About the procedure

Prostate Artery Embolization (PAE) is a minimally-invasive Interventional Radiology (IR) procedure used to treat Benign Prostatic Hyperplasia, or BPH. Men who have BPH have an enlarged prostate that is putting pressure on the urethra (the tube that carries urine and semen to a man’s penis), causing difficulties with urination and sometimes other symptoms such as erectile dysfunction.

PAE is a painless outpatient procedure and does not require the use of general anesthesia. Instead, it is performed under “twilight sleep.” The patient is usually free to return home the same day.

Background

The prostate is an organ of the male reproductive system. Its primary purpose is to produce the seminal fluid that helps to preserve sperm after ejaculation. Located under the bladder, the prostate is normally about the size of a walnut, and surrounds the urethra. In older men, the prostate can become enlarged, which exerts pressure on the urethra and hinders the proper flow of urine and semen through the urethra to the penis.

This condition, called enlarged prostate or Benign Prostatic Hyperplasia (BPH), affects over 50-60% of men in their sixties, 70-80% of men in their seventies, and 90% of men age 80 or older. Although the increased prostate tissue growth is benign (non-cancerous), it can cause obstruction of the lower urinary tract and symptoms such as:

  • Increased frequency of urination, especially at night
  • Difficulty controlling urination; sudden, urgent need to urinate
  • Weak and/or interrupted urination; difficulty starting urination
  • In serious cases, inability to urinate at all, requiring catheterization
  • Blood in the urine
  • Erectile dysfunction
  • Increased risk of and incidence of prostate cancer

Naturally, these symptoms can negatively impact one’s quality of life, so many men with BPH seek treatment. Moderate to severe cases of BPH have traditionally been treated with invasive surgeries such as TURP (transurethral resection of the prostate), Prostatectomy, Laser, Thermotherapy, or Electrovaporization. These procedures require general anesthesia and can result in complications such as incontinence, sexual dysfunction, impotence, and retrograde ejaculation (in which semen “backs up” into the bladder). PAE provides a safer, non-surgical alternative to treating BPH.

What to expect

PAE is performed under light sedation, without the need for general anesthesia. Interventional radiologists perform the procedure by introducing a microcatheter into a tiny incision in the femoral artery in your groin or the radial artery in your wrist.. X-ray guidance is used to allow the small catheter to be pass into the artery supplying the prostate. Small spheres are then inserted into the artery to block it, causing the abnormal tissue (BPH) to shrink, soften, and become reabsorbed.

Procedure times vary, but average 60 to 120 minutes, plus a couple of hours in the recovery area. There is no appreciable at-home “recovery time” after PAE, with the exception of being advised to avoid strenuous activities such as heavy lifting or climbing long flights of stairs for 24 hours after the procedure. The procedure also has a very low complication rate, with zero reports of impotence or incontinence, and with no effect on sexual function. Patients typically report improvement of their symptoms within 2 to 3 weeks.

Getting the best interventional radiology care possible

MTVIR is a team of experienced interventional radiologists who consult with other doctors or hospitals to bring state-of-the-art radiology treatment to their patients. We provide the most comprehensive BPH treatment options in Dallas, because we stay at the cutting edge of new techniques and technologies.