If you’re suffering from an enlarged prostate, chances are your doctor has told you that the only treatment option is TURP or transurethral resection of the prostate.
Well, the good news is that it may not be necessary for you to undergo prostate surgery. Your symptoms can be relieved with a safe, minimally invasive procedure known as PAE or prostate artery embolization.
Want to know more? Carry on reading to learn how PAE works and whether it might be a suitable treatment for you.
How Does Prostate Artery Embolization Work?
PAE is a treatment that can relieve the uncomfortable symptoms of benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland, and improve quality of life.
BPH is a condition that affects men as they age, often starting in their 40’s and progressing with each decade. It’s thought that over 90% of men over the age of 80 have this condition. The prostate enlarges, blocking the flow of urine from the bladder, which can cause severe urinary symptoms.
Instead of surgery that involves the surgeon cutting into the prostate gland, interventional radiologists inject a series of microspheres into the prostate gland’s blood vessels via vascular catheters. This slows down the blood flow to the artery feeding the prostate, causing it to shrink and relieving the urinary symptoms.
Depending on the size and location of the arteries needing embolization, the procedure can take up to three hours.
Symptoms of BPH
- Frequent and urgent need to urinate
- Difficulty starting to urinate
- Inability to fully empty the bladder
- Increased nocturnal urination, which adversely affects sleep
- Weak stream of urine or a stream that stops and starts
- Post-urination dribbling
- Blood in the urine
- Inability to urinate
- Urinary tract infections (UTIs)
What’s the procedure?
The procedure takes place on-site as an outpatient and begins with the doctor administering local anesthesia to ease any discomfort. A tiny pinhole incision is made in the groin or on the wrist, and a small catheter is fed into the artery supplying the prostate.
With the catheter in position, the doctor injects a dye into the blood vessels to pinpoint the location of the blood vessels leading to the prostate.
A series of microspheres travel through the catheter to the necessary blood vessels, thus reducing blood supply to the gland (embolization). The procedure is then repeated for the other side of the gland. After surgery, all a patient has to show is a bandaid!
Following treatment, the prostate starts to shrink and become smaller. Most people notice a difference in its size within 24-48 hours. Over a period of six months, the gland may shrink by 40% resulting in a significant improvement in urinary symptoms.
Benefits of PAE
- Minimally invasive treatment
- Lowers risk of urinary incontinence
- Results can usually be experienced within 48 hours
- Eliminates the need for a bladder catheter
- No sexual side effects
- Less discomfort during and after the procedure
It typically takes a couple of weeks following the procedure for a man to feel relief and that his body is functioning as it did when he was younger.
How does PAE differ from other BPH treatment options?
As mentioned earlier, PAE is not the only treatment for BPH. Here are two other treatment options commonly recommended to men suffering from BPH.
PAE vs UroLift
The doctor utilises small implants during BPH treatment to hold the prostate tissue away from the uretha to avoid blockage. While this procedure may be effective for some men, it does have its limitations. It’s best suited to men with small prostate glands and not those with a large median lobe (part of the prostate that can extend into the bladder and affects 10% to 40% of men in the population aged between 40 and 70 years.
PAE vs TURP
TURP is a standard surgical prostate procedure that involves inserting a resectoscope into the tip of the penis and through the urethra. The doctor uses the tool to trim away the excess prostate tissue blocking the urethra to restore correct urine flow.
While TURP is considered a minimally invasive procedure, it is surgery nevertheless and with that comes some downsides, including:
- Temporary difficulty urinating
- Erectile Dysfunction
- Dry orgasms
- Heavy post-operative bleeding
- Urinary incontinence
- Low blood sodium levels
Based on this list of possible side effects, we’re sure you’ll agree that prostate artery embolization is a safe and attractive alternative to TURP.
Who is a good candidate for PAE?
PAE could be an ideal treatment for patients in the following circumstances.
- They don’t want surgery
- Their symptoms have not responded to medication
- They are unable to have surgery
- They do not want adverse effects like decreased sexual function and premature ejaculation, infertility and urinary incontinence
- They want a simple outpatient procedure with little to no downtime
Are you interested to know more about PAE and whether it could help you?
The experienced team here at the Midwest Institution for Non-Surgical Therapy (MINT), led by Dr. Goke Akinwande, is here to answer your questions. Contact us today and schedule a consultation at one of our 5 clinics, including the latest addition in Chicago, IL.