Prostate Artery Embolization for BPH. Anyone have it done?

Posted by dmp08 @dmp08, Apr 16, 2023

PAE can be done through wrist or femoral artiry. Usually catheter is not needed. Catheter is for as a marker by some radialogists. I am wondering if it can be done without any sedation? Thanks.

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I am aware of it. I understand it is used to treat prostate cancer and is now being used for BPH. It has been around a while. My big concern is risk of injecting in the wrong artery.. Have not seen statistics and long term studies . Sounds like a excellent way to shrink the prostate. Done under light sedation.

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Good place for me to jump in on this subject. I’ve been so busy as a tax accountant that I was anxious to pass this along. I had the PAE on 2/27. I can truly say my results are simply beyond expectations, nothing short of amazing.

The first week of recovery was a living hell having about 50 painful trips to the bathroom a day. I could not void more that an ounce or two at a time. Sleeping was a disaster. All your original symptoms are intensified due to after procedure inflammation. Then on the 7th day I voided about 6 ounces, yes I was measuring. Each succeeding day was a little better. I had gained 6 pounds from I guess water. Then after about 12 days I voided nearly 2 liters overnight and lost 3 pounds. Everyday got better and better as pain disappeared and after about a month I am voiding like a champ. I highly recommend this procedure but do your research. Find a doctor who has done a lot of them. I think the numbers on hitting the wrong artery are few as it is a rare occurrence. The prostate is not touched so there are no side effects other than post procedure discomfort, it’s called PES, Post Embolization Syndrome. This procedure is about 25 years old, used for BPH and research is being done on effectiveness for prostate cancer. I also read that it may become the new gold standard.

Do your research, NIH has some studies on it, YouTube has plenty of videos. Just remember you should stay home for about 10-14 days unless you live in a motor home.

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Thank you! Excellent and valuable information. Did they do it through wrist? Can you opt out of catheter? (U of M) uses catheter for placement. How large was your prostate? If I may, who was the practitioner? Can you be clothed from waist down? What tests or procedures were needed before hand? I have had issues with post operative awareness.. I prefer to be fully conscious. Could you handle it without sedation? Again... thank you!

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@bill5letsfixthis

Good place for me to jump in on this subject. I’ve been so busy as a tax accountant that I was anxious to pass this along. I had the PAE on 2/27. I can truly say my results are simply beyond expectations, nothing short of amazing.

The first week of recovery was a living hell having about 50 painful trips to the bathroom a day. I could not void more that an ounce or two at a time. Sleeping was a disaster. All your original symptoms are intensified due to after procedure inflammation. Then on the 7th day I voided about 6 ounces, yes I was measuring. Each succeeding day was a little better. I had gained 6 pounds from I guess water. Then after about 12 days I voided nearly 2 liters overnight and lost 3 pounds. Everyday got better and better as pain disappeared and after about a month I am voiding like a champ. I highly recommend this procedure but do your research. Find a doctor who has done a lot of them. I think the numbers on hitting the wrong artery are few as it is a rare occurrence. The prostate is not touched so there are no side effects other than post procedure discomfort, it’s called PES, Post Embolization Syndrome. This procedure is about 25 years old, used for BPH and research is being done on effectiveness for prostate cancer. I also read that it may become the new gold standard.

Do your research, NIH has some studies on it, YouTube has plenty of videos. Just remember you should stay home for about 10-14 days unless you live in a motor home.

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Thank you for sharing. Sounds like you had a very rough few weeks but turned out well. I am in the camp of being concerned with missing the artery and causing permanent damage.

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You’re both very welcome @dmp08 and @pablo81

To answer your questions

1. Access was a small incision on abdomen above crease on top of the leg. Since they go into the femoral artery they use a device called an AngiSeal which guides in the spaghetti like instrument. After doing one side he went over to the other side using same incision and upon completion the AngiSeal seals the artery off and dissolves after 3 months. I now have no scar, I’m ready for the beach.

2. My prostate was about 200cc and the procedure results are best with larger prostates.

3. I wore a surgical gown as they shave the hair on one side of the abdomen.

4. They do some blood tests, mostly like an annual without the lipid profile.

5. I was fully conscious, like twilight, didn’t feel a thing and speaking with the team of 5 as they informed me of progress, I never felt so relaxed like I was in meditation which I have no idea how to do.

6. I also was concerned about hitting the wrong artery and causing another problem but he and the resident assisting both said it is rare.

7. Dr Ayyagari at The Lahey Clinic. He has a YouTube Q and A where doctors are asking him the questions. Try and find it. He is personable and makes sure all you concerns are addressed in the consultation, it was not rushed at all. After one month follow up I saw saw him and when he asked how I was doing, all I could say was “I love you man.” That should say it all.

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@bill5letsfixthis

You’re both very welcome @dmp08 and @pablo81

To answer your questions

1. Access was a small incision on abdomen above crease on top of the leg. Since they go into the femoral artery they use a device called an AngiSeal which guides in the spaghetti like instrument. After doing one side he went over to the other side using same incision and upon completion the AngiSeal seals the artery off and dissolves after 3 months. I now have no scar, I’m ready for the beach.

2. My prostate was about 200cc and the procedure results are best with larger prostates.

3. I wore a surgical gown as they shave the hair on one side of the abdomen.

4. They do some blood tests, mostly like an annual without the lipid profile.

5. I was fully conscious, like twilight, didn’t feel a thing and speaking with the team of 5 as they informed me of progress, I never felt so relaxed like I was in meditation which I have no idea how to do.

6. I also was concerned about hitting the wrong artery and causing another problem but he and the resident assisting both said it is rare.

7. Dr Ayyagari at The Lahey Clinic. He has a YouTube Q and A where doctors are asking him the questions. Try and find it. He is personable and makes sure all you concerns are addressed in the consultation, it was not rushed at all. After one month follow up I saw saw him and when he asked how I was doing, all I could say was “I love you man.” That should say it all.

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Glad you are ok now. I have a concern over organ ruptures/ damage hauling around so much pee. About 2 liters is about 65 ounces!

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@anonmike

Glad you are ok now. I have a concern over organ ruptures/ damage hauling around so much pee. About 2 liters is about 65 ounces!

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Thanks @anonmike .

Yes, two liters was a surprise, but it was overnight about 8 hours when my urethra finally opened up and the fact that I was retaining so much water from I guess inflammation. My weight had gone up 6 pounds that I realized when I was on two extra holes of my watch strap. Then a couple of days later after that huge voiding night I lost about 3 pounds.

Before the procedure I would often have a hard abdomen even after voiding. That was the main reason I knew it was time to do something. My uncle who did nothing had infected ureters that they couldn’t fix for years. He eventually died of a kidney issue. That’s why not emptying your bladder can be dangerous if too much is left in there. Now I empty well and no hard abdomen.

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I'm had to go to emergency end of feb due to build up. Lack of pee, big discomfort and big weight gain(another good reason for me to weigh in regularly) were the messages of the need for speed. I got rid of 2 liters at emergency, used Foley for about a month and now on self-cath and finasteride to reduce size of prostate. Now is much better than later. I'm curious if you have an estimate of what amount of pee you are generally carrying around in your bladder that is "safe"? Glad you are in your normal zone now.

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@anonmike I’m not sure what a safe amount left in bladder as residual but last time it was 10 ounces and Uro was very concerned. I think I remember that a man’s bladder can hold 23 ounces, which of course is a lot. You like me Mike, must be coming to the realization that it is time to do something. Finasteride is a nasty drug to be on and needing a catheter is another confirmation to take action. All I can say is PAE was my best option and I would recommend it.

There is something I didn’t mention. I am not losing any hair in the shower anymore. Maybe prostate not making anymore DHT has something to do with it. I keep checking my bald spot.

Good luck Mike, keep us informed, we’re here for you.

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