Had PAE in Tampa 3 weeks back

Men's health
1

I am 73 year old male with severe BPH for decades and my large prostate has caused bleeding and chronic prostatitus.  Have been taking Jaylan far too long.  I had been consulting with Dr Clifford Davis at Tampa General Hospital who works with USF Medical School.  They were part of the trial study and still have a trial study going on looking for new patients.

My procedure was approved by insurance and I still have group insurance as I still work.  I am a high risk patient with heart issues and a large (155 down from 188 with Jaylan) prostate so my BCBS covered it.  I had a heart cath at Tampa General almost a year ago.  I went to the same  heart cath lab for the PAE procedure.  Dr Davis has done about 100.  There was little difference in the two procedures but the heart cath was much shorter as it was negative.  I was in the cath lab about 3 hours and Dr. Davis went into the same right leg that has been punctured several times for heart caths.

They had inserted a foley cath during the procedure and when I was fully awake in the recovery area, they gave me some crackers and juice and water.  After about an hour they removed the foley which was the worse part of the procedure.  I was told if I could pee, I could go home.  I got up and went in and peed with just a tinge of blood.  They gave me some more water and made we wait another hour and I went in and had no issues peeing.  So, they started the discharge process and Dr Davis came by and briefed me.  He said the procedure went well, that I should have some burning pain for a few days but little else.  He gave me some low grade pain killers and a couple of other meds. His scheduled follow up visit is 3 months unless needed as he says unless complications, no need to see him.  But by 3 months, I should clearly notice the results.

I left the hospital about 2.5 hours after the procedure and felt good enough to stop to eat as I had nothing but a pack of crackers since midnight.

 The first night was fine.  The next day it hurt to pee and was getting worse.  Each day the pain worsened as I peed and I was peeing often.  I called the Dr and he sent me for a urinalysis that came back negative.  I told him it seemed like prostatitus that I have had many times, he prescibed anti-biotics and it cleared up after about ten days.  The past 3 or 4 days I am peeing better than I have in years, no pain, and I do not have to get up in night but once at most.

I am to continue taking Jaylan until next week, but already have cut dose in half.  He told me it takes a while to have the effects of the long term use of Jaylan (avodart and flomax) disappear.

Anyway, had I not had a case of prostatitus, there would have been little to the procedure other than it burned to pee which I was told to expect, the prostatitus however made it much more painful and I was getting up every hour or two at night.

So far, very pleased and will update if any changes and try to give a long term update.  I do not think there are many BPH procedures where you can stop and have dinner just hours after the procedure.  I was slightly sore sitting but no big deal.

Scott

2

Thank you for the information I'm glad you doing great. I'm going to have the green light laser as I had a catheter for a year now as I cannot pee on my own. I'm scared to have it done but I will have it done.

3

ScottFree - I recommend looking into less invasive procedures rather than the Greenlight done. You should also look into self cathing until you decide on a procedure. Its much less painful and pretty much allows you to live a normal life.

Before having ANY procedure, you should be scoped and have bladder tests done to confirm that your prostate is in fact, causing the problem. If its your bladder, no prostate procedure will help. Often its both.

If your prostate is the, or the main issue, Urolift, Rezum and PAE are all less invasive options that won't preculde greenlight or anything else if they don't work. There are many horror story threads involving Greenlight on this forum, including ones that left men completely incontinent.

I don't know where you live or what your insurance situation is, but Greenlight is a sort of outdate procedure that in the wrong hands can make things much worse. Best case secnario still involves 2-4 weeks of wearing a diaper.

4

Buzz,   This is Scott (Free), you meant to address Randal....... I am the guy who recently had the PAE I was on this site many months back to make my decision and thanks to you guys and feedback plus and minus of each procedure... I am VERY glad I did the PAE, the procedure was a snap and painless as well as bloodless and I am on blood thinners.

Has anyone with any prostate procedure stopped and had dinner within 3 hours of having their procedure? I was not wearing a cath when I left the hospital just a few hours after the procedure.  My uro wanted to try the Rezum, I called the company and talked to the person in charge of the trial study.  She told me that for some with a very large prostate, they recommend they wear a foley cath for ten days after the procedure.  That eliminated that idea of me.  I hate wearing those, they a pain in many ways.

 I can already notice a huge difference in peeing.  Instead trying to pee and just standing there trying to build up pressure and it taking 2 to 3 mins or more, stopping and starting etc etc.  I already can walk up to the John and start to pee almost instantly with a solid steady stream with pressure I have not seen in many years.  It is a 30 sec process already in just 3 weeks.

Last night I got up once to pee, instead of 3 to 4 times.  If I drink nothing past 8 pm, I would not have to get up.  So, I am more rested.  I really want to get off the avodart/flomax as I have been on flomax at least 10 years and advodart about 5.  Both have bad side effects, particularly avodart since it messes with your hormones. It takes away all of your mojo, not just sexual mojo.  It messes with muscle tone, some guys get man boobs, takes away energy and just automatically makes you older.  It did shrink my prostate from 188 to 155 and kept me from having surgery until the PAE was available for me.

I am in total agreement that anyone should look at the PAE even if you have to pay for it.  Tampa General hospital is running a trial study and looking for patients. I also think they have a flat rate of about $9600 or at least they did before I got mine approved by BCBS as an exception. Just google search Tampa General hospital PAE  Or Clifford Davis, MD Tampa, an interventional radiologists.  I gave him and his staff all 10s and more on the recent survey the hospital sent me. Dr Davis says that the PAE is most effective for large prostates and now has two local urologists referring their large prostate patients to him because of the likelyhood of far more complications the larger they are.

There have been no PAE patients that have had to wear diapers after the procedure. They say there have been no known sexual complications either but that is likely somewhat harder to gauge.  

Scott

5

I know, it's a big deal, but what are our options? I'm getting mine on July 14

We have to be positive and have faith all will be fine

6

Scott Free:

Had PAE in late April at St Louis University Hospital, Interventional Radiology Deparment.  Urologists do not perform this procedure.  Wonderful result.  I had the same very pleasant experince pre-procedure, intra-procedure and in the recovery area.  I also shared your increased urinary frequency and urgency, about every 20 to 30 minutes starting the day after procedure and lasting for 48 hours.  Understandably this is due to the reaction of the tissue of the prostate starved for nutrition and initiating degeneration of cells to shrink the prostate.  I am a dentist and have some understanding of anti-inflammatory drugs.  They take about 24 hours to reach their full anti-inflammatory effects.  I gave feedback to Dr. Periera at SLU that dentists and oral surgeons frequently start anti-inflammatory NASIDS, ie Naproxen sodium or Ibuprophen 48 hours before removing wisdom teeth, as an example, to greatly reduce post operative swelling and pain. He was enthused to investigate this as a change to their protocol.

I am aware that this is a new procedure, a great procedure advance, since I worked in a hospital during college, graduate school and dental school.  I witnessed the TURP procedures (an ancient, relatively high risk procedure).  Men leaving surgery with catheters inserted for at least a week with a bag attached that appeared to be heavy bleeding.  The lining of the urethra took much longer to regenerate and probably was very uncomfortable for a long time. 

The PAE was almost like not having a procedure.  As you said the short time during the procedure that was inserted was the most unpleasant part of the procedure.  Also the Colliplug technique to instantly seal the Femoral artery is a miracle in preventing any post procedure bleeding. 

The PAE has just been approved as an accepted procedure, and is relatively new.  There are a few Interventional Radiology departments that perform the procedure.  I traveled from Kansas City to St Louis for the procedure.  I was originally scheduled a Rezume (Hot steam injection thru urethra walls) with a Urologist.  Not many people know of PAE.  I am fortunate enough to have a family connection to the company who supplies the intravascular instruments to perform PAE.  He found out thru the family grapevine, about my plans for the Rezume procedure and informed me of the PAE a facilitated my appointments at SLU.  I am eternally grateful for his thoughtful intervention/information. 

If you are near St Louis, go to SLU.  Otherwise find a program close to you.  Traveling was the most inconvenient part of this procedure.  Finally a great breakthru for MEN!!!

7

UPDATE!!!!!!!  MY PROSTATE WHICH HAD BEEN AS LARGE AS 188 ABOUT 5 YEARS AGO, THEN DOWN TO 155 TO 160 WITH AVODART IS NOW 106!!!!!!!!!!  3 Months after the PAE.  So roughly already down by 1/3rd.  Been off avodart and flomax for 2.5 months and no issues peeing.  May get up once a night or maybe not depending on how late I drink something.  I do not have the sudden urge to pee but the really big deal is how fast I can pee.  Same as a young guy, 20 to 30 secs max, no stop and start.  No just standing there hoping I can pee.

THERE WAS NOTHING TO THE PROCDURE, I  did develop prostatitus but it has been chronic with me and I was told a good chance it would happen.  The Doc call in antibiotic and I was peeing almost normal in a month and now peeing like a 20 year old.  Thank You Dr. Clifford Davis at Tampa General.  He did say, it has been his experiene it works far better on large prostates.  I think he mentioned 80 to 90 a a minimum.  In FL they are done in Tampa in onjunction with USF medical school and in Miami in conjunction with the Univ of Miami medical school.