Advantages of Prostatic Artery Embolization for an Enlarged Prostate

What is Prostatic Artery Embolization (PAE)?

Prostatic Artery Embolization (PAE) is a minimally invasive procedure for treating lower urinary tract symptoms caused by Benign Prostatic Hyperplasia (BPH) commonly known as an enlarged prostate. Prostate enlargement is a prevalent problem among males over 50. Poor urine flow, frequent urination, and incomplete bladder emptying are all indications of noncancerous enlargement of the prostate gland. While oral medications may provide treatment for some people, they do not provide relief for all.

Transurethral Resection of the Prostate (TURP) has always been the treatment of choice for an enlarged prostate. However, there is a chance that the TURP treatment will accidentally damage the bladder, urethra, or surrounding nerves, which can lead to sexual dysfunction or loss of bladder control.

Symptoms of Benign prostatic hypertrophy:

The prostate is a walnut-sized organ in the male reproductive system that can enlarge and put pressure on the bladder and urethra, causing urinary side effects symptoms such as:

• Dribbling at the end of urination
• Straining
• Trouble emptying the bladder
• Frequent and urgent need to urinate
• Weak urine stream
• Blood in the urine
• UTIs (urinary tract infections)
• Can cause urinary bladder and kidney stones

Who is at risk?

• Men over the age of 50
• Patients with a family history of BPH
• Obese patients
• Diabetics or patients taking certain medications

Diagnosis of BPH:

• Urine test (urinalysis)
• A digital rectal exam can be used to determine the size of your prostate.
• A prostate-specific antigen (PSA) test may be used to help rule out prostate cancer in some circumstances.
• An MRI or ultrasound of the prostate gland.

How Prostatic Artery Embolization (PAE) procedure is performed:

• An interventional radiologist will insert a tiny catheter into the artery in your groin to perform PAE.
• The Surgeon will then guide the catheter into the vessels that supply blood to your prostate.
• Once the Interventional radiologist has confirmed that the catheter is in the correct position, tiny beads are sent through the catheter and placed inside the arteries leading to the prostate.
• The beads restrict blood flow to the prostate and cause it to shrink.
• The Radiologist will move the catheter in order to treat the other side of your prostate, repeating the steps above.
• Following this procedure, the prostate will begin to shrink, relieving and improving symptoms usually within days of the procedure.

During The PAE Procedure:

Unlike surgeries, PAE does not require general anesthesia. However, the patient will get IV medicine to help with anxiety and pain, making the surgery more comfortable. When compared to other surgeries, the treatment is painless and takes less time.

After the PAE Procedure:

Since the method doesn’t include the removal of the prostate part physically, you may not see the results right away. However, the patient will begin seeing good results in 1-2 months and keep coming by reliably improved results until 5-6 months later.

Advantages of Prostatic Artery Embolization:

• Minimally invasive treatment
• Lowers risk of urinary incontinence
• Results can usually be experienced within 48 hours
• Eliminates the need for a bladder catheter
• There are no sexual side effects.
• There will be less pain during and after the surgery
• Shorter hospital stay and recovery time

Prostatic Artery Embolization (PAE) Vs. TURP

Transurethral resection of the prostate (TURP) is a surgical technique in which a section of the prostate is removed.

Despite the fact that TURP is a minimally invasive technique, it is still a form of surgery with several drawbacks, including:

• Temporary difficulty with urination
• Dry orgasms
• Erectile dysfunction (ED)
• UTIs
• Heavy post-operative bleeding
• Low blood sodium levels
• Urinary incontinence

Prostatic Artery Embolization (PAE) is a safe and attractive alternative to TURP. Other indications are when the patient is not deemed fit for surgery or when there is associated blood in the urine that is thought to be of prostatic origin.

Must Read: What Are Uterine Fibroids and what is the best treatment?

Frequently Asked Questions:

Q: What is the success rate of PAE?

A: Prostatic artery embolization has a high pace of progress, with more than 90% of men experiencing relief in the first year. Unlike other treatments that may have unwanted sexual side effects. PAE has no effect on sexual performance.

Q: Is Prostatic Artery Embolization Safe?

A: In the study one-third of PAE patients experienced mild side effects or urinary retention. No major complications occurred in the PAE Patients. Conversely, the TURP Patients experienced three times as many complications as the PAE patients.

Q: What is the Prostate Artery Embolization Recovery Time?

A: Mild discomfort after the surgery is normal and can last for a couple of days post-operation. A few patients feel like they are back to the ordinary in no less than three days of having the procedure and return to work. Others can require as long as about two weeks to overcome feelings of urinary discomfort.

Q: Are the embolization particles permanent?

A: Yes, the particles are permanent.

Q: How long does the procedure take?

The outpatient procedure requires around two hours, so patients return home the same day. Recovery typically requires only a couple of days at home before patients can get back to work and other routine activities.

About the Author:

Name: DR . SURESH GIRAGANI

INTERVENTIONAL RADIOLOGIST

DR. SURESH GIRAGANI CONSULTANT INTERVENTIONAL RADIOLOGIST at Yashoda group of hospitals has more than sixteen years of clinical experience in vascular interventions with a special interest in neurovascular and peripheral vascular disease interventional procedures.

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