What Is The PAE Procedure And Is It Right For You?

One of the questions we’re often asked by patients with BPH is “What is the PAE procedure and how can it help my condition?

Prostate artery embolization (PAE) is an interventional radiology procedure that is non-surgical and minimally invasive. It helps improve symptoms associated with benign prostatic hyperplasia (BPH) including difficulty urinating, getting up in the middle of the night to urinate, and frequent trips to the bathroom.

BPH, a non-cancerous enlargement of the prostate gland, is extremely common and estimated to affect 50% of all men up to the age of 60 and 90% of men aged 85 and above. It causes the symptoms described above by obstructing urine flow through the urethra, making urination difficult and gradually leading to bladder changes that result in frequent and urgent urination.

While the condition isn’t life-threatening, for some men it can significantly impact their quality of life to the point where they’re afraid to leave the house because of the urgent need to locate a restroom. When the symptoms become problematic, it’s time to consider treatment. While traditional surgical options like TURP (transurethral resection of the prostate) are effective, they can be invasive and carry potential risks.

PAE offers a safer alternative with fewer side effects, no need for general anesthesia, and minimal downtime.

So that’s answered the question of what is the PAE procedure, now let’s take a look at who it’s intended for.

Who is a candidate for PAE?

A candidate for PAE is someone who does not want to go down the surgical route, is ineligible for surgery, or has tried medication without significant relief.  An interventional radiologist will assess your case during an initial consultation. You’re likely to be asked how often you experience BPH symptoms, their severity, and to what extent they affect everyday living.

The preparatory evaluation before the procedure may include:

• A urinalysis to examine your urine for any abnormalities.
• A digital rectal exam to estimate the size of your prostate.
• In certain cases, a prostate-specific antigen (PSA) test to help rule out the possibility of prostate cancer.
• Imaging tests such as an MRI or ultrasound to provide detailed visuals of the prostate gland.

Not everyone is suited to PAE. Patients suffering from severe atherosclerosis or other vascular conditions may be turned down since accessing the prostate’s blood vessels could be difficult. 

How does PAE compare to traditional BPH procedures?

When comparing PAE to other treatments, the differences are significant:

 While medications are commonly the first treatment choice, they don’t work for everyone and over time they can become less effective. Surgery like TURP remains an option but comes with risks that some men may prefer to avoid. PAE strikes the perfect balance between effectiveness and safety.

What happens during prostatic artery embolization?

PAE is a non-surgical procedure carried out by an interventional radiologist. The objective of the procedure is simple: to decrease the blood flow to the prostate gland, causing it to shrink. This, in turn, opens up the urethra allowing urine to flow out of the bladder more freely.

 Here’s a step-by-step guide to how it works:

1. PAE is performed via a catheter inserted into an artery in the wrist or groin.
2. Using advanced imaging technology, the radiologist guides the catheter down into the vessels supplying blood to the prostate.
3. A contrast dye is injected through the catheter to identify the exact location of the arteries delivering blood to the prostate.
4. Thousands of tiny particles are then injected into these small arteries that nourish the prostate.
5. These become lodged in the small blood vessels in the prostate gland, permanently blocking the vessels and decreasing the blood flow.
6. The arteries on both sides of the prostate are blocked in this way. Usually, this can be done from a single artery puncture but sometimes two are necessary.
7. This procedure can take between 2 to 3 hours and once it is completed the catheter is withdrawn and pressure applied to stop the bleeding.

It’s all well and good knowing what the PAE procedure is, but what about after the treatment?

Following the PAE procedure, you’ll be taken to a recovery room and cared for by one of our experienced nurses who will carry out routine observations including pulse and blood pressure until you’re deemed fit to leave. Typically, there’s no need for an overnight stay.

Generally, an improvement in symptoms is noticeable within one or two months following the procedure with continued improvement up to six months.

Why PAE is gaining in popularity

More men are turning to PAE over traditional surgeries because of its unique benefits:

• Minimally invasive – Unlike surgeries there is no need for general anesthetic and invasive incisions, making it a safer choice for patients with other health conditions.
• Quick recovery – Most patients can return to work and their usual activities within a few days of treatment.
• Low risk of complications – Conventional surgeries like TURP can result in side effects like sexual dysfunction and incontinence, albeit a small risk. PAE minimizes these risks.
• Effective symptom relief - Studies show that PAE provides long-term relief for BPH symptoms in 80-90% of patients.

Why choose Mint STL for PAE?

At Mint STL, we understand how debilitating BPH symptoms can be, and we’re here to help. Our team of highly skilled interventional radiologists specializes in the latest, evidence-based treatments like prostate artery embolization. We provide a patient-centered approach, ensuring your comfort and safety every step of the way.

Ready to reclaim your quality of life? Contact Mint STL today to schedule your consultation and explore whether the PAE procedure is right for you.