The prostate artery embolization (PAE) procedure shrinks the prostate to improve urinary tract symptoms caused by benign prostatic hyperplasia (BPH). This non-cancerous prostate gland enlargement affects 50% of men over the age of 50 and around
80 % of those over 70. Initially, surgery was the only option to treat the condition, but today, patients are choosing PAE in increasing numbers.
PAE is one of the most exciting developments in interventional radiology. The minimally invasive procedure is performed by a radiologist who uses imaging tools such as X-rays to see inside the body and treat conditions without surgery. Here's what you need to know about the prostate artery embolization procedure.
Preparing For A PAE Procedure
Prostate artery embolization can be performed as a day case or with an overnight stay if you are traveling long distances. Typically you will be asked not to eat a few hours before the procedure, although you will be permitted to drink water. If you are nervous, you may be given a sedative if you wish.
Before your PAE procedure, you will undergo a scan called a CT angiogram. This is to check the arteries supplying the prostate aren't diseased.
During the PAE Procedure
You will lie flat on an X-ray table and may have an intravenous cannula inserted into your arm if sedatives and/or painkillers are required. The procedure is not painful. The most discomfort patients report is having to lie flat for two or more hours.
PAE is performed via a small puncture in the groin or forearm. The skin above the site will be cleaned with antiseptic and then anesthetized with a local anesthetic. Patients do not require a general anesthetic for a prostate artery embolization procedure.
A special needle is inserted into the artery, and a guide wire is placed through the needle and into the blood vessel. The needle is withdrawn, and a catheter (a soft, thin, hollow tube with a balloon at the end)is placed over the wire and into the artery.
The catheter is then guided toward the prostate. The radiologist uses X-ray equipment and other imaging tools to ensure that the catheter and the wire are moved into the correct position. A special X-ray dye, called a contrast medium, is injected down the
catheter so the radiologist can clearly see what's going on. You may feel a warm sensation in the pelvis.
Once the catheter is in place, fluid containing thousands of microscopic beads are released through the tube to plug up the arteries that supply blood to the prostate. This is known as embolization. Both the left and right prostatic arteries are blocked in this way.
PAE can take anywhere between one to three hours, depending on the size and location of the arteries.
With reduced blood supply, the prostate shrinks in size, relieving and improving symptoms. It isn’t possible to block blood flow to the prostate completely, so it doesn't die.
Once the procedure is completed, the radiologist will remove the catheter and may apply pressure to the skin entry point for a few minutes to prevent bleeding.
After The PAE Procedure
After the procedure, you may be monitored for a couple of hours to ensure that everything is ok and there are no complications. Then you will be free to return home.
Are There Any Risks Or Complications?
As with all medical procedures, there are some risks involved, but with PAE, they are mild. They can include:
- A small bruise around the site where the catheter is inserted.
- Some pain. This is usually treated with over-the-counter painkillers.
- A tiny risk of the blockage of non-target organs. However, the radiologist's skills and the quality of the imaging equipment makes this unlikely.
- Other risks include blood in the stool, semen or urine, bladder spasm and infection of the prostate or puncture site. These potential issues will either resolve themselves or can be treated with medication.
How Do I Know If A Prostate Artery Embolization Procedure Is Right For Me?
PAE is for men who are not eligible for traditional prostate surgery or don't want it. An examination with the radiologist will determine whether or not you are a suitable candidate for the procedure.
To help make this determination, you will be asked about your symptoms and how they affect your quality of life.
You may also undergo several tests, including:
- A digital rectal exam to determine the size of the prostate gland
- Urine analysis
- An MRI or ultrasound of the prostate
- A PSA (prostate-specific antigen) test to help rule out prostate cancer
PAE Success Rate
Prostate artery embolization is a safe medical procedure designed to improve your symptoms and prevent you from having a bigger operation. Approximately 90% of men
who have PAE experience significant symptom relief during the first year following the procedure.
How MINT Can Help You
If you've been diagnosed with benign prostatic hyperplasia, we can relieve symptoms such as urinary problems and pain to improve your quality of life.
At Midwest Institute for Non-surgical Therapy (MINT), we perform PAE on an outpatient basis. Contact us today for more information and to schedule a consultation at one of our 5 clinics, including the latest addition in Chicago, IL.