What is Prostate Artery Embolization (PAE)?
Prostate artery embolization (PAE) is a minimally invasive procedure performed by an interventional radiologist that can help improve benign prostatic hyperplasia (BPH) symptoms.
What Does PAE Treat?
PAE targets the blood flow to the prostate, which causes death, or necrosis, of the excess tissue in a controlled manner. Once the prostatic tissue necrosis, the prostate becomes smaller and / or softer, which alleviates some of the symptomatology. Over time, this necrosis turns into scar tissue, which further contracts the gland and further alleviates bulk symptoms.
Imaging and PAE
During a PAE, your interventional radiologist evaluates the anatomical make-up of your blood vessels using a special dye (called contrast) which can be viewed on fluoroscopy, a live X-ray. This allows your physician to have detailed knowledge about which blood vessels feed the enlarged prostate, allowing very specific treatment and management.
Prior to your PAE procedure, you may be asked to receive additional imaging including ultrasound, MRI, or computed tomography angiogram (CTA). This allows your physician to have additional, preprocedural information prior to accessing the blood vessels. Imaging allows your physician to view the baseline prostate volume, which can also add important value to comprehensive care.
Benefits of PAE Treatment For Benign Prostatic Hypertrophy
Minimally invasive and non-surgical
One of the main benefits of PAE is that it is a minimally invasive procedure. Under image guidance, using fluoroscopy (live X-rays) and ultrasound, the interventional radiologist gains access to the blood vessels through a small IV in the groin. Through this IV, a series of small wires and catheters allows your physician to target the specific arteries that feed the prostate. When the procedure is complete, there are no large incisions and most patients can return home and to normal baseline activities the same day.
In opposition to other surgical methods, including a transurethral resection of the prostate (TURP) whereby a surgeon must use incisions to remove prostatic tissue, there are no incisions or excisions during a PAE. Additionally, other surgical procedures often require general anesthesia, whereas PAEs can often be completed under moderate sedation.
PAE is approved by the U.S. Food and Drug Administration (FDA) and has been a popular procedure abroad for many years.
Alternative to TURP
The TURP procedure is a surgical procedure in which a urologic surgeon inserts a resectoscope through the penis tip and into the urethra. Through this scope the surgeon can excise excess tissue. Although this is generally effective, patients have to undergo general anesthesia. Additionally, most patients will need to remain in the hospital for monitoring for at least 1-3 days and will need to remain catheterized. Recovery can be anywhere from 6 weeks to a year.
What Can I Expect From PAE
The PAE Procedure
During the PAE, you will undergo conscious sedation. A small catheter is placed into an artery in the groin. Under live imaging, a series of small wires and catheters will be used to reach the desired arteries that feed the prostate. Then, a solution containing small microscopic beads is injected. This causes stasis, or the stopping of blood flow. Once this is achieved on both sides, all wires and catheters are removed and the hole in the groin is closed using a minimally invasive closure device or by manual compression.
The risks for PAE include:
- Post-PAE syndrome, which includes nausea, vomiting, fever, pelvic pain, briefly increased prostatic symptoms (painful or frequent urination)
- Bleeding at the incision site
- Injury to the bladder or other organs
Recovery from PAE
PAE is a same-day, outpatient procedure. Most patients will require monitoring for about 30 minutes in the recovery bay, then able to return home. Patients can engage in baseline activities the following day.
PAE Treatment In Houston, Texas
If you or a loved one are suffering from BPH symptoms and are interested in learning more about your options, call our center to review your eligibility for this procedure.