Better Stream: Prostate Artery Embolization for the Treatment of BPH
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- Опубликовано: 6 июл 2024
- In this episode, we discuss prostate artery embolization for the treatment of urinary symptoms for men with an enlarged prostate, otherwise known as BPH. In recent episodes, we've discussed several procedures used to treat BPH. Now, what all these procedures have in common is that they all involve actually carving away part of the prostate that is obstructing the urinary stream. But what if I told you that a procedure exists to treat BPH that does not actually involve touching the prostate at all? Rather, this procedure called prostate artery embolization manipulates the blood vessels of the prostate. But how does this procedure actually improve urinary flow? Is it safe? What is involved and what is the recovery like? How effective is prostate artery embolization in the short term and for the long haul? And why should men consider the procedure as opposed to other procedures that actually involve cutting or shaving away the prostate. In order to answer these questions and many more, we're lucky to be joined by Dr. Ari Isaacson. Dr. Isaacson is a board certified and licensed interventional radiologist who specializes in prostate artery embolization. After graduating medical school at USC, Dr. Isaacson completed his radiology and interventional radiology training at the University of North Carolina, where he stayed on as an Assistant and then Associate Professor of Radiology and was appointed Chief of the Division of vascular and interventional radiology. He currently practices at the prostate Centers of America where he also serves as the chair of quality and research. Dr. Isaacson has served as a principal investigator for multiple academic studies of prostate artery embolization and has recently published a textbook on the subject.
#BPH #PAE #prostate #embolization
Update- Now 70 days in after my PAE procedure. Went for check up with my urologist today and PSA went from 21.35 to 5.36 due to prostate shrikage. Sleeping through the night and not having to get up to go to the bathroom. No sudden urges to go to the bathroom. So happy and pleased that I decided to have this procedure. I would highly recommend PAE and Dr.Ari Issacson to anyone who is suffering with BPH symptoms and are seeking the best way to achieve relief and take back your active lifestyle.
Great another cured patient like me I am happy with PAE from Dr Evans unfortunately he is moving and CIC is going so probabl;y will try and stay in contact with him on moving to Bens OR
I'm having PAE done next week and I have done a pretty fair amount of research into different procedures. The pre-procedure CT scan showed my prostate was 120cc. One of my major concerns was maintaining sexual function and initially I was leaning towards Aquablation. Then I read about PAE. After reading numerous studies and speaking with my Urologist I have decided on PAE. This was, by far, the most informative discussion of this procedure that I have heard and I thank you for taking the time to present this and know that it will help so many men suffering from BPH to make an informed decision on the direction they would like to take in their treatment. Well done!!
Thanks so much! Glad it was useful.
How did it go?
Yes, how did it go?
Did it work?
I have a consultation coming up next week with a IR for this procedure. All this information is very beneficial.
Glad it was helpful!
Go for it
I am scheduled to have Dr. Isaacson do my PAE this July. Driving up to have it done from Florida.
Good luck with your procedure. I hope you have the success that I have enjoyed so far.
Good luck. We hope everything goes well. Please let us know
This is so good, so thorough. Really fine job! Thank you. I require no more searching about this subject!
Glad it was helpful!
Information is very helpful and I'm really looking for a doctor or to be able to discuss to PA he procedure if you can help me out with that I would greatly appreciate that
I had the PAE procedure done on 4-16-24 by Dr. Isaacson. Process was very easy to go through. No pain other than the pinch you feel when they give you the numbing shot. Recovery was a little different for me. I felt fatigue for about 10 days and not able to sleep well at night. I attribute this to the 5 meds i was given to take for the first week. Now on day 15 and things are much better. Sleeping good and getting up 1 time per night to go to the bathroom. Flow is much better and looking forward to continued improvement. I would highly recommend this procedure and Dr. Isaacson to anyone who is searching for relief of BPH. I did a lot of research before I proceeded with PAE and now I am so glad I went for it. My prostate was 160 gm and I am looking forward to seeing how much it will continue to shrink in the future. I am a healthy 71 year old and have had a high PSA reading for years which has been attributed to BPH.
Thanks for sharing your experience!
I had PAE procedure done and the information shared here matches what I went through yesterday. Thank you for sharing all these scenarios. My Aquablation surgery will follow next week.
How did aquablasion do? Can you still have sex?
Pae how much time did you give it to work. I had to wait 7 weeks my prostate went through a biopsy right before I had PAE done... one year later good and everything is working well
What an excellent informative explanation! Thank you. BTW, what are these beads made of?
Do they dissolve? And what about using glue instead of the beads?
Best PAE interview on RUclips! Ari mentioned in the interview that he would be glad to recommend somebody who does this in my area. My area is Sioux City, IA, Sioux Falls, SD, or Omaha, Ne. Is it possible for Ari to provide a recommendation?
Thank you!
Is there a place to get a Pae in New Mexico, or neighboring state? my VA just want to do TURP.and as of now they won't give me a referral. Great and very informative.
Dr. Isaacson do you have a recommendation for the Boise Idaho Area? If not is it possible for me to come and see you for the procedure?
Dr Isaacson, can you recommend a PAE physician in the Seattle\Bellevue region?
I need a place in NYC REGION?
5 to 7 years is not great. I’m 55 and the thought of doing this every 5 years and who knows if I will have insurance in 5 years. I have been with a supra pubic tube for over a year now because I couldn’t decide on a minimum invasive procedure. I thought this would be perfect but not to encouraged since things don’t just abruptly stop working if they say 5 years you might start having the declining gradual effect’s in 4 years who knows. Seems like I may have to go this route to avoid others.
What size of beads and how much does the Dr. usually use?
Can you also target the median lobe in addition to the right and left lobe ?
We asked Dr Isaacson your question and here was his response:
"The blood supply to the median lobe comes from one of the two lateral lobe arteries. So the median lobe is treated during bilateral embolization. "
Hope the helps!
Better Man Clinics
has anyone gotten any answers from your questions yet?
Thank you for a very informative video. Greatly appreciated.
Thank you!
Question: would the beads stay in place at all times or after time they migrate some place else. ? Thanks
They tend to say in place. Ari also uses a capping fluid.
You mention targeting both sides of the prostate, what about patients that have a median lobe in addition to the two sides, can you target all three lobes ?
We asked Dr Isaacson your question and here was his response:
"The blood supply to the median lobe comes from one of the two lateral lobe arteries. So the median lobe is treated during bilateral embolization. "
Hope the helps!
Better Man Clinics
Can PAE successfully target large median lobes? History: UroLift 2 years ago (intact and working) . No improvement with UroLift. New Doc. discovered high bladder neck and large median lobe. prostate size 55g. Lobe is where all my issues are stemming from. Want to preserve current Sexual level. On daily coumadin ( heart valve). I've not had much luck finding out if a median lobe can be treated successfully with PAE. Closest IR who does PAE is Jacksonville FL, about 5 hours one way.
Here was the response to the question about median lobes from Dr Isaacson:
"The blood supply to the median lobe comes from one of the two lateral lobe arteries. So the median lobe is treated during bilateral embolization. "
Hope that helps!
Where in the UK can you get this procedure
I'm sure that your closest medical center's urology department can tell you.
Have, stage 4 prostrate cancer, but also bleeding from the penis. Which I believe is the prostrate bleeding. Will a PAE. Stop the bleeding?
I had PAE done for my large prostate 120g in Reno NV at CIC Jan 17 23 and my insurance did not cover it I am appealing their decision I paid a little over 12 k to the Dr Evans at CIC. By Mar 14 23 it worked and I can pee now like normal again. I had a cath for over 3 months--not fun....PAE works no matter what the lying Urologists might tell you and its not invasive and not dangerous. My urologist told me it would not work for a large prostate and he was totally wrong---Most net sites say that it does work with a large prostate.and I am proof it does work
I am doing my PAE ON 8/11, still they did not tell me if insurance will cover. I have to check with them before the procedure. Hope it works for me. I also have a 120g large prostate like you. Is there any symptoms you suffered after the procedure? Thanks
not really any bad symptoms after but I was with a cath the whole time...a little blood not really anything painful---the cath was the worst part and uti it caused, I have prominence medicare dis-advantage which did not cover me and I am still in appeal after that I am going to AARP United does cover it so does senior demensions The only reason PAE is maybe somewhat cheaper is there is no hospital stay, no putting you asleep for rotor rooter etc I paid 12028 @@rodofgod7394
How can I get in touch with you via email or WhatsApp to discuss this procedure with you? I have just been to my urologist and I am not that fond on the procedures he offered me.
@@rodofgod7394 did your insurance cover it
@@rodofgod7394 no bad symptoms just some blood a few days from penis. The catheter gave me ecoli infection which the right antibiotic got rid of... it's been a year now and procedure worked prostate is under control
Is a Foley catheter used during the procedure?
Here is an expert from the transcript:
Better Man Clinics
Do men need to maintain a catheter in their bladder for a while after prostate artery embolization (PAE) as is often required for other prostate surgeries?
Ari Isaacson, MD
The vast majority of the patients do not require a catheter after the procedure. There is one small group for which I do place a catheter after the procedure. That group is composed of people who have gone into acute urinary retention (they could not urinate) in the past and have needed catheters to urinate. I’m talking about patients whose urinary stream is so slow to come out that sometimes it doesn’t come out at all and gets stuck and they have to go into the emergency room and get a catheter placed. If a patient has a history of that happening, then I will give them two choices. One is I can place a catheter ahead of time for their procedure, and then they’ll have it taken out a week or two afterward. Or, if they’re willing to, they can self-catheterize after the procedure. Then I feel secure knowing that they have a way to urinate. What I don’t want to happen is for the patient to go home and have an emergency where they can’t urinate and then have to go to the emergency room. That’s what we try to avoid.
You can find the full transcript here:
www.bettermanclinics.com/better-stream-prostate-artery-embolization-for-the-treatment-of-bph/
Goo day Doctor's. Do you have any referrals in Las Vegas, [Dr. Isaacson]?
CIC in Reno Nv does this and is very good Dr Brian
If only my brain was larger than my prostrate.
nobody ever says what it costs
Could I have dr isaacson’s emIl address?
Could you please tell me Dr. Isaacson's email address?
Could I have dr.Isaacson"e- mail address, please ?Thank you.
All these normal and alternative treatments seem to SUCK! They might help for some, might really help for some, might help just a little for some, might not help at all for others, and might cause tons of side effects for most people!
Why can't these geniuses just get to our prostate DIRECTLY, not thru the uretha, and inject the damn prostate directly with something to shrink it.
There should be (and will be eventually) a way easier, safer, and more effective way to fix the damn prostate without having to have a damn catheter and having other issues afterwards. Also, the TURP and Green Light laser one have too many side issues.
I know 4 guys at my golf course who have had these things done, and amazingly all 4 tell me it helped a lot and they are telling me to get it! I am scared and not convinced and I do not want those side effects!
Cut down on SUGAR ASAP is one tip I have taken and am trying......
I have not had any improvement at all
could you give more detail?
@@artsline604 yes I cannot urinate most of the time but when I change my catheter sometimes I can urinate but I have to go often.... once every eight minutes. Which means I don’t urinate completely. So I have to use a catheter. It is already eight months that I am using a catheter!
@@MrJOHNMICHAELVEGA thanks for getting back to me, sorry for your problems. another question please, Are you on a Foli? full time?, I intermittent cath when needed. And when did you have the PAE and what do the drs say about this? thank you so much for sharing.
@@artsline604 April 7,2022 was the Prostate Artery Embolization. It didn’t work, so I used a catheter all the time. The radiologist didn’t have much to say after the 3 month waiting period. The radiologist gave me my paperwork and said good luck! The urologist just wants to cut which doesn’t make any sense since I think it’s the detrusor muscle and not the prostate that is causing the initial problem. Sometimes I can urinate but not enough to empty.
My question, why are urologists so against this procedure?
Could you please tell me Dr. Isaacson's email address?
Hi Vincent, did you get the email address?
Could you please refer a pro in the New York City/ Long Island vicinity?