I am trying to decide whether to go with urolift or pae. I wonder if the pae is not effective then I could get a urolift or maybe not if the uro would not allow that. Lew
Why do you only consider PAE and Urolift ?
What advice have you been given as to the most suitable for your situation. You can choose whatever you want but it might not be the best option for you. Nor do any of us know that no matter what some may say from their own experience.
Personally I have had GL and Thulium/ Holmium laser (similar to HoLep) and both worked well for me.
Because they are less invasive and are office procedures.
I have not been given any advice. The urologist just asked me if I wanted a urolift or a turp. he never explained anything.
In my experiences most URO’s only offer the procedures that they personally perform. I had the Urolift and found it to be somewhat of a failure, but the jury is still out. But immediately the URO started talking TURP, I let him know that would be the last resort and tried discussing the PAE and he did not approve of it. Reason being he had only done a few and the results were NOT good. I guess my point here is, do your research and see several URO’s if necessary and when YOU decide, seek out the best you can find. Hope this helps…Billy
He sounds the type to avoid.
Radiologist do PAE not urologists
Lew,
I expressed my unequivocal opinion about PAE on that forum more than a few times. My opinion is that first procedure for any BPH should noninvasive or minimally invasive. I hope that eventually most surgeries will be that way, when early diagnostic and medical instrumentation will reach that proper level. I’ a strong opponent of TURP (which has close to 25% of complications after surgery, even at best surgical centers). Urolift works not for everybody. It all depends on your age, prostate size and median lobe enlargement degree.
My prostate was huge (135 g) before I learned its real size, symptoms horrific at the end, and I was offered only TURP by my HMO URo and my PCP. They both told me that regardless of teh chances of complications as incontinence and impotence, TURP is one of the safest “golden standards” of BPH treatment, while PAE is not proven and can have disastrous complications with many pelvic organs, including my penis, messed up. I decided to join a clinical study at UCSD wich was looking for BPH patients for PAE. It was the best thing that happen to my in my life. My urinary and sexual functions are literally rolled back by at least 30 years. I don’t wale up at night., I can hold and not rush to restroom for 4-5 hours, my stream flow is like in my 20th,. My bladder has relaxed to the it’s much younger function and can hold up up to 300 cc at a time and is emptied fully. It’s now 9 moth after PAE; my BPH symptoms vanished dramatically and I continue improve by the day, week, month.
Urolift is for small prosattes with minimally enlarged median lobe. TURP is a vastly outdated barbarian medical technique for. PAE is only good for prostates larger than 80 cc, and if done with highly experienced IR. Requires a brilliant ability to read persona pelvic angiograms, using sophisticated comic scanning x-Ray machine with digital subtraction. If done with correct technology, it’s not a cheap procedure . Medicare pays up to $41K for it.
It’s worth every penny, believe me. It’s real 21st Century medicine, if performed correctly. It’s only for large prostates with possible bleeding and cases when anyting else is too risky with complications.
Unlikely somebody will give you the ultimate advice. URO and IR are in two different feuding camps. Don’t expect any of them to give referral to another professional.
I spent weeks and moths reading this site and research paper before making the only right decision for myself.
Decide for yourself. Nobody knows you your circumstances better than yourself. Write to me privately if you have any further questions. Read my other postings.
God Bless.
Lew It’s true urolift is now being done in the office but the PAE is done by an interventional radiologist in the hospital.
The fact that you urologist didn’t explain anything to you would raise a red flag to many. Maybe you should seek a second opinion
Regards,
Raffie
It held up for9 months. Will it hold up for 9 years?
Hi Lew,
That would be a question for a urologist, and I wouldn’t be surprised if you got different answers from different urologists. I posed a similar question to an interventional radiologist who performs FLA for BPH: if I had a PAE and it didn’t work, could I then to FLA. At first he hesitated, saying the reduced blood flow to the prostate after the PAE might increase the possibility of infection post FLA. He then gave it some more thought and said that he didn’t think that it would be a problem.
BTW, if you do decide to have a PAE, I would strongly recommend having it done by a doc (an interventional radiologist) who has done hundreds of them.You don’;t want someone learning his skills on you… way too risky. I traveled from NY to Virginia for my PAE just for that purpose.
Rich
That would be a question for a urologist, and I wouldn’t be surprised if you got different answers from different urologists. I posed a similar question to an interventional radiologist who performs FLA for BPH: if I had a PAE and it didn’t work, could I then to FLA. At first he hesitated, saying the reduced blood flow to the prostate after the PAE might increase the possibility of infection post FLA. He then gave it some more thought and said that he didn’t think that it would be a problem.
BTW, if you do decide to have a PAE, I would strongly recommend having it done by a doc (an interventional radiologist) who has done hundreds of them.You don’;t want someone learning his skills on you… way too risky. I traveled from NY to Virginia for my PAE just for that purpose.
Rich
Sorry about the messed up formatting. I don’t know what’s causing this. Does anyone know how to contact the moderator directly?
Here’s my last sentence:
BTW, if you do decide to have a PAE, I would strongly recommend having it done by an interventional radiologist who has done hundreds of them. You don’t want someone learning their skills on you …way to risky. When I had my PAE done, I traveled from NY to Virginia for just that reason.
Nobody really knows. it’a a matter if luck and skills of the initial IR procedure. so far it’s still improving my symptoms. means far from going downward. I have read on this forum and in the literature about 5- year old cases. still holding up. Pres. Reagan had three TURPs in his lifetime. So, there no panacea, except for full castration or radical prostatectomy since 19th century. Wanna go back to these times? I plan to perform Gat-Goren embolization of the seminal artery, which fixes the prostate growth permanently. So far it’s performed only in Israel and is rumored to cost around $30K cash
I went with PAE on October 18 of this year and am very happy with my results. I chose Dr. Bagla at the Vascular Institute of Virginia even though I live in Washington State. How much your radiologist can do for you will depend some on the health of your vascular system. If you are not significantly over weight, have not had a high fat American diet, if you exercise a fair amount and your blood pressure is low, a good radiologist will do a more aggressive treatment and you will have better results. I am 71, BP was 110/69, I weigh 155 lbs, 5 ft 8 inches, with a heart rate about 60 and he treated me aggressively. I had just been diagnosed with mild Gleason 6 prostate cancer and had a PSA of just under 8 with a 127 cc prostate. He told me that he would target the area where the prostate cancer was found. I just had my PSA redone and it is now 3.63. I call that reason to rejoice! I went from getting up in the night 5 to 7 times to about 3 times a night. I still can get extreme urinary urgency and have wet my pants at least once while in public, but that is better than I was doing before. My bladder empties but I don’t have a lot of bladder capacity. I was in one day and was able to go home after 24 hours. I had no pain at all. This is the least invasive procedure I know of, yet the improvement was quite noticeable within 2 weeks. Bill
I had urolift hated the procedure and the next 4 weeks but now I think I’m getting back to normal and probably a little better off than before the procedure. Some people have great results some don’t. I think the risks of complications are less with urolift but it’s probably not as effective.
Hi all, I just found this site and decided to join. After having a UTI two years ago, and my urologist said my prostate was 100 grams and therfore too large for turp, I elected to have the PAE. I was instructed how to self cath after UTI and I did that until PAE and after until the amount of urine dropped below 100 cc after voiding normally. That was about two months, I think. I quit tamsolusion (Flowmax)after the morning cath produced about 60 cc for about 10 days, and then resumed taking it for ten days. I didn’t see any difference so I quit altogether.
I just saw my first urologist this morning for the annual DRE, and he said things are good. I asked him if my prostatewas smaller than two years ago and he said no. He also said the last urology conference he went to said PAE wouldn’t work so don’t do it. My experience was pretty good, so I questioned his reply. He said if it worked then good.
Max,
Don’t listen to urologists. They will all become unemployed if PAE becomes standard for BPH treatment. I’m 9 months after PAE, continue to improve and so far rolled back 30 years of my sexual and LUT life. It’s beyond my wildest dreams. My prostate was 135 g, but Uro wanted perform TURP. I refused. He now says that it’s a placibo effect. DRE can tell the size, let alone PAE produces caverns inside the Prostate, and if performed correctly, targets the median lobe. I hope it will last long enough for you and me. I’m off all prostate medicines altogether and don’t wake up at night now vs. every hour before the PAE.
Good luck in the New Year. Who performed you PAE?
I’m glad my first urologist said don’t come back this morning. But it involves more than just prostate. I had a penile implant two months ago, and he said he didn’t want to mess that up doing anything else. I had a lot of swelling from implant and that changed night time bladder needs for a while.
The PAE was done in Billings, MT by Dr Zachary Bland (whose wife is a urologist in the same hospital). The doctors in Billings seem to be interested if helping patients instead of promoting their specialty. I was referred to Dr Bland by a urologist in that hospital.
I’m off all prostate meds also. I hope things go good for us also.
Thanks for your reply.