Newbie on this form and so glad to have found it. really appreciate all the 'bearing of soul" from the participants, helps to know you are not alone.
I live in Texas and was scheduled to have PAE next week. After reading this forum I found out about Urolift. Short on time I emailed Dr. Kella in San Antonio. To my surprise he emailed me back and saw me the next day. Did a number of test and I am a candidate for Urolift. My local urologist in Mcallen really missed the ball on my issue, but that is another story.
Bottom line is does anyone have any results comparing PAE vs. Urolift? Both are relatively new procedures. I have researched, but haven't come up with anything yet.
My options are PAE at UNC CHAPEL HILL or Urolift with Dr. Naveen Kella in San Antonio.
Any feedback on either procedure and/or Dr. Kella and UNC would be appreciated.
Hi Soben, welcome to the forums. Pae seems to be a mostly unknown method in these forums. I think I have read replies from only two patients and neither one was good, although one was recent and the Dr told him that PAE would take six months, I believe to be effective. In theory, it seems to be a great idea; starve the blood flow from the prostate and cause it to shrink. I'll bet that procedure is a future winner and maybe there are hundreds of successful operations already. Hopefully, other patients will see these forums and speak up.
Dr Kella should be a good choice for Urolift, as he would be one of the more experienced urolift surgeons, especialy in Texas. I believe that urolift is a reasonably good solution to quickly get you off the meds and buy you some time if you just can't stand the thought of a more-invasive procedure and you want to wait and see if better solutions come along. Your prostate will likely continue to grow and eventually you'll be facing another surgery.
My opiinion, based upon my experience alone, as I have said many times on these threads, knowing what I know now, when time comes for either medications or surgery I would find some way to have the HOlep procedre done as I did in October. It was painless and trouble-free except for the trip to find a Holep surgeon as it is not done in Texas. I am now 100%, like I never had a problem.
Whatever you decide, best of luck to you and don't forget to give back by posting your experience here. There are many thousands of BPH sufferers who can benefit from your experience.
Hi Soben; I had "PAE" on Sept. 10th of this year. Flew to Alexandria, Virginia and had one of the pioneers of the procedure (Dr. Sandeep Bagla) of Inova Hospital perform the surgery. The reason I had it is because I was getting up 4 times a night to go to the bathroom. It has now been a little over 3 months since the surgery and I have seen "NO RELIEF" whatsoever. Still getting up 4 times a night. He told me it would take anywhere from 30 days to 6 months to see relief. His goal was to get me to "two times per night" for the bathroom. By "embolizing" the arterys and veins that lead into the prostate it is suppose to "shrink" the prostate by 20 to 25% over this time period. Hence, giving you some relief from the constant nightly bathroom breaks. I have tried all the usual meds with no relief. The tamsulosin and avodart routine or as some here call it the "castration drugs". Thats a good name for them too. I have since discontinued taking those drugs. Here's something that does help me sleep atleast for the first 3 1/2 hours of the night. Get a script for "Oxybutynin Chloride 5mg" and take it at bedtime. It helps the bladder control the urge to go. Also at bedtime take 4 oz. of "tart cherry juice". Get the real stuff not the blended crap. Also put on a "Breathe Right Lavender strip" at bedtime. It goes over your nose. Not nostrils!!!! It has a calming effect and help you doze off quicker. Those 3 things have helped me immensley get to sleep and stay asleep for the first 3 1/2 to 4 hours. After that its every one hour and forty five minutes up and to the bathroom. Some here swear by the "button turp" procedure but it is "major stuff" and Iam going to avoid it for now. Hope this helps answer atleast some of your questions. My understanding on the "Urolift" is that it does not stop the prostate from "growing" so it is only a temporary fix. Hope to hear back from you. Take Care. ChuckP
Hi again; I forgot to explain what "tart cherry juice" does. It acts alot like a natural sedative and relaxes you and helps you fall asleep. Its not a myth as it does work. I found out about it from Dr. Oz. You have to get the "real stuff" not all the mixed blends.
I had PAE 1 month ago, done by prof Pisco in madrid.
Just had 1 month check up.
Prostrate volume was 163ml now 136ml (a normal size is 30ml).
Retained urine volume: was 127ml
, now 2.5 ml.
Used to need bathroom 4 or 5 times a night - every 1 1/2 to 2 hours. Now maybe neef one visit, but usually go 7 or 8 hours - the whole night.
Only negative side effect, had been blood in semen from about weeks 3 to 4, though now seems clear.
I was also suffering complete retrograde ejaculation, for about the last year. Things here also seem to be returning to normal.
I travelled from Scotland, could have gone to Southampton but believe they had only done the procedure 15 times. I was prof Pisco's PAE patient 732, and total price with flights and stay was less than UK price.
I'm 59. The CT scan showed I should be a straightforward case. But one artery did an acute angle turn. Ended up the professor had to use a special catheter for the very first time. He said afterwards that he doubted Southampton would have been able to do this.
So very glad I chose Madrid.
Just found out that Hospital St Louis had now done over 20,000 embolisims. Embolism of Uterine fibroids started about 20 years ago. so not a new idea. I guess procedure has just been adapted to the prostate.
Thakns guys really appreciate our input.
I am leaning towards the urolift prcedure. Seems to be the least invasive. Might have another issue - neurogenic bladder. So I am waiting on the results.
I will keep you updated with the results. Hopefully will help someone else.
Hi I am living in Dallas, Tx.. My Urologist suggested that I should go for TURP . My Prostate is 5.5cm or 30 to 50 gms . He also suggested to look into UROLIFT. I ahve read about Urolift.. not many doctors know this procedure. One concern brought to my attention is forming of Scar Tissues adn Calcium formation since you have a foreigh object inside your body. However when I read the FAQ on this system, they indicate that its very easy to remove the implant if needed . So its kind of confusing. Woudl appreciate any comments.......
I am also considering Urolift, but have some concerns about scar tissue formation and calcium deposits surrounding the implant. Have you looked into these complications related to Urolift? Would appreciate comments
Don't forget that the Urolift is done by a urologist. A PAE is done by an interventional radiologist. The urologist doesn't make money recommending a PAE! This can color the recommendation.
Neal
Hi all,
I'd like to try to stir up this discussion. Seems to me that PAE v Urolift is THE question of the moment. If you have experience or perspective on this, can you please contribute.
Here's what's true about both procedures:
Relatively new (no longterm studies, but lots of positive short-term and anecdotal evidence)
Neither has risk of sexual side effects or incontinence. So who would want to do anything else, if one of these might be sufficient?
$5k - $15k
Minimally invasive. Inpatient.
Good results for most men, though not all. Can take a couple months or more before full benefits are realized.
Not clear yet how long results last.
Having a medial lobe can compromise results for both
PAE involves radiation (though acceptable levels?). Urolift recovery can be tough for a week.
I'm trying to decide between them. So any insights appreciated. Thanks.
Dan
On Wednesday I met with my PCP to discuss my urologist pushing, hard, to have me do a TURP.
My internist agreed that TURP would personally be his last choice, given the side effects. As to PAE, he was not familiar with the procedure, so I gave him a printout of the web page from Tampa General Hospital, the gold standard in this area, and he noted there it is currently in medical trial and it is not yet an FDA approved procedure.
He advised that means insurance would probably not cover the procedure, yet.
Have any of those who've had PAE done been able to get their medical insurance to pay for this procedure?
According to NIH, by the way, the clinical trials are being done at 8 US hospitals (3 orther US hopsitals had withdrawn), plus 1 in Europe. The Clinical Trials identifier is NCT01789840.
Found an old comment of yours and wanted to follow up if possible.
The availability of alternative minimally invasive procedures continues to explode. I am in the research stage having had a greenlight about 12 years ago with symptoms gradually reappearing----not nearly as bad as the last time as of now--but I wanted to get ahead of the curve.
I have run into an incorrect stricture diagnosis by a urologist so I am particularly wary right now.
Regarding HOLEP, I have read it is particularly helpful for men with very enlarged prostates. Mine is large, apparently about 60 grams, but not massive.
Any comments about REZUM, EUROLIFT, and PAE would be appreciated.
I had a PAE at Tampa General Hospital on April 07, 2017 by Dr Clifford Davis. Proceedure a snap, they insert catherter once you are out. They do it in the heart cath lab, I work up with a cath. They gave me water and some crackers and after an hour pulled out Catherter which is worse part but nothing. I then had to go into pee. The firsr few drops of blood were slightly pink then clear. They had me drink another quart or of water and after aout 45 minute had me go pee and no issues, so they release me. Zero pain. We stopped to eat on the way home. We had arrived at 11 am and left about 5 pm.
My prostate was very large, as high as 188, avodart got it down to 155-160 after a couple of years and it stablized there buy the side effect of avodart and flomax were bad. At home, the next day it burned to pee which I was told was normal for 3 to 4 days but it continued beyond that. I have had chronic prostatitus and knew that is what it was and the radiologist said it is common with the procedure and called in a double antiiotic. By the 20th day I was cleared up and stopped anitbiotics and also stoped Avodart and Flomax. I was having no issues peeing ang getting up once. It has been that way since. The biggest plus is that I can pee now as fast as the youing guys, 30 secs or less. No going into a busy public sports bar and tying up a urinal for several minutes. Here is the BIG DEAL. My Urologist did not know I was doing this, I had an appointment yesterday and told him and he was skeptical. He had me do a sonagram to measure the size of my prostate. He was shocked to see that it had already shrunk to 106. Yes, 3 months and it already is down to 106. So, Extremely pleased and wondering what it will be in 6 months. THIS COULD NOT HAVE GONE BETTER FOR ME, IT WORKS BEST ACCORDING TO DR. DAVIS WITH LARGE PROSTATES 80-90+. He is getting referral from urologists who do not want to do their traditional treatments on prostate that are very large like mine was as there is so much more chance for ocmplication. GLTA
i had the PAE procedure done in Feb 14,2020 at Alate Health in Houston . My outcome thus far has been remarkable .
My history with Bph has been a typical journey , except that my prostate at 188 ml was super enlarged . After suffering with incidents of urgency , and retention at alarming rates , i started investigating the options for a remedy beyond Flomax , which had lost its efficacy . My urologists all recommended I undergo a procedure . 2 urologists recommended the TURP and 1 recommended the urolift . None recommended the PAE largely because they didnt do tge procedure and didnt have any skin in that game . After investigating the choices i chose Dr Doe in Houston , an interventional radiologist and I am thrilled I did . The procedure was done as an outpatient in his office , it was a non event , no pain and mild sedation . Able to go home 3 hours after it began! No catheter !! Main side effects lasted 4 days . They were mild burning and blood in urine . Blood in semen lasted 2 weeks .
Outcome was incredible . Prostate shrank by 1/3 within 3 months and even more as of 9-5-20 . My sexual function improved significantly as well due to opening if caplillaries in penis through the procedure , a pleasant but unintended consequence for me .
bottom line : research , research and research like I did . Not a single urologist made the PAE recommendation because they didn't get paid to do it!!!! Here's to PAE and Dr Doe
Have you heard of any updates about these procedures in the past 5 years?
Any news on the PAE procedure? Has it been covered by any insurance companies?
Has the PAE treatment continued to work for you?
It looks like it was approved in July 2018: https://www.radiologybusiness.com/topics/care-delivery/fda-approves-minimally-invasive-cheaper-option-prostate-surgery
Having had a failed Urolift I would opt for a PAE first and leave the Urolift as a secondary option. But objectively you should consider the prostate size and problem area as primary drivers of your decision. Urolift works better with smaller prostates and PAE works better with larger ones. (AFAIK) PAE doesn't address an obstructive middle lobe but Urolift might. And neither will address a high bladder neck. I would be skeptical of a practitioner who schedules you over the email for the next day. Get a second and third opinions to help you make the decision.
Good luck
I had a PAE done by Dr. Bagla approximately a year ago. Initially I thought it was going to be a success but one year on and I'm right back where I was before I had it done.
Within a week or two post-op, the pressure of my stream when I urinated increased noticeably and I was encouraged. But that was the best it ever got. After about month I noticed my stream pressure decreased. One year post-op and I'm back to getting up 2 - 3 times in the night to pee. I have the urge to go frequently during the day.
I think PAE works for some but it didn't work for me.