What Is Prostatic Artery Embolization (PAE)?

prostatic artery embolizationOne in four men over 50 and half the men over 75 suffer from enlarged prostate or benign prostate hyperplasia (BPH). This condition is not linked to the risk of developing prostate cancer, but it negatively impacts the quality of life. Men with BPH feel the urge to urinate several times during the night. Also, their sexual function is affected.

The solution for solving these issues is an innovative treatment called prostatic artery embolization (PAE). Its purpose is to shrink the enlarged prostate as close as possible to its normal size (which is the size of a walnut).

Who Qualifies for Prostatic Artery Embolization?

PAE is a minimally invasive procedure that does not require full anesthesia. Thus, it is a viable alternative for men who do not qualify for traditional surgery due to various preexisting conditions.

It is also a great choice if you are not keen on having surgery and want to spend as little time as possible in hospital. However, you will be screened before signing up for the procedure. The examination typically consists of:

  • Urine test
  • Digital rectal examination
  • PSA test to rule out prostate cancer
  • MRI of the prostate gland.

Understanding the Risks of Prostatic Artery Embolization

Almost all medical procedures have negative side effects for some patients. In the case of prostate artery embolization the most common risk is the so-called “post-PAE syndrome”, which has the following symptoms:

  • Fever
  • Nausea
  • Vomiting
  • Pelvic pain
  • Painful urination.

Some patients have also reported a hematoma forming at the incision site and bladder spasms.

What Happens during a Prostatic Artery Embolization Procedure?

PAE is performed by an Interventional Radiologist. This medical specialization relies on imaging technology to see the inside of the human body and perform interventions without surgery, through a small incision.

Before the procedure itself, the Interventional Radiologist will insert contrast material based on iodine into the patient’s bloodstream to have a clear mapping of the arteries and veins around the prostate.

The procedure starts with conscious sedation. The patient is relaxed, but awake. The doctor will make the incision and insert a thin tube called a catheter in the pelvic artery. The catheter is guided into the blood vessels that supply blood flow to the prostate.

Next, using the vein mapping image, the doctor delivers a charge of tiny particles into each of these blood vessels, in order to reduce the blood flow. As a result, the prostate will start shrinking. The patient will experience the first signs of improvement within the first month after prostatic artery embolization.

After the Procedure

Prostatic artery embolization does not require hospitalization, except for staying overnight for observation and monitoring. Patients report a 75-80% success rate of the procedure, and state that they experienced significant improvement in about 5-6 months.

You may have to come for a follow-up examination, which will involve a scan or MRI to observe the results of PAE. As for long term results, there are few data available. However, several studies found that the shrinking of the prostate maintains for around 3-4 years, even longer.