Where can I get a PAE, and are they covered?

Men's health
1

Hi everyone, I'm 64 years old, from the Pittsburgh area, and I hear nothing but great things about the procedure called "PAE," though for some it apparently doesn't work.  I'll take my chances. I'm interested in having it done, though I don't even know if the procedure is still in clinical trials or not.  I'm making an assumption that insurance would NOT cover it.  If they don't, any suggestions you can give me on where to have it done, and the out-of-pocket cost(s) would be very much appreciated, and thanks in advance.

2

Dr. Ari Isaacson at UNC Healthcare is excellent and has done the second most in the country.  You might want to call him - he is versy responsive and willing to answer all questions.

3

Dr Bagla is now at the Vascular Institute in VA. If you are paying out of pocket you should definitely check with him- and he's very experienced and compassionate. 

4

Hi Alan,

I have heard good things about PAE, mostly on threads here on Patient.  I have no experience with the procedure.  I had the Urolift treatment done, after refusing my urologist's insistence that TURP was the "golden standard."  You may want to Google the Urolift treatment.  I'm in Bethlehem, at the other end of the Commonwealth.  Because my situation was a little touchy (small but swollen prostate, ca. 39 gm, no central lobe but totally shut down peeing system), I found the most experienced surgeon in the country, out in Salt Lake City.  Dr. Steve Ganges.  Easy to talk to, and you would have another option, if the PAE won't work for you.  

Also: Urolift IS covered by SSI, and by most  insurance.

Whatever you do, please do not rpt. NOT go for TURP or even laser surgery, before considering PAE and Urolift.  

5

I used Dr. Sandeep Bagla when he was still at Inova Hospital in Alexandria, Virginia but as you said he has now moved on to a different medical center.  I had the "PAE" in the summer of 2014.  It "DID NOT WORK FOR ME".  Since then I have had a "UROLIFT" in the summer of 2015 and it also did not work for me.  Iam now having my bladder tested as the Doctor thinks thats where the problem might be.  I do have some serious advice for you though.  After the Procedure before you even leave the facility you need to drink alot of water and I do mean alot of water and then just wait there until you pee freely.   Good Luck to You.

6

I strongly considered PAE but decided to go with UroLift 2 weeks ago. I was looking for any way to get off of FloMax which was interfering with my ability to exercise intensely. So far UroLift appears to have been the right choice for me. I am now off Flomax at 2 weeks post procedure and am peeing much better than before while on Flomax. I still have incomplete bladder evacuation at times but other times I pee perfectly. So bottom line I am making real progress and am happy with my Urolift implant. Day 2 and 3 post procedure were tough as I almost completely stopped peeing and was running to pee every 15 minutes with only drops and dribbles, but enough to measure out 200 mL/ hour. That resolved by the end of the 3rd day and been peeing relatively well since then.

 

7

Appreciate that advice, Chuck.

8

Thanks for taking the time to answer, Kc110.

9

Thanks, arlington.  I just may look into Dr. Isaacson.

10

Your symptoms, cartoonman, are practically identical to mine.  I, too, simply won't have a TURP.  And to my other brothers-in-suffering, you may want to Google the procedure, and include Youtube as a filter.  That way, you can watch how the procedure is performed.   That said, I do believe it's a last-ditch alternative for guys in trouble.  It at least lets them pee again, but not destroying the nerve that governs sexual functioning is a real trick for a lot of urologists.  You gave me a few things to think about, cartoonman, and I truly appreciate the advice.  Please keep me posted as I am completely in the dark on these procedures.

11

Thanks, bill69734.  Two of your comments resonated with me.  (1) "FloMax which was interfering with my ability to exercise intensely ... "  I've read the same (paraphrased) version of your comment regarding exercising from others who have posted on here, and have had the procedure. (2) "Day 2 and 3 post procedure were tough as I almost completely stopped peeing ..."  Once again, others have echoed the same sentiments.  But!  The important thing is that it's WORKING for you.  You've definitely given me something to think about, and I'm grateful.

12

Hi, Alan,

I just checked into having a PAE done with RIA Endovascular in Denver, CO. They quoted a cash price of $13,000. I'm checking to see if my insurance company, BCBS of Idaho, will cover it, and it looks like they may not. Hope to learn more about that tomorrow. I've heard there are radiologists in Salt Lake City, UT and Chicago, IL doing PAEs now. But you probably have more options along the East Coast.

Stebrunner

13

Stebrunner, $14K sounds highly inflated. I looked into PAE at Duke and also  at a clinic in Tampa and the price was free if you were willing to have follow up Urodynamics and cystoscope. If you did not  want to be in research, you could pay for PAE at a cost of $4K to $8K.  Much better than what you were quoted.

14

Thanks very much, stebrunner.  Appreciate the information.

15

Good to know, bill69723.  I suspect that over time, as the procedure becomes more and more accepted, the availability will also go up accordingly.  I'll keep Duke in mind. Thanks again.