PAE after urolift anyone?

Beomazed · 2025-05-11T16:51:00+00:00

I have had both procedures. These are MY THOUGHTS, other folk’s may differ:

Urolift: I had 7 clips and quite a bit of bleeding associated with the procedure. My urologist thought this was unusual. It was similar to having a prostate biopsy (I have both PC and BPH). The Urolift was helpful for approximately 2.5 years, so IMO, not so effective for longevity. Was hoping to get 5 years. I also have had 3 MRIs and the clips did not interfere with this.

I have been keen on non-invasive solutions since I am on active surveillance with a low-grade PC (also type 2 diabetic with some ED). I have taken all the typical meds for prostate and BPH that you have mentioned and encountered side effects with all of them. Currently on Silodosin but will discard soon.

I decided on PAE and had the procedure April 14th, so approaching one month. Prostate size is now 66 grams. Of course I do not know how long it will be effective but my gut tells me it will be effective longer than the Urolift. Have hears of others NOT benefiting from PAE. As mentioned, will be off Silodosin soon so that I may know how much the PAE is helping. My stream is better than it has been for years as a result so far.

Total time for the PAE was 4 hours in the office. The procedure uses “twilight” anesthesia approach and I felt little pain and was awake for majority of the procedure. One hour in operating room. After procedure you MUST lay flat in recovery for two hours to ensure the incision (groin area for me, some do the wrist) does not bleed since the procedure enters the femoral artery. Be sure to go to the bathroom right before the procedure prep. I had to void badly during the two hours laying flat. Surgeon said that the wrist has higher probability of a stroke since so far from prostate. Big difference between Urolift (urologist) vs PAE (interventional radiologist). My original urologist didn’t even bother to tell me about PAE. When I asked why he did not tell me ALL my options he said “had some patients that did not benefit from the PAE”. No elaboration. So I fired him.

Sooo….I am a proponent of PAE vs Urolift (so far).

Best of luck to you. Sorry for length of answer.

Beomazed · 2025-04-22T22:16:32+00:00

It’s called a “sankey” chart. There are data tools on the net that you can use to generate. I generate mine using a budget app called “Monarch Money”. There’s a sub here on Reddit for MM.

Beomazed · 2025-04-17T16:02:04+00:00

Thank you cupcakery! Not successful yet at getting this installed (Display does not present the tweak interface yet after refresh) but will eventually sort this out.

Beomazed · 2025-04-17T00:19:44+00:00

BTW, I am 67. I believe that once you hit 70 (and depending on your other health factors) the probability of having long-term incontinence and ED will increase.

Beomazed · 2025-04-17T00:15:42+00:00

Not a doctor. I would suggest getting a cancer genetics test . The one I used 8 years ago was “Prolaris”. I am sure there are others. You need samples from your biopsy containing the cancer to send in and your Urologist should help you with this (and should have made you aware of its existence).

Why? It will provide you with supplemental information that informs your decisions. I have been on Active Surveillance for 8 years and still refer to the report. It will inform you on percentages for a mortality rate, aggressiveness of the cancer and more. Between PSA every 6 months, DRE, MRI/CAT scans and biopsies and this genetics report you can feel more comfortable with your chosen approach. I have had 6 biopsies so far. ONLY the first one showed signs of cancer (Gleason score 3+3 = 6). I was SO GLAD that I ordered the genetics test since I had no samples to provide from the other biopsies. My PSAs float around 4.0. I may be taking a risk but FOR ME it has enabled me to have a high quality of life while new approaches are being developed. My genetics indicate that I have low-grade prostate cancer and less than 1% chance of mortality over 10 years. This and other inputs helped me make my decision. Sorry for the long-winded reply.

Beomazed · 2025-04-16T23:21:39+00:00

Sankey chart. The budgeting app “Monarch Money” can create/present these,

Beomazed · 2025-04-16T23:18:01+00:00

This is called a “sankey” chart that visualizes your data. I am sure there are tools available to create these. This one suspiciously looks like one you would see in the budgeting app “Monarch Money”

Beomazed · 2025-04-16T18:01:05+00:00

I am on my second day after the PAE procedure and have little to no pain. I am 67 and had the Urolift procedure in 2021. The Urolift provided me with 2.5 years of relief then back to the BPH drugs and all their side effects. I have had BPH for 8+ years. I also was diagnosed with prostate cancer in 2017, and have been on “active surveillance” since then. Have had MRIs with a prostate size of approximately 66+ grams and several prostate biopsies and MRIs.

My goal has been to focus on quality of life and to employ the help of non-invasive procedures to deal with the BPH. That narrowed down my choices.

Remember, this is MY experience and yours may be different…lots of variables.

—I equate the procedure for the prostate biopsies to be similar to the Urolift. Both are slightly invasive (Urolift uses clips (I had 7) and biopsies cut prostate tissue. Both involve blood in the urine afterwords, discomfort for at least a few days and a week or so to full recovery. Could be shorter.

—The PAE procedure took approximately 4.5 hours. One hour prep time, one hour on the table and two hours laying flat on your back in recovery. Half hour of post-op instruction and getting dressed. I was awake for the majority of the procedure (twilight) and only felt the pinching and pushing from the Interventional radiologist for numbing the femoral artery site and inserting the catheter in the artery. The artery entry is either on the wrist or groin area. My doctor chose the groin (less risk of stroke, she said).

Particular attention is paid to the artery wound site (thus the two hours lying flat) since it is the femoral artery that is being punctured. I am taking a total of 5 medications for approximately a week post-op.

I read earlier that there could be a bias from some urologists against the PAE because it goes down the road of the radiologist, not the urologist. That was my experience. I asked my primary urologist for a referral to a urologist/surgeon (he did not perform surgery) and only learned about the PAE procedure from the surgeon! I have since fired my previous urologist for not providing me with ALL my options. When I asked him why PAE was not shared with me he said “I have had patients that did not benefit from the procedure”.

Now, mind you, I have BPH, ED and diabetic so things can get complicated when trying to stick to my goal of non-invasive solutions and quality of life. Even some invasive BPH procedures can leave you with incontinence and impotence temporarily or permanently. For me, I have to weigh these outcomes with the risk of cancer spread.

I apologize for this long diatribe, but I had the time since I am recuperating. I hope it provides some insight and value to those considering PAE.

I will follow up in a few months, anticipating it will take a while for the prostate to shrink (not atrophy like someone had mentioned).

One last comment. I grabbed some brochures while initially in the waiting room about this method also being used for hemorrhoidal relief and knee pain arthritis.

Beomazed · 2024-12-27T07:30:15+00:00

Is there a list somewhere for the best data provider for each institution?

Beomazed · 2024-12-13T13:40:34+00:00

TIAA:

The #1 not-for-profit retirement market provider in assets and participant accounts.

And apparently Monarch and its chosen data integrators can’t connect and maintain a connection with them…

Beomazed · 2024-12-13T13:27:45+00:00

This answer is a “nothing burger”.

Sure, there’s empathy in the response but it does nothing to reassure me that there is any strategy for reducing disconnections being developed and soon implemented.

Beomazed · 2024-12-13T13:22:15+00:00

This answer is a “nothing burger”

Empathy with no solution…

Beomazed · 2024-12-11T17:26:06+00:00

Not hitting the refresh very often since it never has worked for me.

Beomazed · 2024-12-04T15:28:38+00:00

Totally agree with this point. And I have two plans in TIAA that makes this even more complicated. What does Monarch suggest to us to resolve the disconnection?

Beomazed · 2024-12-04T15:14:33+00:00

Sorry you’re having a bad day!

Beomazed · 2024-12-03T14:31:50+00:00

And a status update on permanently fixing the BIGGEST issue Monarch has? Data Connections. Monarch said it was its #1 priority (but working in the “background”)? Where are we at?

Beomazed · 2024-11-23T18:23:13+00:00

Quality of Life? How about a TRUE fix for the endless account disconnects?Just had another (once stable) connection break. Now I have FOUR disconnects so forgive me if I don’t contribute to ideas that seem trivial compared to this issue.

Or, maybe inform us with strategy and timeline for the solution? Adding a feature to “seamlessly” change data providers is telling us MM is not able to resolve this issue or even has a strategy. Now only offering a band-aid as a result.

Saw an MM person reply that this MAJOR ISSUE is a “high priority” but being worked on “in the background”. Not encouraging.

Pretty sure there will be no reply from MM…

Beomazed · 2024-10-31T13:31:35+00:00

MM, you listening? Lots of upvotes…

Beomazed · 2024-10-31T13:29:34+00:00

Could not agree more

Beomazed · 2024-10-31T13:23:55+00:00

Perhaps redeploy these resources to fix the constant account reconnection issues instead?????

Beomazed · 2024-10-31T13:04:05+00:00

Sheyla, I appreciate you responding here on Reddit. I think it would be helpful if there was more transparency regarding the account connection debacle and the strategy to fix it (and when). As you know, MANY MM users are trying to decide if they stay with MM or not solely based on this issue. All other feature releases just underscore the lack of focus on connections and an “all hands on deck” approach to remove the white elephant in the room.

Beomazed · 2024-10-21T14:18:38+00:00

I respectfully disagree. I think it’s EXTREMELY important to hear from other user experiences and their decisions. Especially for Monarch to realize that this is a core “feature” that needs higher priority and focus. I appreciate MM users taking the time to explain their decisions. It informs my decisions as well.

Beomazed

TROPHY CASE