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Prostate artery embolization

BPH is a common condition that affects most men, starting at age 40. Prostate artery embolization (PAE) has emerged as an alternative to more invasive surgical procedures for the treatment of prostate enlargement (BPH). This minimally invasive procedure is available at our new Interventional Radiology Center in Worthington, OH.

 

BPH is the most common urological condition men face and the leading reason that men visit a urologist.

As the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms such as:

  • Frequent need to urinate both day and night
  • Weak or slow urinary stream
  • A sense that you cannot completely empty your bladder
  • Difficulty or delay in starting urination
  • Urgent feeling of needing to urinate
  • A urinary stream that stops and starts

What is prostate artery embolization and how does it work?

PAE is an interventional radiology procedure that injects small particles directly into the arteries (blood vessels) that supply blood to the prostate, which leads to devascularization (decrease in blood supply) of the obstructing portion of the prostate.

When the prostate reduces in size, (because the blood supply is slowed), there is lessening of obstruction along the urinary pathway and less pressure on the bladder.

Where does prostate artery embolization fit in with the other treatment options for BPH?

The standard approaches to address urinary bother associated with the enlarged prostate are procedures that remove the part of the prostate that blocks the urinary pathway, and include TURP, greenlight laser, and HOLEP. These procedures can provide excellent outcomes for patients but are associated with potential hazards which can include sexual dysfunction, bleeding (which may require blood transfusion), and incontinence.

Alternative minimally invasive surgical techniques now available include Urolift and Rezum. Of note, the minimally invasive procedures are restricted by the size of the prostate, and if the prostate is too large, then the minimally invasive techniques are less likely to provide benefit.

PAE is an increasingly used treatment option for the management of lower urinary tract symptoms associated with prostate enlargement (BPH). It provides an innovative and effective alternative to surgical procedures and offers the opportunity for fewer hazards related to treatment.

How is prostate artery embolization done?

The PAE procedure is carried out by an interventional radiologist. A tiny catheter is placed through the artery in the groin (called the femoral artery) and directed under x-ray vision to the prostate artery, so that small particles can be placed into the prostate artery to decrease the blood supply to the prostate.  It is an outpatient procedure, carried out with sedation or a ‘twilight sleep’, and does not require general anesthesia.

What are the benefits, and what are the potential hazards?

The PAE procedure can lead to improvement in urination, with reduction of bothersome symptoms and improvement in quality of life.

Potential burdens of treatment include the post-operative temporary presence of blood in the urine, blood in the semen, and a temporary (5-7 days average) increase in urinary frequency. There is a rare potential for urinary tract infection, or urinary catheterization or skin discoloration, however these are not encountered frequently. Patients typically do not have bothersome pain after the procedure. The procedure does not also typically involve placing a urinary catheter or anything via the penis.

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These conditions can now be treated in our new, office-based, outpatient Interventional Radiology suite located in Worthington.

Worthington

350 W. Wilson Bridge Road Worthington, OH 43085

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