Patient Note — 266095

4/15/26, 5:18 AM Print Preview [PATIENT_NAME] DOB: [DOB] (63 yo M) Acc No. [ACCOUNT_ID] DOS: 01/28/2026 Patient: [PATIENT_NAME] Provider: [PROVIDER_NAME], MD Account: [ACCOUNT_ID] DOB: [DOB] Age: 63 Y Sex: Male Date: 01/28/2026 Phone: [PHONE] Address: [ADDRESS], FAIRFAX, VA-[ZIP] Pcp: [PROVIDER_NAME] Structured Data: How did you hear about us? : Other; Patient's temperature : 0 Subjective: Chief Complaints: 1. PAE CONSULT. HPI: ARTERA: 63-year-old male patient with a history of elevated PSA and BPH with LUTS. He endorses bothersome urinary symptoms including: incomplete emptying, frequency, intermittency, urgency, weak stream, straining and nocturia. Most recent IPSS/QOL from 05/2025 was: 10/2, but symptoms have worsened recently. Cysto/TRUS (1/21): mild bladder trabeculation, trilobar prostate enlargement, prostate volume of 134 grams. The patient has been referred by his Urologist to discuss potential minimally invasive treatment options. Medical History: Mild asthma. Surgical History: prostate biopsy , finger , rotator cuff tear repair left 02/25. Screening: Medications: Taking Silodosin 8 MG Capsule TAKE 1 CAPSULE BY MOUTH EVERY DAY FOR 90 DAYS , Taking Sildenafil Citrate 20 MG Tablet take 1-5 tables as needed for sexual activities Orally prn Objective: Vitals: Assessment: Assessment: 1. Benign prostatic hyperplasia with lower urinary tract symptoms - N40.1 (Primary) ASSESSMENT: The patient is a male with LUTS secondary to BPH, referred by Urology for evaluation and management options. After an in-depth discussion of potential treatments, including surgical options, minimally invasive surgical therapies (MISTs), and Prostatic Artery Embolization (PAE), the patient expressed a desire to proceed with recommended combination therapy of PAE followed by Aquablation. PLAN: 1. Treatment Plan: Combination therapy with PAE followed by Aquablation was recommended. The patient's urologist will discuss the details of the Aquablation procedure separately. 2. Risk and Benefit Discussion: The patient was informed that PAE works by reducing blood flow to targeted prostatic tissue which results in decreased blood loss during Aquablation. Overall, the anticipated outcome of this combination approach is an improvement in LUTS. Potential risks of PAE were reviewed, including minor complications such as temporary hematuria and/or transient urinary frequency, and rare risks like infection, blood vessel injury, and non-target embolization of adjacent structures (e.g., bladder, penis, scrotum and/or rectum). These risks are exceedingly low, especially in experienced hands. Provider: [PROVIDER_NAME], MD Date: 01/28/2026 Generated for Printing/Faxing/eTransmitting on: 04/15/2026 08:18 AM EDT 1/2 4/15/26, 5:18 AM Print Preview [PATIENT_NAME] DOB: [DOB] (63 yo M) Acc No. [ACCOUNT_ID] DOS: 01/28/2026 3. Pre-Operative and Post-Operative Course: The patient was educated on the pre-operative preparation. Post-procedural follow-up is planned to assess clinical outcomes and