Hi all,
It is looking more likely that I may need some 'intervention' regarding my enlarged Prostate after being on medication for several years.
I was just wondering if you had a choice of Urolift or PAE which you would choose and why?
Any advice from those of you who have personal experience of either procedure would be greatly appreciated.
Apart from the above does anyone have a positive experience of TURP? My main worry with that is incontinence.
Thanks and take care.
We have had reports of problems with both procedures. I still don't understand Urolift. The tied back prostate must still grow.
Having had trouble free GL PVP and Thulium/Holmium laser procedures over the years. I would have either again or HoLep. HoLep needs a longer learning curve than GL but saves tissue for histology if that is a concern.
FLA is another interesting option. It seems like we had alot of super positive comments awhile but havent seen many lately.
I had PAE - didn't work for me and it was very expensive. I am now considering UROLIFT. TURP is a non-starter for me.
Urolift was my first choice but didn't work so I got a Holap at Mayo,2 months ago,pee great but still need to go when I get urge, Hope to get better with time
PAE did nothing for me but cost money, and give me a heck of a prostate infection. I am waiting on available dates with Dr. K for FLA now. It is expensive also, but the science behind it seems a lot more sound than some of the other procedures. I did not qualify for the Urolift because of a large median lobe, which DR. K can remove completely.
I had Urolift 4 months ago. So far so good. I had bladder stones w/ some bleeding along with bph--69 cc prostate. Treatment and recovery was easy. Done in outpatient surgical center with iv sedation. Propofol. Good flow. Not much urgency or leakage. Up once or twice a night. No sexual issues. But having said all those positive things I am concerned about how long it will last. As
Someone said prostate continues to grow. I know it can be redone if situation is right. I'll just have to wait and see and enjoy it while it works.
I don't know anything about PAE other than reading about it. It wasn't offered to me by my Urologist.
All the best
Tom
I am 61 years. Come from a remote country called Sri Lanka (Ceylon). As I learned from comments given in various forums .. FLA procedure has given very good results and minimum adverse side effects. I assume that cost is very high. In my country, only option available is TURP. So I decided to go for TURP after two acute retention events.
Here, the total cost was around 2000 US$. I was with catheter for two days and on 3rd day it was removed. After about one hour catheter was removed and removal I could empty my bladder and flow was very strong. After 3 times of emptying I was discharged. Reddish colour of urine and few drops of blood at the beginning of urinating was there for two weeks. Also mild discomfort existed for about 3 weeks. Onr month after surgery I was asked to see the Dr. with reports from uroflowmetry, US scan, urine report, K, Na levels and biopsy. Dr. said everything was OK. It's great relief and success but RE is the only negative effect.I assume RE will be there for rest of my life.
That was a good result for you. If you had been able to go to India there are a lot of options for newer procedures at low prices at vast specialist hospitals.
I am not sure I agree with the comments on PAE vs FLA. I had a PAE with Dr. B in northern VA about a year and a half ago, and had an uneven course of relief of symptoms afterward--initially it gave excellent results, but after 3 months or so my problems came back gradually, and by 6-8 months (still off Tamsulosin) I was nearly back to my baseline symptoms. After that, I found that some adjustments of diet and perhaps some herbal supplements seem to control my prostate symptoms adequately, so I would rate the PAE as at least a modest success at this point. Not perfect but good enough to justify the cost. And I think I would consider going back for a re-do with Dr. B if necessary in the future. If nothing else, if the PAE can keep me off Tamsulosin/doxazosin/terazosin, I will be happy (against the day I need cataract surgery).
In contrast, I have a friend who had FLA with Dr. K and he is doing very well at this point. But it sounded like he had a fairly rocky course immediately after the procedure that delayed his return from Texas, and I have the impression that his out of pocket costs were higher than mine. So I think before you go ahead with any of these procedures you need to get as much information as you can to make a rational decision. All of these interventions have up-sides and down-sides, and it looks to me that it is hard to predict what your individual outcome will be. For instance, I know someone who had robotic surgery to take out the entire gland and ended up very happy with the results, without RE or impotence. Function intact. So when "You pays your money and you takes your chances" like this, let the buyer beware. It looks to me like a gamble either way.
I looked at both and rejected both because of the downside risks. If they fail you can be left impotent or incontinent and then there isn't much they can do for you.
I went with the iTind procedure which is a temporary implant that creates three channels inside the prostate for urine to pass. It was great for me, but everyone's body is different. The key for me was that iTind causes far fewer problems because it uses a far less traumatic mechanism of action so the surrounding tissue is not disturbed as much. It is the only procedure that is done under direct visualization so the surgeon gets the placement right. The worst that happens is that it does not work for you because of the shape of your bladder neck and prostate or because of comorbidity of other health issues. I believe I heard that it has an 85% success rate.
The procedure is done under sedation and only takes 5 minutes. No pain. Just a little burning when you urinate, similar to all other procedures, but that passes when you stop. Then you wait a week and go back and they take it out with a catheter which took about 1 minute. Took a Vallium to relax the muscles first. That was uncomfortable for about 15 seconds. Then blessed relief. A few small blood clots but no more urgency or hesitation or retention.
The other procedure i hear is coming on line is water ablation. It is like a mini pressure washer that erodes the tissue inside your prostate. It is also very precise so the surgeon can avoid damage to the seminal vessels and the nerves controlling your bladder.
Of course it is up to your doctor's ability and knowledge and what your insurance will pay for.
Best of luck.
I have had a PAE with Dr. Isaacson one year ago. My results have been spectacular. PSA dropped from 10.3 to 5. At most, one week of gradually reducing discomfort , awoke feeling like a new man. Anyone posting who hasn't had this procedure has no credibility. It is a fairly simple non-invasive procedure from an Intervention Radiologist, not a Urologist. That is why you see these BS posts. I believe many are Urologists who are threatened by this procedure, a little like Cardiac surgeons were threatened by Cardiologists. Urologist are nothing short of medieval practioners with their horrible surgical procedures. The success rate on PAE is 80% and when fails can be done again with a 50% success rate. The net result is a 90% success rate. Importantly is if guys have this procedure and it doesn't work you can either have it again or do the more invasive procedures. Cost of $6000 sometimes covered by insurance is a bargain compared with surgeries. A Turp runs over $20000. Be aware of the urologists on this site. They are toast as this procedure gains acceptance and full coverage.
["Cialis] increases blood flow to the prostate." So says the commercial. Maybe that's why Cialis works for a lot of guys.
Let that sink in.
Cialis is allowing a human gland to perfuse, and that's important.
What do we have without perfusion?
We have ischemia.
That's sometimes what happens when someone has a myocardial infarction (heart attack),
or angina pectoris (coronary pain, either with or without exertion).
In these cases, it's the heart that isn't receiving enough oxygenated blood flow.
So maybe this is an oversimplification, but isn't a P.A.E. a form of medically-induced ischemia?
The IR is using something called an embosphere to block the arteries that feed the prostate.
End result?
Ischemic tissue death.
I'm not so sure that's such a good thing.
Maybe it would be a good thing to find the arteries that feed a prostate tumor and block them,
thereby mitigating prostate cancer.
However, to use this procedure to alleviate the symptoms of BPH by killing off part of the gland? Hmm ...
In conclusion, I honestly do not know of ANYONE who has experienced a positive, permanent outcome from P.A.E.
My heart truly goes out to the men who have had this procedure.
It makes me question the clinical trials behind this procedure as well as the IRs who may have been sold a bill of goods by the developers of this system.
Maybe they honestly think it works.
OR ... maybe they do know of it's deleterious effects but, nevertheless continue to bilk unsuspecting, suffering men out of their hard-earned dollars in order to line their own pockets.
Who can say for sure?
Finally, to the moderators:
Please allow this post to stand.
We come to this forum because we either want the truth
or we want to give our own perceptions of the truth.
I had my FLA on 4/28/17.....best money I have ever spent.
I had FLA in July this year. BPH woes are now long forgotten. I would recommend to anyone.
I had PAE because of frequent urination at night (an average of 6 times per night). In my case, there was no noticeable difference from the procedure. I also had to pay for the procedure because it was not covered by insurance.
Hey Peter. did Dr K do your FLA? If so have you talked to them since the hurricane hit Houston? I emailed them last week, to get the dates he had available in October, and did not get an answer back yet. I was just wondering if they were damaged.
Also did insurance cover any of yours? I turned in a Pre-authorization request to BCBS and they indicated that they would cover it out of network, Dr K said not to hold my breath on getting reimbursed from them tho. Just curious if anybody else had any luck with insurance.
Thanks
I heard from Dr. K after the hurricane. You should email again. Perhaps email got lost.
Good luck.
Pete Kline
HONG KONG
Thanks Pete, will do that today. Where did you stay while in Houston?
Joe
Good to hear that your procedure went okay and the outcome has been so positive for you, long may it last.
I take it that you have not had any problems regarding incontinence following the procedure as that is one of my main worries regarding TURP.
Take care,
Steve.