Prostate Artery Embolization

BPH is a widespread concern amongst men as they reach middle age. Typically, men start to experience the symptoms of BPH around the age of 50. By this time, about half of all men may be waking at night to urinate, experiencing urge or frequency of urination, and managing the feeling of incomplete emptying of the bladder. This is due to the enlargement of the prostate that restricts the free flow of urine through the urethra and out of the body. Many men are reluctant to undergo treatment for their BPH because they modify their lifestyle to cope – often by drinking less and only performing activities that are near a bathroom. However, the limiting effect of these activities and habits not only delays the inevitable further growth of the prostatic tissue but also impedes their lifestyle in many significant physical and psychological ways.

We often see men who have waited years, or even decades, to have their BPH treated. Treatment has changed their lives so dramatically that they feel an unbelievable sense of relief and excitement when they can perform the activities they once avoided. They are finally free without worrying about being near the bathroom or the potential embarrassment of leakage during an event or activity.

To that end, there are many BPH treatment options, and one such treatment is prostate artery embolization (PAE).

What Is PAE? How Does It Work?

PAE involves reducing blood supply to the prostate to shrink it. The procedure is performed under anesthesia by an interventional radiologist. During the procedure, a catheter or thin tube is inserted into the hip or groin and threaded down into a prostatic artery, one of the vessels that feeds the prostate with blood. Small pellets or microspheres are deployed into the artery to cork it and limit the amount of blood reaching the prostate. This is repeated in another blood vessel. Strategically placing these microspheres allows the radiologist to cause cell death that shrinks the prostate by anywhere from 20 to 30%, allowing patients to enjoy some relief from their BPH symptoms.

PAE Combined with Aquablation

For men with more significant enlargement and certain qualifying patients, Aquablation, a minimally invasive, non-thermal procedure that uses jets of water to blast away prostatic tissue, is well suited for pairing with PAE. Just a few days after the initial embolization procedure, Aquablation can be performed. These two procedures, in combination, can shrink prostatic volume dramatically and give patients symptom-free voiding for up to 10 to 15 years.

In addition to the mechanical benefits of both procedures, performing an ablation after a PAE further reduces the rare risk of bleeding after an Aquablation. Because Aquablation does not use thermal or heat technology to destroy the prostatic tissue, the inevitable blood loss from cutting small vessels requires a touchup to cauterize these areas and stop the bleeding. However, since the PAE procedure already limits prostatic blood supply, the risk of significant blood loss and blood transfusion is significantly reduced. In fact, in a study evaluating this combination procedure, no patient with PAE followed by Aquablation required a blood transfusion.

Is PAE Right for Me?

Working with a practice like Georgia Urology has many benefits, not least of which is that we have a wide variety of BPH treatments that run the gamut from minimally invasive five-minute procedures performed in the office to robotic surgical procedures performed in a hospital setting. Choosing a urologist with experience in many, if not all, of these therapies, allows you to make an informed decision without being guided toward a less unsuitable procedure. Fortunately, all the BPH procedures we offer are effective and safe in qualifying patients; therefore, it just remains for you to visit a qualified urologist and understand your best options. It’s important to remember that you don’t need to suffer from the symptoms of BPH any longer. There is a therapy for any size and anatomy of the prostate.

Feel free to book your consultation with one of our doctors, during which we can discuss your options.