Prostate enlargement often called benign prostatic hyperplasia (BPH), is one of the common health condition mostly seen in older men. It is also known as older people’s urination problem, which causes symptoms like poor urination flow, frequent urination, incomplete emptying of their bladder, and sudden urge to urinate.
This condition can be treated with the help of medication, but only some patients can get relief from the symptoms with medications alone. In case of severe symptoms, a urologist recommends undergoing a surgical procedure like transurethral resection of the prostate (TURP).
However, medical technology has developed an alternative procedure to TURP and named as prostate artery embolization (PAE), a minimally invasive surgical procedure. A highly trained interventional radiologist performs the process by making a small incision in the upper thigh.
What is Prostate Artery Embolization (PAE)?
Prostatic artery embolization (PAE) is a cutting-edge procedure used to treat the lower urinary tract problems caused by Benign Prostatic Hyperplasia (BPH) or an enlarged prostate. The procedure involves injecting of microparticles into the prostate’s blood vessels to prevent blood flow to the gland. As the blood flow reduces, the prostate shrinks and provides relief from symptoms.
Prostatic Artery Embolization Procedure
PAE procedure is done by an interventional radiologist (IR) using X-ray imaging techniques or under ultrasound guidance. They can see inside your body with the help of these techniques, which helps to treat these conditions without surgery.
An interventional radiologist makes a small incision in your wrist or groin area to access the prostate blood vessel( femoral or radial artery). Then a small catheter is inserted into the artery and guide it to the vessel that supplies blood to the prostate.
A dye is injected into the blood vessel to map the vessel that supplies blood to your prostate.
Then microparticles are injected into the blood vessels through the catheter to reduce blood supply to the prostate. Microparticles are particles available in various materials which include ceramics, polymers, and metals.
This procedure causes embolization (blockage of the artery) and reduces blood flow. As a result, the prostate begins to shrink and relieve from symptoms within a few days to weeks following the procedure.
Both the right and left prostate arteries will be blocked in the same manner. Often the procedure is done by accessing the arteries from the right groin, but in some cases, it becomes difficult to block the right prostatic artery branches from the right groin. So the procedure is completed accessing the arteries from left groin as well.
At the end of the surgery, the interventional radiologist withdraws the catheter then presses the incision site firmly for some time, to prevent any bleeding.
Benefits of PAE
Compared with surgeries such as prostatectomy (removal of part or all of the prostate) and transurethral resection of the prostate (which involves removing tissue through an instrument inserted into the penis), PAE offers several advantages:
- No need for hospitalization because it is an outpatient procedure
- very less pain as the incision is like a pinhole either in your wrist or groin area
- faster recovery time
- The risk for sexual complications like retrograde ejaculation (a condition in which semen goes into the bladder instead of flowing out through the penis), and erectile dysfunction (ED) is very less
- less risk of urinary incontinence
- No need of indwelling Foley catheter (a tube inserted into the bladder to remove urine during surgery)
PAE has turned out to be the best choice for many people suffering from BPH, as it offers excellent benefits compared to other surgeries. An interventional radiologist evaluates and decides whether PAE is right for your specific condition.
To know more details about this procedure or suffering from any urinary problems, consult Dr. Pradyumna Reddy, one of the best radiologists who has more than 12+ years of experience.