PAE, having second thoughts
Apologies for the rambling...my BPH symptoms are progressing after years of medication. I have a PAE consult coming up soon, (and am having second thoughts) and I want to understand whether PAE is a good option for me versus HoLEP, TURP, or another procedure. I wanted to explore PAE to minimize my risks for urinary incontinence, and sexual disfunction. I also want to be off the medications. Before I committed to a surgery, I asked my smaller-town urologist about PAE and he made the referral to the center I'm going to.
Here’s some questions I need answered maybe from your experiences, and by the Interventional Radiologist. This is sort of my questions outline for him, or my script so I don't get flustered in the 30 minutes I'll have with him for this first appointment. Please let me know if I’m missing something...
I am 68 years old in good health. Based on my anatomy, bladder function, and retention risk, how likely am I to get meaningful relief? My prostate volume is 136.4 with large (don’t have exact size) intravesical profusion. What size reduction might I anticipate? Assuming 30%, wouldn’t my new prostate size technically be considered to still have BPH? (and the issues that go along with that) What is the chance I can reduce or stop my BPH medications afterward? (Long-term Alfuluzuzin and Finasteride)
Will this be done with moderate sedation or general anesthesia? How long is the procedure? Do you routinely treat both prostate arteries in one session when possible? Do you use radial or femoral access, and why for me? What is the blocking material, beads or glue?
Post surgery questions: I should also note regardless of my treatment options, all will require about 100 miles of travel each way. Can I safely ride in a car for two hours after a PAE?
How long does it usually take to notice improvement? What are the main risks, and what is the backup plan if it doesn't work?
Should I go directly to surgery? What else do I need to know?