Hy guys, I would like to know, from all of you here that had made a PAE how long of BPH have improved, regressed or worsened, and what were these symptoms.
Personally, I have at first a great improvement on urine flow but now flow has regressed a little bit (60 days after a PAE). Still have to pee 3 times at night (before was 5). As of now, I can´t walk too much because I got blood in urine after that.
I had PAE Oct 28 2015. It took about 6 weeks for me to get off flomax after the procedure, which I was having to take two aday. After a little over 18 monhts I am still doing ok. I do not get up at night except maybe once a week. That usally happens when I drink water to late. I can hold off the urge for hours if I have to where before on flomax I had to tend to it right away or pee on myself. Glad that got corrected.
I am almost 75 so the change has been great and getting off flomax made the cost well worth it.
During the peeing process, I tend to have a slow start then a regular stream and then a slow finish which is completely acceptable to me. I am able to clear my bladder every night by taking a regular shower and then running cold water on my lower back which in my cases empties my bladder. By doing this before i go to bed may be one of the reasons I do not have to get up at night.
I realize I may have to do this procedure again sometime in the future. But for now I am quite satisfied with the results.
Right after the procedure I had brown pee for maybe a week with small amount of burning. I had very little pain so I did not have to take any pain medicine.
good luck to you.. Hope it works for you as it did for me.
I'm sorry that your problems have retruend.
I did great for 30 days after my PAE. Over the next 60 I returned to my pre-PAE BPH condition, getting up 5-6 times per night, interrutpion, delay starting, etc.
I think the temporary improvement was due to the steroids and meds given during the PAE.
I wish you better luck.
Didn't work for me - but I've spoken to someone who said it worked like a miracle for him. You shouldn't have blood after 2 months in my opinion.
Where did you have your PAE done, if I may ask?
I had mine done in Northern Virginia by Dr. Sandeep Bagla, who has performed more PAEs than anyone else in the US--and maybe in the world, after Dr. Pisco in Portugal (who I believe pioneered the proceudure). I can't say enough good things about Dr. Bagla and his team--all extremely competent, patient, and kind.
My PAE was done 42 days ago, and has allowed me to stop taking Finasteride, which I'd been on for several years. I'm still on Cialis, 5 mg. a day, but hope to gradually wean myself off of it. Unlike Finasteride, which takes months to work, Cialis works immediately, so even if I stop taking it, I'll keep a supply on hand in case I need it. A urologist I know, who has mild to moderate BPH symtoms, always takes a bottle with him when he travels. I'll do the same.
In general, I'm quite happy with the results of the procedure. My symptoms pre-procedure were not very severe, because the meds worked. The main point for me was to get off the meds, in particular Finasteride, and so far the procedure has done what I wanted it to do. While there hasn't been a dramatic improvement in symptons, since my symtoms weren't all that bad (getting up several times at night, occasional urgency and inability to empty my bladder), I'd say there's been a 20% improvement since the operation. I think I'm probably peeing as well as a 72-year-old man can hope to. I'm still getting up at night, but only 1-3 times (versus 3-6, pre-procedure). I have no trouble going back to sleep, so I'm not particularly bothered by this.
That's my PAE story: So far, so good. If you--or anyone else reading this--have any questions, don't hesitate to ask.
Don
Good discussion that should help others decide if PAE is a good choice.
As an additional information, I have pain in the urethra when ejaculating and after 60 days of PAE, still sometimes a little blood in semen. Would like to know from the guys who had PAE done, how long (in months) last the good symptoms like improvement in urine flow, few bath trips at night, etc...
My experience has been very similar to Don's. I had the PAE with Dr Bagla about 2.5 months ago. Symptoms pre-PAE were difficult, but tamsulosin kept it under control. Unfortunately, the side effects were pretty bad. Now post-PAE, I slowly weaning myself off tamsulosin, and my symptoms are better, but I wouldn't say dramatically. Dr B said symptoms may continue to improve. Matching Don, I'd say there's been a 25% improvement, which should be enough to stop taking tamsulosin entirely.
My IR was only able to get to one side - I improved for six months, then all progress ceased and I returned to the starting gate. It was a waste of $7000 for me and $37,000 for my insurance company. My procedure was in July of 2015 at St. Louis University Hospital, St. Louis, MO.
What proceudure did you have that cost $44,000?! My PAE, done at the Vascular Institute of Virginia, was a little over $7,000 (90% of which was paid by my insurance company).
Standard PAE - nothing unusual. 2 hours for the procedure and 4 hours in recovery. Welcome to US hospital costs!
I don't think this is a normal cost for a standard PAE in the US. As I said, it costs a little over $7,000 at the Vascular Institute of Virginia in Woodbrige, VA (where it is performed by Sandeep Bagla, who has done more PAEs than anyone else in the US). I believe it also costs in the $7,000-$8,000 range at the University of North Carolina.
My insurance company paid, so it must not be all that unusual.
I had PAE in 2013 as part of a trial with Dr Bagla in VA, At the time my prostate measured 100CC on the MRI. I can only say it was a short lived success. I experienced some symptom relief for about 2 years and the the symptoms came back in force since culminateing in a few episodes of AUR.
I had a 3T MRI done a few weeks ago prior to my MRI guided Focal Laser Ablation and the interventional radiologist was able to walk me through the images and show me exactly why my PAE failed and where it had worked. I had a large protruding median lobe growing into the bladder neck, the MRI revealed that its blood supply was perfectly in tact and there lies the problem with PAE. It is untargeted and therefore pure luck whether or not it will affect the part of your prostate causing the most harm. The PAE hadn't successfully embolized my median lobe.
I had considered doing a 2nd PAE at one time but fortunately I chose FLA. My median lobe has been dealt with and I am peeing like it was double digit years ago.
Here's the mistake I made when I selected to have a PAE. My dealings with professionals usually goes something like this: I call my dentist and say "the filling you just put in is hurting me" Or I call my auto mechanic and say "Even after you repaired my car I'm still getting the banging noise".
The say "Sorry to hear that, Come in and let me take a look." They welcome me back and begin to examine the problems. They look at things, poke around, push and pull in places, xray the tooth or put a scope on the car. And finally say, It needs a little more work, I'll just charge you for the parts.
In the case of my PAE, the reaction when the initial great results started to decline, was 'I don't know'. or 'Could be'. Period.
I didn't think it was necessary to ask the doctor if he has any concern to help a patient get better even if it takes 2 tries or if he'd be curious about why the failure happened.
I think the dirty secret about PAE is docs can't be sure they embolized the parts of the prostate that is blocking, and can't be sure if blood supply is not re-routed. They are happy to keep trying to improve their technique while charging a lot of money for it. Somehow PAE seems to work well for a lot of people, but even if it's 80-90% success rate that is not enough. I don't think they are curious because they know if it didn't work they can look at your images they already have and next patient they can hopefully do better knowing yours didn't work.
It appears from all I have read if one has a large medium lobe then the PAE probably will not work. The other problem appears to be that they are not aggressive enough with this procedure to reduce more of the prostate. I am sure there probably is a reason for this including reducing the probability of damaging the bladder, colon or other sturctures. Getting off flomax was great since it had created some other issues I did not like at all. Slowly getting those important functions back after 18 months. I was on Flomax for years with one pill a day and then two pills a day for the last two years before PAE. It appears all procedures have a downside. Some work for some individuals and not others. Hopefully my PAE procedure will keep me off medication for at least 3-5 more years. Then hopefully something new will be available that really works without all the downsides. Good luck to all
I think the PAE results have a lot to do with the size of your prostate before the procedure. I think the optimal reduction is about 25 to 30%.. Some guys have truly massive prostates 150 to 200 plus grams etc...so if you reduce 200 grams to 150 or 140...that still seems like a problem...
But they are onlhy looking at the before images not after. And no examination of any sort.
Almost no chance of know how to do better for the next patient.
I am guessing that they have your images from before and a "plan of attack" Then they have images of the actual procedure so they know where they injected the material - sure if they had images 6 months later it would be better and I know that's what they asked me to do in Australia, but I still think they might have an idea from where they injected the material and if it didn't work - maybe a PAE surgeon will comment some time so we will know.