few side effects and I think you will be fine. Enjoy your life and remember it is your choise to pick what you want. You have to take charge with the doctors for your body. Take care and good luck Ken
yes there have been a very few cases of the neck of the bladder being partially embolizated and surgery was required to repair it. The first one was in Portugal where this process started.
I had PAE done Oct 28th 2015 at Universiy of North Carolina medical center by Dr. Isaacson. He stated there were some anecdotal information that if you had cancer this procedure may increase the cancer activity. Since my procedure I have had 3
PSA test. Jan 25.2016 the score was 3.4.... Oct 13, 2016 was 4.9 and Nov 18, 2016 was 5.7.... I had the free PSA done on the Nov test and it came in at 1.3 which means it is 23 percent of the total PSA.. This indicates I have 16 percent or less chance of this increase being cancer. I have had a little burning sometimes when I urinate and a little more burning during sex.
I will start the 30 day antibotic treatment to see if that drives down the PSA and reduces any infection in the prostate.
The PAE procedure worked well for me and allowed me to get off a two flomax aday reginament. I have been off flomax for 11 months. My sex life has improved by getting of flomax
If I have cancer I will probably consider Proton radiation at University of Florida Medical Center in Jacksonville, Florida. It is near my home and has been quite successful.
Yes that is true there can be problems with any procedure. I'm happy the PAE is working for you and it does take some time all men heal in diffrent ways. Some take longer then others. I had a Uro-lift and it worked well for me. I to have been looking at diffrent treatments for prostate cancer. I like being prepared just in case. I live in Orlando and I have looked into the Proton procedure but it does take a long time for the treatment but it look like it works well. Do you know if you can go to the University and talk to anyone there to ask questions . I was in Georgia and went to another center to talk with them because the doctor never sent me a e-mail back which the book-let that he wrote said he would. I think it was because I'm going against what he is doing. I think the treatment is good in it's own way buy it destroys the whole prostate. It's like having a Radical Prostateomy without surgery I think it could be ajusted to the patient and what he whats. I do not know if any other men out there feel like I do but I for one will not have any treatment that will take away my ejaculation just because I get cancer. I will not give up one for the other. I feel it is just as important. Had dry orgasm and they suck. No feel at all. I will not live like that. I'm 61 and may not have sex has much as I did when I was younger but when I do I want the whole thing. I fell that the ejaculation is part of the orgasm. Most doctor do not consider the ejaculation a function. They tell you when we are older we don't need it because we are not having kids. And the orgasm is the same. That is a text book answer. In principal yes but not all men have the same orgasm. We may not need it but I still what it. Please get all the information you can before you dicide. It is up to you. Has we get older we still need to enjoy our lives the best we can Ken ( ProstRcision was the treatment 
kenneth 1955 .. The Center in Jacksonville has once a week lecture or question and answer session on the topic. A neignbor of mine works every Wed. from about 10am to about 3pm as a volunteer to talk to individuals that are interested and show them around. He had the proton procedure 2-3 years ago and his PSA has been the same since the procedure. Less than 1.
They appear to have very good follow up. They only target the cancer cells and destory very little other prostate tissue. He stated it had no downside effect on sex or urinating.
When he had his several years ago they still have a problem with burning a small part of the Colon. I believe this has been solved with injecting a gel into area to protect the Colon. If my PSA keeps rising i will go to one of these sessions.
I will start the 30 day antibotic on monday. hate it but need to determine if my increase is an infection or something else. Best to you.
Originally Artery embolisation was used to treat tumers and cancers. If your read one report published by the American Cancer Society about embolization of cancerous liver you would know that embolization cuts blood from cancerous organs so cancer cells do not grow, rather they die. However, you said your nodule is now 7 mm after 4 or 5 months since you had your PAE. To me it's an indication that it has been shrinked to this very small size instead of grew to this very small size. That's my opinion presuming you haven't had an MRI before PAE. All the best
I hope you are correct!! I originally thought as you did which is why I brought this up to an IR I know. He then scared me when he said that that is true when the tumors are actually targeted by the embolization. But they do have evidence that quiet nearby lesions that may be growing very slowly and would never be a problem in our lifetime suddenly become aggressive when their blood supply is reduced. He told me this is "the little dirty secret about PAE".
Anyway, next Wed. is my biopsy with Dr. Karamanian and I pray it is just a granuloma. I really like him and if needs be I will use him to remove the lesion by FLA. All the best to you.
Hello Richard. All went well. I had mine November 28, 2016. It was a 9 hour operation. They burned the whole left side of my heart. Have not had a problem in a year. Doing great. Last year I was in the hospital 9 times because of it. Also lost weight down to 180 from 250 When are you going. It will be the best thing for you. It was for me. Let me know Ken
My wife found something interesting by googling Prostatic Infarction after PAE,, the artifacts left behind after PAE could show up as possible cancer on a 3T MRI.. The images shown was one month after PAE, 6 months after PAE and 1 year after PAE. You can still see artifacts of the dying tissue even at the one year. The images came from a Medical Journal in China. This maybe where the Cancer scare came from after PAE. Hope my small spot on the prostate is an artifact from my PAE procedure.