I know that a lot of you will be interested to read this.

 

The National Institute for Health and Care Excellence (NICE) in the UK announced on 25 April that PAE (Prostatic Artery Embolisation), a safe and effective non-surgical treatment, may now be offered on the NHS. Read the announcement here:

https://www.onmedica.com/newsarticle.aspx?id=03120310-1d6e-447a-a60a-d6fd9cbc37b8

 

This significant endorsement of a relatively new procedure (first was done in 2000 and has been performed regularly in the UK since 2009) follows the results of the first multicenter prospective registry, UK-ROPE, which was initiated in 2014 and completed its recruitment target by January 2016. One-year follow-up data were available by the close of the study at the end of January 2017.

 

A total of 305 patients (PAE, 216; TURP, 89) were recruited from 17 centers and followed out to 12 months post-procedure. The results showed a convincing success.

The benefits of PAE: the procedure is safe, good clinical response, none of the side effects of TURP, no general anaesthetic, no sexual dysfunction, big reduction in prostate mass, and a reduction in androgen receptors post necrosis, reducing the conversion of testosterone to DTH-trophic in the aetiology of BPH.

 

Overall success rate from this study in the UK was about 70% and the success rate in India is reported (by the hospitals offering the treatment) at 98%.

This is good news if you suffer from BPH and do not want to be subjected to barbaric roto-rooter type surgery, and it is particularly welcome news to those with over 80cc super-sized glands who cannot opt for TURP anyway and are faced with the even grimmer prospect of open prostatectomy.

PAE is not available yet in Thailand as far as I can tell. PAE is undertaken by specialized radiologists, not by urologists. Expect resistance from urologists (here and elsewhere) who make a tidy income out of biopsies and surgical procedures who will lose all that business to PAE if it is introduced. Expect to hear them talk about ‘gold standard procedures’ using equipment to push inside your urethra that was designed over 50 years ago, against ‘unproven new methods’.

 

Apparently PAE undertaken in the UK costs the NHS 2,500 GDP. Meanwhile in India, where many specialist centres already offer the treatment, the cost is about 2,500 USD and requires just 24 hours hospitalization - you need to be in town for 3-5 days.

 

If interested, I urge you to eschew Wikipedia and secondary sources and instead go directly to the original sources of expert studies. Start with this brilliant lecture with informative slides published Feb 2017:

 

“Oxford University surgical lectures: prostate artery embolisation in the management of BPH”. Dr Mark Little (Senior Fellow in Interventional Radiology at Oxford University Hospitals NHS Foundation Trust and Lecturer in Anatomy and Embryology at Keble College, Oxford University) discusses his ongoing research into the role of prostate artery embolisation within the treatment of benign prostatic hyperplasia (BPH).

 

Follow this up with the full results of the study here:

https://evtoday.com/2018/04/a-uk-perspective-pae-is-it-ready-for-prime-time/

 

“A UK Perspective: PAE: Is It Ready for Prime Time?” A look at the current use of prostate artery embolization for symptomatic benign prostatic hypertrophy and what further dissemination could offer to patients. By Nigel Hacking, BSc, MBBS, FRCR, FRCP.

 

Finally there are forums online with case studies from patients in the UK, USA and Australia which you can find with a Google search.

India surprisingly have lacked any thrust in this approach, Delhi hospital were doing it couple of years ago, I wanted to have it done,but opted instead for laser,again in India,could not hold out any longer

1 hour ago, altcar bob said:

India surprisingly have lacked any thrust in this approach, Delhi hospital were doing it couple of years ago, I wanted to have it done,but opted instead for laser,again in India,could not hold out any longer

Not sure what you mean by lacking thrust. There are many hospitals in India that provide the service today for sure and not only in New Delhi.

 

It was Dr Pradeep Muley at Fortis Hospital, Vasant Kunj, New Delhi who informed me yesterday that PAE needs just 24hrs hospitalisation and costs around $2,500 there. Could be cheaper at other places but his service is prominently advertised and he has a very informative website.

 

I am not trying to plug India, or that hospital by the way. It just happens to be a centre with many years experience in the procedure that is close to Thailand.