PAE AND Varicocele Repair
Greetings, you all!
Well, I have taken the bull by the balls, so to speak, and have done several things that may, or may not have been good ideas. But here goes!
First, I tried to find an interventional radiologist in Germany willing to tackle GG or PAE, or varicocele repair. This was wasted effort. None were willing to give it a shot, nor did any of them consider the size of my varicocele worth treating.
As I mentioned before, my insurance company AXA won't even cover PAE, and certainly not GG. So, I was about
to make an appointment in Portugal for a PAE. Peeing 8 times a night is exhausting.
Then, my company decided to send me to New Delhi for a couple of weeks, and so I thought, what the hell, I'll see if there are any IR doing PAE in India. Turned out there was a Senior IR by the name of Dr. Pradeep Muley, who appears to be the first IR to be performing PAE in India, and has done around 80 (I believe that was the number) of them. He also routinely does varicocele embolization. So, I got the bright idea to call him and see if GG made sense to him. After all, being the only doc in India to provide it could make him rich beyond the dreams of avarice. So, I sent him the typical information about
GG, and made an appointment with him after I arrived.
When I got there, he explained the whole PAE procedure. In fact, he was in the middle of one when I got there. He showed me the videos and it was obvious that the guy knew his stuff. But he was not willing to try GG yet. He said that he wants to see more studies and proof of its efficacy before he will try it. But he said something else that I found interesting: Because he uses the JUGULAR vein when he embolizes the ISV when treating varicocele, he feels that GG would actually be far easier to do than PAE, owing to the relative ease of using the jugular instead of the femoral artery. And so, he's going to do more study, and may indeed start offering a GG type procedure within the next couple of years.
He offered to do a PAE for me, and to also look into my varicoceles (if I really had any) and to embolize them as well. if necessary. The PAE would cost $1800, and the Varicocele would be $1000. That covered everything, including one night in the hospital in a nice private suite. And let me say, the hospital room, the operating theater etc., were very nice, up-to-date, and I never felt like I was being treated by third-world hacks in an unsanitary environment. The hospital belongs to the Fortis chain, which has a good reputation, and treat many foreign patients.
OK, so next day, June 25th, I went downstairs to accounting (major credit cards accepted) and paid for the PAE (deposit to the hospital), and then was prepped (shaved) and cleaned, and rolled into the theater. The procedure took close to two hours, owing to my arteries being pretty tortuous. He was only able to embolize the right side, which he felt wasn't too terrible a result, because he estimated the right artery to be providing 75% of the blood supply to my prostate. My prostate as measured radiographically(?) was around the size of a small lemon (60-65?), much larger than the 50 reported by my German urologist and his rectal ultrasounography. He then took a real close look at my varicocele, and said there was one only on the left side, so he went in and put one of those coils in place.
After recovery, I was rolled into my room. After they removed the catheter, I got up and urinated normally (for me). Just the slightest pain on the right side of my scrotum, very much like the pain I've had off and on for years with prostatitis. And my left side, where I had testicular pain, was completely pain free.
So, to recap - right side, PAE. Left side, varicocele embolization.
Over the next few days, I began to notice a slight improvement in my urine flow. I still took my Alfuzosin and some Ambien because I needed to sleep. I took some diclofenac (an NSAID) for several days, too, as well as a few days of antibiotics for an unrelated dental problem. No fever or infections of which I am aware. I then set about
doing my job, and sightseeing a bit. Absolutely no problems noted.
All seemed to go very well until the day I flew home, on Sunday the 6th of July. That morning, I began to have a moderately uncomfortable burning feeling seemingly making feel like constantly wanting to urinate, along with a heaviness in my right testicle. Very much like prostatitis. I contacted my doctor, who advised me to treat the discomfort with Tylenol, which doesn't work as well for me as does Aleve. Actually, I am taking them both. And I am using Ambien to get a good night's sleep at the moment. And all of this as me really constipated and uncomfortable in that area, so I have some Psyllium Fiber drink and Dulcolax, which sort of helps, but not greatly.
So, my friends, here we are. I will post as things get better (or worse).
Here are my thoughts, questions, etc. about
the whole thing:
1) Although the IR has done thousands of embolizations, his PAE experience was around 80, so I wondered if the Portuguese might have been able to get both sides. You see, I am 60, and the tortuousness problem usually affects men around 70. Still he was more than qualified, with a long list of citations, certificates, US work, etc. Probably the results would have been the same in Lisbon.
2) Is my constipation a symptom of the spheres maybe migrating into a vein they should not have?
3) Is my current pain a reaction of my prostate to having its blood supply reduced? When will it stop?
Time will tell, I guess. I have hopes that the PAE on the side with no varicocele, and the varicocele on the side with no PAE will give me a good result!
If you plan to be in New Delhi, and might be interested in a PAE, go take a look at indianinterventionalradiology.in. But if you aren't in a hurry, stick around. I'll post again.
Post Edited (Gavrikon) : 7/8/2014 3:19:32 AM (GMT-6)