April 24, 2024
Prostatic Artery Embolization

Prostatic Artery Embolization: A Minimally Invasive Option for Treating Enlarged Prostate

 Prostatic Artery Embolization

Prostatic artery embolization (PAE) is a minimally invasive treatment option for patients with symptomatic benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate. PAE involves blocking the blood flow to the prostate gland by injecting tiny gelatin or plastic particles, known as embolic agents, into the arteries that supply blood to the prostate. This results in a reduction of prostate size without the need for surgery.

How is Prostatic Artery Embolization Performed?

PAE is performed as an outpatient procedure under local anesthesia. The doctor first inserts a catheter into the femoral artery in the groin. Using angiography and fluoroscopy for imaging guidance, the catheter is navigated through the blood vessels until it reaches the prostatic arteries. Contrast dye is injected to identify the prostatic arteries and ensure the placement of the catheter tip is correct. Then a mixture of embolic agents is injected into the prostatic arteries, blocking the blood flow. The whole procedure takes about an hour and patients can usually return home the same day. There is little to no downtime after the procedure.

Effectiveness of Prostatic Artery Embolization

Clinical studies have found Prostatic Artery Embolization to be an effective treatment for relieving BPH symptoms such as frequent urination, weak urine stream, urgency, and straining. After the procedure, most patients report significant improvement in their urinary symptoms within 3 months. Prostate size is also reduced, on average by 25-30%, leading to less obstruction of urine flow. The effects of PAE appear to be long-lasting, with studies showing sustained symptom relief and prostate size reduction for up to 5 years after the procedure. The success rates of PAE are comparable to other minimally invasive options like transurethral resection of the prostate (TURP) surgery.

Advantages Over Surgery

As a minimally invasive treatment, PAE offers several advantages over traditional surgical procedures for enlarged prostate such as TURP. PAE does not require general anesthesia, so patients can return home the same day. It leads to less post-procedure pain, lower risks of side effects, and a faster recovery time compared to surgery. There is no need for catheterization after PAE. There is also no risk of erectile dysfunction or retrograde ejaculation which can occur after prostate surgery due to less trauma to the tissues. PAE provides an alternative for patients who aren’t candidates for surgery due to anticoagulation therapy or medical conditions. With PAE, the risk of bleeding complications is lower than with surgery as well.

Potential Risks of Prostatic Artery Embolization

While PAE is generally a low-risk procedure, there are still some potential risks to be aware of:

– Groin pain or bleeding from the puncture site used to insert the catheter. This is usually mild and temporary.

– Risk of non-target embolization if the embolic agents enter blood vessels outside the prostate, such as the bladder or rectum. This can cause temporary symptoms like pain, urgency or bleeding.

– Erectile dysfunction, although risk is lower than with surgery.

– Urinary retention requiring temporary catheter. This occurs in 5-10% of patients.

– Infection, which is rare but possible. Antibiotics may be prescribed before and after PAE to prevent this.

– The procedure may need to be repeated if BPH symptoms don’t improve adequately after PAE. Retreatment rate is about 10-15%.

As with any medical procedure, it’s important for patients considering PAE to discuss the risks and benefits thoroughly with their urologist. Close follow-up monitoring after PAE is also needed. With proper patient selection and technique, PAE can safely and effectively treat enlarged prostate issues

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it