Prostate artery embolization (PAE) is a relatively new treatment that helps improve the symptoms of benign prostatic hyperplasia (BPH), also called prostate gland enlargement. This noncancerous prostate condition typically affects men as they age and causes uncomfortable urinary symptoms such as a weak urine stream, incomplete bladder emptying and increased urination (particularly at night).
BPH occurs in approximately a third of all men aged 50 or over, rising to 50% by 60 years and about 90% by the age of 85. Scientists do not yet know why this happens.
What is the Prostate?
The prostate is a small gland in men about the size of a walnut that makes the fluid part of semen that nourishes and transports sperm. It sits between the bladder and the penis in front of the rectum.
The gold standard surgical option for BPH is called trans-urethral resection of the prostate (TURP). During the operation, a device known as a resectoscope is inserted through the penile urethra to remove prostatic tissue blocking urine flow.
The treatment is generally safe, but it has several significant downsides, including potential side effects such as the loss of fertility and sexual function. Another possible side effect in men who elect to have the operation is retrograde ejaculation. This is when semen enters the bladder during orgasm instead of out through the penis.
Additionally, TURP is performed under a general anesthetic, which may not be an option for some men. It also requires a stay in the hospital, and there is a significant recovery period of four to eight weeks.
Minimally Invasive Alternative
Fortunately, there is now an alternative to TURP - prostate artery embolization. It was first performed in 2009, and thousands of men have had the procedure since then.
Instead of surgically cutting into the prostate gland, a catheter is inserted through a tiny pinhole in the skin. State-of-the-art imaging is used to guide a small catheter to the prostate arteries, where microscopic beads are released, blocking blood flow to the prostate. This causes it to shrink and improve urine flow.
The procedure has a high success rate, with more than 90% of men experiencing an improvement in symptoms within one to two weeks.
Several studies back up the anecdotal evidence. A 2016 review of more than 650 PAE patients showed a roughly 60% decrease in IPSS six months and one year after PAE. IPSS stands for the International Prostate Symptom Score, which determines the severity of symptoms on a scale ranging from 0 (no symptoms) to 35 (most severe symptoms).
Another study found that the procedure was still effective in 76% of patients between three and six years after having their treatment.
Below, we will outline the key benefits of PAE:
Benefits of Prostate Artery Embolization
The procedure is minimally invasive - it is performed under local anesthetic and is usually done as a day case. Typically, PAE requires about two hours. There is less pain and discomfort during and after the procedure. This makes it easier for men to have the treatment.
- Fewer complications - no surgery is required, which reduces the risk of complications such as urinary incontinence, retrograde ejaculation, impotence and sexual dysfunction.
- Symptoms start to improve very quickly - this means patients can return to normal activities much sooner than if they had undergone an operation.
- Improved quality of life - men who undergo a prostate artery embolization often enjoy a much better quality of life than previously. Patients report having fewer urinary problems and pain and feel much better.
- Short recovery period - TURP patients can require up to two months of downtime. However, PAE patients experience a much quicker and more comfortable recovery period.
- Reduced bleeding - traditional surgical options can result in heavy bleeding. Not so with PAE.
When compared to TURP, prostate artery embolization is seen by many as the better option.
PAE is a safe and effective treatment with an impressive successive rate. However, as with other medical procedures, complications can arise.
- A small risk of bleeding or bruising at the groin. Blood vessels may also break during the procedure leading to bleeding.
- Some patients experience mild discomfort in the lower abdomen and while urinating, but these problems soon resolve after about ten days.
- The catheter used during the procedure may introduce bacteria into the blood, which can lead to infection. If this happens, you will be given antibiotics to clear it up.
- Some patients may feel more tired than usual for up to a week after the procedure.
- There is a slight possibility of experiencing pain when passing urine, but typically this settles down by itself.
- Some patients may have temporary incontinence after their PAE procedure. However, compare this to TURP patients who may experience long-term incontinence.
Prostate artery embolization is a safe procedure designed to alleviate BPH symptoms and save you from having a larger operation.
The Midwest Institute for Non-surgical Therapy (MINT) specializes in PAE on an outpatient basis. Vascular and endovascular specialist Goke Akinwande, MD, is the first physician in St. Louis to perform this procedure in an outpatient non-hospital setting.
Contact us today for more information and to schedule a consultation at one of our 5 clinics, including the latest addition in Chicago, IL.