PAE followed by Aquablation - Part 1
I posted before and wanted to give this and other communities an update. You all have been so kind and helpful and encouraging. I thank you profusely.
For the record, mid-50s male with BPH, near 130cc prostate, acute urinary retention got me down this path. I’ve had a Foley cath for over 2 weeks.
After failing a void test and having a new Foley put on about a week ago, I discussed options with my Urologist. He recommended Aquablation, but with a PAE 3 -4 days prior for bleeding control. i explored many options, did a lot of reading, and got comfortable with his treatment plan. A number of other places are using this combo therapy for large prostates. My doc was willing to get me on the fast track, so this week is the week.
I had the PAE done this morning. Honestly, it was pain free and easy. I’ll try to capture the process, because, for me anyway, knowing what to expect helps immensely.
Got to hospital at 8:30 am. Could not eat or drink after midnight the night prior. You have to stop blood thinners (I’m not on any, but doc will tell you this) and I stopped taking my multivitamin in that some ingredients can have a thinning effect.
Taken back to pre-op. The main OR nurse talked to me and got information. Another nurse added an IV and took some blood for a pre-surgery blood test. All looked normal except for potassium which was a little high. She briefed Interventional radiologist and he was not concerned. Then waited about 45 mins for OR to open up.
Taken to the OR (really a cath lab). Scoot over to a long table where the procedure will be done. They use a C-arm CT for imaging, so you aren’t in a Tube like for an MRI or the like. Lots of nurses all of whom were introduced. Lots of prep—shaving of insert sight, a sterile field onset up (so lots of drapes and a surgical blanket, cleaning of insert site, etc.). There is a large screen and a smaller screen the doc uses for navigation. I could not really see it, though I wanted to. They asked for what music I’d like to hear, which was nice.
Doc comes in, music off, everyone verbally agrees on what procedure they are doing. They confirmed the same with me earlier. Then they give me some Versed and a small amount of Fentanyl through the IV. You start to feel like you’re drowsy and they start. To be honest I couldn’t even tell they started. Didn’t really feel the doc numb the area with lidocaine, didn’t know he did the puncture…it all just happened.
I noticed myself snore a couple times.l, so I was in and out for the first prostate artery. In the middle of the second one I became more lucid. No pain, but I could pay attention to what they were saying. The nurse gave me a little more drugs to relax me for the rest of the procedure. At a couple times they had me cross my arms over my chest. I was able to follow instructions with a little assistance given wires, etc. I did feel a little warmth when contrast dye was used. Nothing awful.
Then at the end, I could feel a little form pressure at the entry site as the doc used some closure device. No pain. Just like someone pressing on your thigh a bit. Soon after I was talking with the nurses. They have you stay flat incl neck and head) and use a board to move you to the stretcher. This is to protect the closure at the puncture site.
Then had to wait maybe 1 3/4 hrs in recovery flat on my back. Nurses for me some snacks and water, watches a little TV, got post op instructions and now I’m home. Need to stay horizontal for a day. Can’t shower for 24 hrs. Tylenol if there is pain (if there is any it’s like a “1” on a scale of 1/10).
That’s it. If you’re a good candidate and PAE works for you, or if your situation requires a PAE before Aquablation, I would not hesitate.
Stay tuned for Part 2 with the Aquablation later this week.