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What is Prostatic Artery Embolization (PAE)?
PAE is a minimally invasive procedure for the treatment of Benign Prostatic Hyperplasia (BPH) with lower urinary tract symptoms (LUTS). The prostate arteries are embolized by tiny microspheres that block some of the blood flow to the prostate, shrinking the tissue and relieving symptoms.
What is Benign Prostatic Hyperplasia?
Benign Prostate Hyperplasia (BPH) is the most common disease of the prostate and is very common in middle-aged and elderly men. It can affect 50% of men at age 60, and 90% of those aged over 85 years. BPH is a benign, non-cancerous increase of prostate volume, and commonly causes obstruction of the bladder outflow. The condition can cause debilitating symptoms that have an impact on the quality of life.
Common Symptoms:
- Increased frequency and need to urinate
- Increased Frequency of urination at night (nocturia)
- Difficulty starting urination
- Weak and/or interrupted urinary stream
- Sensation of incomplete bladder emptying after urination
These symptoms may occur in isolation or in conjunction with one another, and can vary in severity.
What are the treatment options of BPH?
The diagnosis is made based upon the patient’s medical history and a detailed physical examination, including: medical history, physical examination, blood test, digital rectal examination, and rectal ultrasound.
There are several suggested treatments, according to the severity of the symptoms:
- Mild symptoms: “watchful-waiting approach” and lifestyle changes
- Moderate symptoms: drug therapy
- Severe symptoms: non-surgical Prostatic Artery Embolization
Frequently Asked Questions
When is PAE the best option for me?
PAE represents the best treatment option for you if you suffer from common symptoms caused by an enlarged prostate gland. It is also indicated if you do not benefit from drug therapy, cannot have general anesthesia and / or show prostate dimensions not suitable for surgical treatment. The results of the tests your urologist ordered (Prostate Ultrasound with rectal probe, PSA level, Uroflowmetry, and sometimes cytoscopy and pressure study, known as Urodynamic) need to qualify you for embolization. If embolisation is indicated, you will need a CT angiography to evaluate the pelvic vessels and determine whether or not you are a candidate for PAE treatment. After undergoing this examination you will be contacted by the hospital medical team and informed about your expected degree of treatment success.
When might PAE be inadvisable?
Before embolization, patients must be examined to rule out the presence of a malignant tumor, which contraindicates a PAE. Other contraindications include atherosclerosis and a tortuous (twisted) pelvic and/or prostatic vessel anatomy, as demonstrated by CT (computed tomography) angiography. Regardless of prostate enlargement, the patients must be symptomatic to qualify for PAE surgery.
Who will be doing the procedure?
PAE is done by our specially-trained Interventional Radiologists who are experts in image-guided surgery.
How do I prepare for PAE?
On the day of treatment, you may be admitted to the hospital. You should not eat for six hours before PAE, only water. As the procedure is generally carried out using the artery in the groin or wrist, you will be asked to put on a hospital gown. It is very important that you inform your doctor about any allergies you might have and/or previous allergic reactions to contrast medium.
Will my sexual function be affected?
Based on studies to date, patients treated with PAE for BPH have not experienced a decline in sexual function. Sexual dysfunction is mostly associated with the side effects of the prescription medication therapy that patients used to treat BPH, prior to the PAE procedure.
