Having PAE next week, what can I expect the next day?

Yeah I remember the recovery nurse telling me it's going to get worse before it gets better. She was right. I had a PAE/Aquablation combo procedure (PAE followed 5 days later by aquablation). The discomfort from the PAE was worse than the Aquablation due to the increased inflammation. My BPH got much much worse, in fact thought I was going to have to go get catheterization as I was barely able to urinate at all by day 3. The Aquablation was actually a huge relief. I would say neither procedure was particularly painful, only that the PAE was the worst of the two. I am surprised you're having PAE with a prostate that size and a large median lobe. I had nearly identical prostate size and large median lobe and multiple Uros told me PAE alone would probably not work for me and if it did the results would not be long lasting. Good luck.

At 67 I had a PAE done. I requested no anesthesia because I wanted to watch what was going on via the screen.
The only discomfort was when they use the dye to identify the right pathway, it is a very warm sensation. Feels like you are peeing on yourself. My wife drove me the 2 hours home, and although I could have, it was just much easier relaxing, as Houston traffic is a pain even without a PAE! Nothing afterwards, just a little lump where they made the insertion. That lump will disappear in a few months, it's the artery bandage, if your IR goes through the femoral artery. I got no relief from this, or very little. I still had to take 2 tamsulosin just to pee 6 times a night. A few months ago I got an aquablation and still peeing a 10 foot stream. Make sure the IR does BOTH sides. Good luck.

Thanks guys. Your replies have helped.

The bad outcome possibilities have put the choice of HoLEP or Aquablation into second place. After speaking with the more invasive procedure doctors I learned that they will remove the bladder neck, sphincter and part of the floor. That is what scared me the most.

My neighbor had a 300+ cc prostate and told me about PAE initially. He had a rough 5 or 6 days until they gave him a second drug to curb the bladder spasms. The first wasn’t working so a second was added while keeping on the first. This has helped with my decision.

@oldfiddler your description of what they would remove doesn't sound familiar to me and I had almost identical size and median lobe. The good news is if you don't get relief from PAE and decide to opt for aquablation the PAE will greatly reduce post op bleeding meaning less catheter time and lower chance of any complications (this is why my Uro Practice does the combo procedure for larger prostates). Also the worst that can happen is it doesn't work and you have to opt for one of the other procedures though don't be surprised if the inflammation makes it even harder to urinate that first week so be alert for that. Doesn't matter what procedure you get they all have a shelf life, my doc said I might get 10-15 years with the aquablation but that the prostate will start to grow back just a little more slowly since I had the PAE too. Good luck!

@fireman123
Did your insurance cover it?

Just had a HOLEP on 19 June. It's a little over a week ago. No pain, only the sharp stinging sensation while urinating immediately post Holep. The stinging sensation became just a dull one by day 5. Stinging senation is due to the instrument used in such proceducedure being "threaded" through the urethra (hence there are no cuts or incisions). Catheter was out 40 hours post Holep - standard protocol.

There have been some OCCASIONAL loss of bladder control but it's all expected as part of recovery process. Pink urine became totally clear by 40th hour post Holep. Cleared to resume blodd thinners, 4 days earlier than originally required 10 days.

Bowel movement and voiding are working perfectly fine without any drama. Days 5/6 are the "worst" because inflammation of the "enucleated" srface area inside of the prostate, is at peak inflammation. This means it can occasionally BLOCK voiding. When that happens, don't force it because the bladder isn't full - just the bladder being over sensitive from the raw wounds of Holep. So Holep is a highly recommended non intrusive procedure for BPH.

@slopez2026 Yes it did. 100%. but i am on medicare with a plan g supplement. i got that clear up front.

I had the PAE procedure this morning June 30. Washington driven the three hours home with a stop at the pharmacy for antibiotics, acetaminophen, ibuprofen, and something for bladder spasms.

Sitting in the car for that long made me feel some ache in my rectal/prostate area. The only other pain is a slight stinging near the far end of my urethra. I’ve had stinging upon urination off and on for a few years, so this is nothing new. This first seven hours is tolerable. I’m glad I took the initiative and traveled home.

I just now thought that I could have brought a donut pillow for the ride home. Hindsight. Also, could help someone in the future if they read this.

@oldfiddler
Can you give us the name of the IR provider?

I went to UCSF Radiology and saw Dr. Kohlbrenner. The entire staff treated me very well. The procedure included the micro-beads which are held in place with something like superglue.