What is Prostate Artery Embolization?

Prostatic artery embolization (PAE) is a minimally invasive treatment that helps improve lower urinary tract symptoms created by benign prostatic hypertrophy (BPH). BPH is a noncancerous enlargement of the prostate gland and is the most common benign tumor found in man.

The PAE procedure is performed by an interventional radiologist (IR), a physician who uses X-rays and other advanced imaging to see inside of your body to treat conditions without surgery.

Benign Prostatic Hyperplasia

Why have Prostatic Artery Embolization?

As the prostate enlarges, it may constrict and partially block the urethra, causing symptoms such as:

  • Urinary incontinence, which can range from minimal leaking to complete loss of bladder control
  • Irritative voiding symptoms
  • Increased urinary frequency, urgency (the sensation that you have to urinate), and pain with urination
  • For some patients, these symptoms can significantly interfere with their quality of life.

    How do I know if Prostatic Artery Embolization is right for me?

    The PAE procedure is for patients who are not surgical candidates or not interested in traditional surgical techniques. Evaluation by an interventional radiologist can determine if you are a candidate for PAE. At his visit the interventional radiologist will ask about symptoms of BPH, how severe they are and how much they affect your quality of life.

    A typical pre-procedure workup:

  • Urinalysis
  • Prostate-specific antigen (PSA) test to exclude a possible prostate cancer
  • An MRI or ultrasound of the prostate gland
  • What happens during Prostatic Artery Embolization?

    • PAE is performed by an interventional radiologist (IR). An IR doctor who uses X-rays and other advanced imaging to see inside of your body to treat conditions without surgery.
    • A Foley catheter (a small tube held in place by a balloon at the end) is occasionally placed into the urethra and positioned inside of the bladder to provide a reference point of the surrounding anatomy.
    • PAE is performed through a small tube, catheter, inserted by the IR doctor into the artery in your groin or wrist. The catheter is then guided with X-ray into the blood vessels supplying your prostate gland.
    • An arteriogram (an X-ray created while dye is injected into the prostate blood vessels) is performed to create a map of the blood vessels supplying the prostate gland.
    • Tiny microspheres (particles/beads) are injected through the catheter into the blood vessels supplying the prostate gland to reduce the blood flow.
    • The IR doctor will move the catheter in order to treat both sides, right and left, of the prostate gland.
    • After the procedure the prostate gland will begin to shrink, relieving and improving your symptoms typically within a few days following the procedure.

    What are the risks of Prostatic Artery Embolization?

    PAE should only be performed by knowledgeable and experienced interventional radiologists. Dr. Hodgkiss has performed several hundred embolization procedures (including treatment of uterine fibroids, metastatic cancer in the liver and kidneys as well as metastatic cancer in bone.

    Patients may experience "post-PAE syndrome" for several days after the procedure, which can include nausea, vomiting, fever, pelvic pain or painful or frequent urination.

    Other risks include a hematoma (bruise) at the puncture site, blood in the urine, semen or stool, bladder spasm or infection of the puncture site or prostate gland.

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