Prostate artery embolization, or PAE, is a minimally invasive procedure designed to help relieve the symptoms caused by benign prostatic hyperplasia. This is done by blocking the blood vessels that are feeding the prostate causing the prostate to abnormally enlarge. Once these blood vessels are blocked, the prostate can return to a healthier size, and the patient will experience significant symptom relief.
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.
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. 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.
PAE is best suited for symptomatic patients who have prostates with a volume greater than 40 grams, and don’t wish to have more invasive surgeries or procedures to reduce their BPH symptoms. PAE has been shown to be especially effective for men with very large prostates, >80 grams, for whom TURP or prostatectomy are their only urological options. These invasive procedures generally involve major surgery, and the associated risks that it carries.
PAE can help remedy benign prostatic hyperplasia without need for surgery. Recovery is much more rapid with PAE compared to surgical options. You are not required to stay overnight, and will leave the same day to recover in the comfort of your own home.
PAE is also minimally invasive, and does not require a large incision or general anesthetic. The patient is sedated but conscious, therefore avoiding the risks that accompany the use of a general anesthesia. Because the procedure is not a major surgery, it also carries a smaller risk of infection.
Now that you know what PAE is, it’s important to select the best facility to undergo your procedure. It’s important to choose well trained specialists, who utilize only the best in state-of-the-art medical equipment.
The main risk with any blood vessel procedure is bleeding from the site of access. To decrease this risk, the interventional radiologist will often use a closure device in conjunction with firm pressure on the groin or wrist access site at the conclusion of the procedure. Temporary increase in urinary symptoms and discomfort around the prostate area is typical. Some patients may have temporary blood in the urine, semen or stool following the procedure which resolves in a few weeks. During the procedure, the interventional radiologist is very careful to observe the blood flow while placing the microspheres but if microspheres go outside the prostate artery, termed non target embolization, they can go into surrounding blood vessels in the including those leading to the bladder, rectum, penis, bones and muscles in the area. That is why careful embolization is key to a successful procedure. Depending on how the prostate shrinks after the procedure, it is possible but unlikely to cause retrograde ejaculation, a condition where the ejaculate flow backward into the bladder instead of through the penis. Over time, other blood vessels in the pelvis may start supplying the prostate allowing it to start growing again. Recurrence rates with PAE are similar to TURP.
If you want a team that specializes in vascular treatments with extensive experience doing PAE with excellent outcomes, your best option is Peripheral Vascular Partners.
At Peripheral Vascular Partners, patients are our priority. We take the time to walk you through every step of your treatment, and make sure you are 100% comfortable during your stay. Our trained specialists know prostate artery embolization inside and out, and will perform your procedure with the utmost care and precision.
Major surgery is not your only option. If you don’t wish to have a prostatectomy, PAE can offer you relief from the symptoms of benign prostatic hyperplasia without the risk and discomfort of invasive procedures. We understand you have questions, and our trained professionals have answers. Simply schedule a consultation today!
