“When the time comes that you're dealing with [an enlarged prostate], I can tell you that there's a team of doctors that can help you at Penn.”
Retired from a successful career in real estate and very active at 80, Max faced a medical issue that’s common for men his age: an enlarged prostate. And like others, he faced a difficult decision.
Starting in his 50s, Max had begun to experience issues due to benign prostate enlargement. He had problems with frequent urination at night, had a weak urine stream, and found it difficult to empty his bladder completely. Over the next three decades, he tried a number of treatments, from herbal supplements to prescription medications.
“I think that that worked adequately,” Max said. “But I think all I needed was a little bit at that point in time. Things got worse over time, and so finally toward the end of 2020 I'd had enough.”
The Drawbacks of TURP
“My urologist had pushed me for several years toward a TURP,” Max said, referring to a transurethral resection of the prostate, a surgical procedure that can have a long recovery time and a number of undesirable side effects, including incontinence, erectile dysfunction, pain, and infection. Three of his friends had undergone a TURP, and none of them were satisfied with the results.
“The TURP was going to give me a surgical scenario,” Max said, noting that he’d be required to stay in the hospital for a few days and wear a catheter for a up to a week after surgery. “I was going to go through a probable year of hell. My friends were opposed to me doing that. For all three of them, it had not worked well. They'd gone back on medication.”
Despite his worries about negative outcomes, Max felt he had to do something to ease his prostate issues and improve his quality of life.
Reluctantly, Max decided to go through with the TURP, and scheduled surgery at a hospital near his home in January 2021.
A YouTube Search Changes Everything
As the surgery date approached, Max continued to search for possible alternatives. One of the places he looked was YouTube. And it was there that he first saw information about a prostate artery embolization (PAE). Performed by an interventional radiologist, PAE involves using microscopic particles to block blood flow to the prostate. Once these blood vessels are blocked, parts of the prostate shrink, creating more room for urine flow and reducing symptoms of prostate enlargement. PAE has fewer risks than surgery, and a faster recovery time.
“I went through the holidays and for whatever reason, you'll laugh at this, I discovered YouTube had an enormous amount of information. I probably saw 15 to 20 different shows on prostate issues,” Max said. “And lo and behold here was a PAE. And it seemed to be being done elsewhere in the world, but not very much in the United States. And I thought my goodness gracious: This is the answer because all of the bad things associated with TURP, none of them are done with a PAE.”
A Detour, Then A Solution
Max had been a Penn Medicine cardiology patient for more than a decade, and had already taken advantage of the health system’s skilled care and cutting-edge technology.
“They probably saved my life a couple times,” he said.
Initially, Max consulted with a urologist at Penn Medicine, who also recommended TURP. But Max kept looking, and eventually he connected with Timothy Clark, MD, director of Interventional Radiology at Penn Presbyterian Medical Center, the first hospital in the Philadelphia region to perform PAE.
“I got to see him pretty quick,” Max said. “Well, first of all, I was certainly impressed with the [interventional radiology] group and what they do. As I learned more about the PAE, I was really impressed with the procedure, and we proceeded to do it.
“I went in, I had an appointment at 12 noon. We had a delay because they had an emergency in front of me. It probably was about two hours from coming in to getting prepped, to exiting the building. And, you know what? They didn't spill a drop of blood. I didn't have a Foley catheter. I didn't have to stay overnight.”
A Significant Improvement in Symptoms
Perhaps more important than the outpatient procedure, Max has seen significant improvement in his symptoms. His urine stream is much stronger, and instead of getting up 6 to 8 times per night to use the bathroom, he not gets up only once, and on rare occasions, twice. In addition, he still enjoys an active sex life, which may have been threatened by the more invasive TURP.
Although his urine stream is strong, Max does still experience dribbling. And sometimes he does not fully empty his bladder. But he says that it’s a good tradeoff compared to the possible downsides of a TURP.
A Team of Doctors that Can Help You
“The PAE offered me all of the improvement without any of the negative side effects. It was just a sharp improvement. It's just really impressive,” Max said.
In fact, he feels so positive about his experience that he’s been sharing his story with some of his close friends.
“I'm in a church group of a bunch of geezer guys that meet once a week, Tuesday morning, for prayer. And I told every one of them about this,” Max said. “And I said, ‘I know all of you have issues. And I'm just telling you when the time comes that you're dealing with it, I can tell you that there's a team of doctors that can help you at Penn.”
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