I've had the Urolift but with disappointing results. Have been reading about PAE and it sounds promising. If you've had it I would like to know your opinion. Also, can it be done after the Urolift (do the implants have to be removed)? Thanks,
William,
Many here have had the PAE procedure (myself included). I am not aware of anyone who has had it AFTER a Urolift. The PAE shrinks the prostate by about 30%, and this might change the way the Urolift implants are anchored to the prostate, so you should check with both your urologist who did the Urolift and the IR who is going to do the PAE. Maybe someone here can shed more light on this situation.
Tom
Just as a matter of response, I haven't had the PAE but I have had the REZUM procedure. I was diagnosed with PC back in 2015 but have only been watchful waiting. I thought the REZUM might help to get rid of any bad cells along with that portion of the prostate that died off. I am told that is unlikely. Also, at five weeks post procedure, I am a bit disappointed in REZUM as you are with Urolift. I have heard people with good results from both so I guess I am just one of the unlucky ones. That, or I had too high of expectations. I like the idea of the PAE because it cuts of blood to the prostate. I was wondering if it also would cut off blood to any tumor in the prostate and if so, might it keep any tumor from growing. Anybody have any input about the PAE in that regard?
The problem is the blockage of the bladder by the medium lobe. You probably need surgery. The PAE is for stopping future growth, and if there is blockage now, I don't think the PAE will work, as I have experienced.
I have had both, first PAE and then Urolift. Can't say either was really a success for me. The PAE clearly wasn't and it can be harder to be successful per the doc that did mine if you are overweight. Apparently that factor and I was pretty complex case with respect to multiple arteries to my prostate and he couldn't get in a good position to block them. I was in for the max time they could allow for the radiation exposure so had to quit.
I could live with a lot of my symptoms other than getting up 5 times a night. It is slowly, or quickly, killing me. Urolift seemed to help flow some but not the number of times getting up. Doc thought maybe my bladder had hardened over time and put me on OAB meds to see if that will help. I fly a lot for work and the max I could've have gone between pitstops before was 2-2.5 hours. Just had a flight that was 4.5 hours in the air and was able to hold off until we landed for a bio break. Unfortunately that increased endurance isn't translating into better sleeping times.
Not true at all. I had blockage, median lobe, dribbling, used self-cath. PAE has solved all the problems, even dribbling and leaking after voiding. The bladder is still tense due to the increased wall thickness, which makes me wake up twice per night on average. During the day can go without peeing up to 4 hrs. PAE shrinks teh whole prostate by 30%, median lobe up to 36% in some cases, if performed right and arteries are still in a good shape and allow for easy access for the IR. Having atherosclerosis and being overweight complicates PAE procedure and makes it sometime ineffective. It doesn't prevent future growth in the long run due to revascularization, but helps in the 12-24 months span most of patients with large prostate.
No procedure is perfect for everyone. You take your chances. That is why you have to sign a waiver of liability before undergoing any procedure.
I had a PAE in March 2017. I've had modest improvement and have been able to stop taking any meds (tamsulosin). I think it's real important to have the procedure done by an IR who has a lot of experience doing the procedure. I opted for Dr Bagla in Virginia.
I've had PAE first by inexperienced docs, then by a so called expert with a lot of success. Don't know if Median lobe is to blame, but it did not work at all. The expert doc in Denver told me before the procedure "sometimes it does not work and we just don't know why" After the procedure he was quite confident that it was going to be effective.
Hi Mike, Did Dr. nutting perform the PAE? Did your Psa drop and then slowly rise? Thanks
My Uro said same thing about my REZUM. Said procedure was successful. I guess he meant the procedure went well but the result so far has been unsuccessful. Only six weeks out so far but no more blood seen or detected in urine via urinalysis . There is still some in ejaculate though. So after six weeks, the jury is still out. A shame though that the Youtube video suggest positive results after two weeks. I haven't seen any yet.
Carlos yes, and yes PSA dropped and rose a bit on my last test, but since I do CIC it doesn't mean much - why did you ask?
Vernon from what I read around 6 weeks out is the time you should see improvement not only Rezum but other procedures relying on tissue dying then being passed out by the body. All surgeons tend to say it went well but this time I could tell by look on his face he looked really happy and confident he found the problem.
Thanks for the reply Mike.
Its been almost 2.5 years for me. Psa went from 1.5 to 2.2 in eight months. I'm beginning to experience a slow return of symptoms. I guess prostate is growing as to be expected. I worry about Pca
I wouldn't worry about 2.2 I think anything below 4 is quite normal and as you probably know PSA can go up and down depending on activity before you do the blood test - I think this is the problem with PAE and many other procedures really, it will grow back. My latest PSA is 2.4 or 2.6 I forget.
Mike: Did you have PAE?
Vernon I had PAE in Australia a few years ago - TWICE because they encouraged me to try again. Then about 6 months ago my Urologist told me he had referred several people to someone here Dr Nutting who has had a lot of success, and it was worth trying again. Sadly I must have blood supply they can't see and get to because it didn't work.
Thanks Mike, I found Dr. Nutting to be an expert on Liver embolizations. New to (Pae). Dr. Nutting goes in through the groin (femoral), the more experienced guys use the wrist. Dr. Nutting inserts a catheter to use a landmark to locate the correct arteries. This method is for less experienced or learning Doctors.
A prominent researcher looked at my Mri following Pae and mentioned one side needed more treatment. There were a few other details.
I had a PAE with Dr Nutting in May - he did not cauterize me, but did enter via the femoral artery. I also had an enlarged median lobe, and so far am doing fairly well. I used to get up 5 to 6 times a night and now I get up twice a night. I have no illusions that this treatment will last my lifetime, but it was the best treatment for me at this point in my life and has bought me some time. I'm undergoing active surveillance for Pca, so my situation is a little more complicated in terms of bph treatment options.
How does one go about finding the right doctor for the job. There are some artists out there. I just know there are but finding them...that's the ticket.