About Prostate Artery Embolization
Prostate artery embolization (PAE) is an FDA-approved, minimally invasive procedure that can improve lower urinary tract symptoms (LUTS) caused by BPH and bladder outlet obstruction (BOO) with low risk of sexual side effects and urinary incontinence. PAE is performed by an interventional radiologist, a physician specializing minimally invasive, image-guided therapies to treat conditions without surgery. Before the procedure and depending upon your IR's protocol, a Foley catheter may be inserted into your urethra and positioned as shown. The catheter provides a reference point for the surrounding anatomy.
Prostate artery anatomy
Foley Catheter
PAE is performed through a small incision in your groin or wrist. Your IR will insert a catheter into the incision and guide it near the vessels that supply blood to your prostate. Once the catheter is positioned near your prostate, an arteriogram ( an X-ray in which dye is injected into the blood vessels) is done to map the blood vessels feeding your prostate.
Next, tiny round microspheres are injected through the catheter and into the blood vessels that feed your prostate, reducing its blood supply. From the same incision, the IR surgeon then repositions the catheter in order to treat the other side of your prostate, performs another arteriogram, and injects the microspheres into the blood vessels feeding the other side of your prostate.
With its blood flow reduced, the prostate begins to shrink relieving pressure on the urethra and improving symptoms usually within days of the procedure.
Click on the movie below to learn more about PAE for BPH or click here to learn more
PAE Benefits
Shorter hospital stay and recovery time
Shorter hospital stay and recovery time
Decreased discomfort
Low risk of sexual side effects
Significant improvement in IPSS and overall quality of life.
Low risk of urinary incontinence
Reduction in prostate volume, especially large prostates
Shorter urinary catheterization time (may be avoided completely)
Improvement in urine flow rates
Are You a Candidate?
PAE is ideal for patients who:
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Are poor surgical candidates or who are seeking a less-invasive prostate-reduction procedure
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Have urinary retention requiring indwelling bladder catheter
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Have large prostate glands
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Suffer from hematuria
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Have had prior surgical history
You May Be a Candidate
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You're experiencing symptoms associated with benign prostate hyperplasia (BPH).
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You experience an adverse reaction to medication such as intolerance, side effects, or allergy.
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You want to preserve your sexual function.
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You don't want surgery
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You're not a candidate for BPH surgical treatments
Literature
Prostatic Artery Embolization: A Promising Techniquee in the Treatment of High-Risk Patients with Benign Prostatic Hyperplasia
Poor Surgical Candidates
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22 patients with BPH and LUTS refractory to medical therapy and at high risk for surgery or anesthesia.
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Results: Significant reduction in LUTS with increased urinary flow, reduction in prostate volume and serum PSA
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Conclusion: BPH patients with failed medical therapy at high risk can be treated safely and effectively with PAE
Efficacy of Prostatic Artery Embolization for Catheter-Dependent Patients with Large Prostate Sizes and High Comorbidity Scores
IBC Patients
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30 patients with urinary retention and IBC and BPH (55-557 ml)
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Results: 87% were no longer reliant of IBC at a mean of 18 days. Significant improvement in IPSS score and quality of life and significant decreased prostate volume.
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Conclusion: PAE is an effective option for management of patients with BPH and urinary retention
Prostatic Artery Embolization for Treatment of Benign Prostatic Hyperplasia in Patients with Prostates > 90 g: A Prospective Single-Center Study.
Large Prostate Volume:
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35 patients with BPH (90-252 g)
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Results: Size decreased significantly at 3 months and mean IPSS and quality of life index improved significantly.
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Conclusion: PAE is safe and effecgive for LUTS secondary to BPH in patients with prostate voluume > 90g
Medium and Long-term Outcome of Prostate Artery Embolization for Patients with Benign Prostatic Hyperplasia: Results in 630 Patients.
Long-Term Results:
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630 patients with BPH with mean prostate volume of 80g
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Results: Clinical success rates at medium and long-term follow up were 82% and 76% repectively
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Conclusion: PAE had positive effect on IPSS, QOL, and all objective outcomes in symptomatic BPH