Benign prostatic hyperplasia (BPH) is a non-cancer medical condition, which occurs when the prostate gland becomes larger and bigger than normal. The prostate is a small organ in men that can press the urethra, a tube that carries urine. BPH is a common condition in men over 50 years of age. This is generally not dangerous, but it can be uncomfortable. Treatment of BPH includes lifestyle changes, medications, or surgery, and it depends on how bad or severe the symptoms are. Lately, prostatic artery embolization (PAE), is preferred as an effective treatment option for BPH.
What Is Prostate Artery Embolization?
Prostatic artery embolization (PAE) is a minimally invasive and simple treatment to help with urine problems caused by an enlarged prostate (BPH). PAE Procedure is performed by a special doctor, called an interventional radiologist, who uses X-rays and other latest imaging technologies, and directs the process without surgery. They prevent, block blood flow in the prostate, which causes it to shrink and reduces urinary problems within a few days of the PAE procedure.
Who Is a Candidate for PAE?
PAE, or Prostate Artery Embolization, is generally considered for men with moderate to severe BPH symptoms, who cannot undergo surgery, or who prefer minimally invasive options. Ideal candidates are often more than 50 years old, and the size of the prostate is usually larger than 30-40 grams. It is ideal for those patients who may face risk during surgery due to other health conditions. It is also suitable for those who didn’t respond well to medication for BPH. Candidates should discuss their medical history and any pre-existing medical conditions with their healthcare provider to determine if PAE will suit them or not.
Symptoms That PAE Can Help With
The prostate artery embolization (PAE) helps men with problems caused by an enlarged prostate (BPH). The big prostate squeezes the tube that carries urine out of the body and causes health and lifestyle issues. There is a need to urinate more frequently, especially at night, resulting in a disturbed sleep pattern. Difficulty starting or weak urination, and as a result, the bladder is not empty after urinating. BPH can irritate the bladder, and a sudden urge to urinate, as well as dribbling or unintentional leakage of urine.
Here is how it;
Prepare: The patient gets a shot of injection to numb the area & make him stay comfortable.
Start: A small hole is made in the waist or wrist to reach the blood vessels.
Guiding the tube: A Catheter, a thin tube, is inserted and guided to the prostate using X-ray images via blood vessels.
Blocking blood: Small particles are sent through the tube to block blood flow to parts of the prostate.
Shrinkage: The prostate becomes small because blood does not reach there, which helps in solving urination problems.
Finishing Up: The process takes 1-2 hours, and most patients go home on the same day.
Looks better: The prostate shrinks over time, which makes it easier to urinate and reduces problems like frequent urination, urge to urinate at night, or sudden dribbling.
Interventional radiologist job: This doctor is trained to direct the tube and use X-rays to place particles in the right place, ensuring that the process works well.
Benefits of Prostate Artery Embolization
Prostate Artery Embolization (PAE) has the following benefits;
- Less Invasive: PAE isn’t surgery. It uses a tiny cut, so it’s safer and you heal faster.
- Works Well: Studies show PAE helps pee problems for most men, and most of the candidates feel better post procedure.
- Keeps Sexual Function: Unlike some surgeries, PAE usually doesn’t affect your sex life.
- Quick Recovery: You get back to normal work faster than with regular surgery.
What to Expect During the Procedure
Before starting the procedure, the doctor will check the flow of your urine with urodynamic testing and your PSA levels with blood tests. You may also need an MRI or CT scan. You should not eat or drink anything for 6 hours before the procedure, but you can take small sips of water with your medicines. If you are on medication for some other health issue, you need to consult with your health care provider, as some medicines like blood thinners are to be avoided before this procedure.
During PAE, you will be awake with light sedation and local anaesthesia, to numb the area and make you feel comfortable and relaxed - no complete anaesthesia is required. The doctor makes a small cut in your groin or wrist. A thin tube, a catheter, will be guided into the prostatic artery through advanced imaging. Microspheres or tiny particles will be injected to block the blood supply to the prostate. After that, the tube is taken out, and the cut is closed. The entire process takes 2-3 hours, and you will be observed for a short time before being discharged to your home.
Recovery and Aftercare
The recovery is fast and quick, and most people return to normal activities the next day. Mild pelvic pain or irritation when urination is normal, and it can be controlled with over-the-counter pain medicine. Drink a lot of water, eat healthy, balanced food to support recovery. Follow up with your doctor to check and monitor your progress.
Risks and Complications of PAE
PAE is usually safe, but like any other medical treatment procedure, there may be some risks. You can feel sick, Vomit, or feel nauseated, fever, pelvic or lower abdominal pain. You may feel painful/persistent urination. Bleeding from the cut site. You may see bleeding in your urine, semen or poop. Sometimes patient may feel allergic to the dye used. Very rarely, Penile Glenn Necrosis (damage to the penis tip) or serious issues such as blood clots may occur in some cases. Hence, an expert and seasoned interventional radiologist should be chosen who can help reduce these risks. Some patients may require another treatment in the next five years if the symptoms return, but PAE can often be repeated safely.
PAE vs. Traditional Surgery (TURP)
Transurethral Resection of the Prostate (TURP) and Prostate Artery Embolization (PAE) are two popular medical treatments for an enlarged prostate, called Benign Prostatic Hyperplasia (BPH). PAE is a less invasive option that works by blocking blood flow in the prostate, which shrinks. TURO is a surgery that removes an additional part of the prostate tissue.
PAE is a good choice for men with troubled urinary symptoms who want to avoid surgery. TURP is often better for people with severe BPH problems, such as when urine flows are completely blocked. PAEs have a low risk of issues like leaking urine or reduced sex drive. TURP is more likely to cause bleeding, infection, or other surgical problems. Cost-wise, PAE is usually cheaper than TURP.
Choosing between PAE and TURP depends on one’s symptoms, prostate size, health, and preferences. An experienced urologist can help determine the most appropriate treatment option after evaluating the patient's health situation.
(This article is meant for informational purposes only and must not be considered a substitute for advice provided by qualified medical professionals.)
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