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Benign prostatic hyperplasia (BPH) Surgery Options

Men's Health | Last Active: Nov 4 11:00am | Replies (245)
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@bill5letsfixthis

Hi Bruce,

This is what I found out about PAE. If you have a large median lateral lobe there is a high rate of PAE failure. I don't know how high but that is definitely a consideration. Of course the pre procedure exams are important especially the arteriogram to see the vascular system. I have looked into a number of interventional radiologists and found that there are some around the country that claim to have high success rates, some as high as 98%, but I think the average is much lower at 76-80%. I have not gone any further as I mentioned I am doing quite well with my own combination of botanicals and tamsulosin. Good luck, let us know your progress and what you find out.

Best,
Bill

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Replies to "Hi Bruce, This is what I found out about PAE. If you have a large median..."
bruce1sparkle | @bruce1sparkle | Jul 11, 2021

Thanks for that reply about PAE, Bill.
July 7 I had an initial visit with SC at Mayo Rochester to discuss treatments for my BPH. I noticed he both followed the AUA guidelines for selecting treatment but also went beyond them, based on Mayo experience. The guidelines group treatments by prostate size. Given my size (110 cc as of 2017) I should not be a candidate for Rezum. But SC was enthusiastic about Rezum and said I could choose it if I wanted to, based on Mayo experience. His enthusiasm did not go beyond what is said about it elsewhere. The other surgical treatment he offered, given my prostate size, was HoLEP. His description of it followed what is said of it elsewhere.

I asked him to quantify sexual side effects for medical treatments and he offered numbers, which were not so bad. But, what I've seen about them and my own experience suggests the reality is not good. So I am presently evaluating which surgical treatment, Rezum or HoLEP to seek.

I'll say he also counseled that I could drop two of the four daily self-catherizations I'm doing, which gives me greater mobility during the day. He confirmed that increasing tamsulosin from one to two/day is appropriate. My most disturbing symptom of BPH was several episodes of acute urinary retention. I have not had any more acute retentions since I've begun self-catherizations and increasing tamsulosin from one to two/daily.

If I do choose Rezum, which I would do in early November, after a European trip Sept-Oct, I should add Dutasteride now but could drop it (and tamsulosin) after Rezum.

There are a number of talks at Grand Rounds comparing Rezum, HoLEP and other treatments.

I'd be grateful for comments of individuals who have undergone Rezum or HoLEP.

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bruce1sparkle | @bruce1sparkle | Jul 11, 2021

Bill,

I forget to say in my previous reply that SC at Mayo Rochester said he had no confidence in PAE, that Mayo does not do it. So I'm no longer considering it. Although I have seen glowing comments on it from the Yale Medical School and docs at UCSan Francisco and UCLA. There is disgreement about almost everything.

Bruce

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