An Enlarged Prostate can be painful. Let us find you relief. ​

Learn about prostate artery embolization, an effective, non-surgical way to treat Benign Prostatic Hyperplasia (BPH). 

How is Benign Prostatic Hyperplasia (BPH) treated?​

Prostate artery embolization (PAW), is a highly efficacious and minimally invasive procedure that blocks blood flow to the prostate, reducing the swelling of the overgrown gland, causing it to shrink over time. 

How is prostate artery embolization performed?

Step 1

A small incision is made in the groin or wrist.

The treatment is performed by a specialist known as an interventional radiologist. First, they will make a small cut near the skin of the patient’s wrist or groin. From there, they will insert a thin catheter into their artery, and guide it towards the prostate. Then, the doctor will inject contrast that can be seen under real time xray that allows them to map out the pathways of a patient’s blood vessels. There is typically one prostate artery on each side of the pelvis. 

Step 2

A catheter is placed into the arteries leading to the prostate.

Once the prostate has been reached with an even smaller catheter, small microspheres are fed through the catheter into the blood vessels supplying the prostate to block the gland’s blood supply. The microspheres are FDA approved specifically for prostate artery embolization and have been on the market for decades used in embolization procedures throughout the body. Once one side of the supply veins are blocked, the doctor will move to the other and stop that blood supply as well.

Step 3

Recovery begins almost immediately.

Once the procedure is concluded, the catheter is removed and pressure is placed on the blood vessel access site to prevent bleeding. Patients will recover for an hour or two in the recovery area then go home. When the prostate arteries are closed suddenly, the prostate gland initially swells for a couple days that is usually associated with increased urinary symptoms including urinary burning and discomfort in the area of the prostate gland for several days to a week. The patient will receive medications to take after the procedure to help make recovery easier. The prostate gland will begin to shrink with symptomatic improvement that is usually noticeable in 2-3 weeks with ongoing improvement for several weeks or months thereafter. After a few days, the prostate gland should return to a healthy size, relieving the symptoms of BPH.

Prostate artery embolization FAQ

Most plans do.
​We will work with our network providers to  check with your insurance company to make sure they are not going to deny the procedure. 

No. But after the procedure you will have mild to moderate pain for a few days, sometimes longer.

During the procedure you will feel a warm sensation during the injections. But no pain. And you will be quite relaxed as we are giving you medicine to help with anxiety.

 

If your anatomy allows, I will perform a nerve block (just like what a dentist does to numb your mouth) during your PAE that will decrease any pain coming from your pelvis for the first day or two after your procedure. Most men with feel a burning sensation in your pelvis for several days. Often Advil is sufficient to take care of this discomfort, but I am there for you if you need stronger medicine.  You may also feel an increase in urgency and frequency for the first several days after PAE, but this is self-limited…it will go away on its own.

No.
​PAE is done from inside of your artery. It is similar to a heart catheterization. I place a tiny tube into the femoral artery at the top of your leg, through a tiny nick in the skin. Nothing goes in your penis, unless you need us to place a catheter into your bladder to empty the urine. That can happen to men with severe BPH; we are prepared to help you if it happens to you.

Yes.
​All of the early patients we studied with PAE were facing prostatectomy as their only other option. Once your prostate is over 90 grams, TURP, laser, Rezum, and all of the other surgical methods to ream it out from inside your penis tend to fail. Urolift will not work when the prostate is that large, either. So the surgical option becomes prostatectomy (though some urologists are reporting success with laser with prostates up to 150g)
Unfortunately, all of the negative things that a TURP can cause, like ED and incontinence, are much more likely with a prostatectomy.
Oh, all of those things except for retrograde ejaculation, because during a prostatectomy the tubes that carry your semen into the penis are removed. You will never again ejaculate, retrograde or otherwise. 
These early patients taught us that PAE causes none of those problems. Even when your prostate is over 90 grams. 
With PAE, not only will you continue to ejaculate normally, you will remain fertile. Not sterilized and impotent. 

80% of patients will have significant improvement in their symptoms following PAE.  Six years after PAE almost all of that original 80% are still enjoying the benefit; so YES it does provide lasting relief of symptoms. 

If PAE does not work for you, you can still have TURP or prostatectomy. 
If PAE works for you but your symptoms eventually do come back, you can have PAE again. 

Who should I choose to perform my prostate artery embolization?

 If you want medical expertise you can trust, and a facility designed with your safety and comfort in mind, let us help you get started with your PAE procedure.

 

At Peripheral Vascular Partners of Boise, we care deeply about our patients’ well-being, and we’ve made it our mission to provide the best treatment with proven surgical alternatives and minimal recovery time. Our providers focus specifically on vascular treatments, so you can rest easy knowing your procedure is being performed by an experienced and skilled specialist.

 

Major surgery is not your only option. A PAE treatment can offer you relief from an enlarged prostate without the risk and discomfort of invasive procedures. We understand this can be a confusing time, and we would be happy to answer any questions you may have. Our staff is ready to help, take our quiz to learn if you are eligible for PAE.