Benign prostatic hyperplasia (BPH), or an enlarged prostate, may not be a life-threatening condition, but its symptoms can seriously impact quality of life for those suffering from it. For many, deciding how to treat BPH comes down to weighing how bad their daily struggles with urinary problems are against the possible side effects from corrective surgery, especially when lifestyle changes or medication are ineffective in alleviating symptoms. For those hesitating at the thought of surgery, prostate artery embolization is a relatively new, safer outpatient procedure to shrink the prostate without unwanted sexual side effects.
Prostate artery embolization (PAE) is a minimally invasive technique performed by an interventional radiologist that targets the blood supply to overgrown prostate tissue. When this blood supply is reduced, the tissue naturally dies back and is reabsorbed by the body gradually. Unlike surgery, which may require general anesthesia, hospitalization, and significant recovery time in addition to potential side effects, PAE is performed under local anesthesia, allowing you to go home the same day. Because you have only a small incision and no tissue is removed, the recovery time is very short. PAE can also be a suitable alternative for patients who need relief from BPH symptoms but can’t undergo surgery due to underlying conditions or medication such as blood thinners.
The prostate is surrounded by nerves and structures that are vital to normal urinary and sexual function, so having surgery to alleviate the symptoms of BPH carries an inevitable risk of producing unwanted changes to those functions. Potential side effects include permanent urinary incontinence, erectile dysfunction, and retrograde ejaculation.
Due to these risks, surgery is normally not recommended for benign prostatic hyperplasia until symptoms have become moderate or severe and lifestyle changes and medications have failed to produce any improvement. Complications from BPH can include recurrent urinary tract or bladder infections, bladder stones that can lead to blood in the urine or urinary obstruction, kidney damage, or urinary retention. PAE is effective in preventing or lessening these kinds of complications, without the risks of surgery.
Prostate artery embolization is an image-guided procedure performed by an interventional radiologist. First, a small incision is made in the groin to insert a catheter through the artery that supplies blood to the prostate. After the catheter is guided to the appropriate location, a solution containing thousands of microscopic plastic beads is injected to block blood flow, a process known as embolization. This is repeated on the other side of the prostate, also using the original incision for access. Depending on the size and location of the affected prostatic arteries, the entire procedure can take from one to four hours.
PAE does not require the use of general anesthesia; patients receive medication to keep them comfortable and relaxed and to eliminate pain. No hospitalization is required, and patients experience minimal discomfort during the procedure. Patients are able to return to normal activity afterward much more quickly than they can with surgery, and they report few side effects.
One important thing to note is that because PAE does not involve physical removal of any part of the prostate, results may not be apparent immediately. However, patients usually start experiencing significant results in one to two months, with continued improvement until five to six months after the procedure. Over this period, the prostate shrinks about 20 to 40 percent, alleviating the pressure on the urethra that causes slow or obstructed urine flow and producing long-term relief from the troublesome symptoms of BPH.
At the Vein & Fibroid Treatment Center, we specialize in minimally invasive treatments that allow patients to avoid surgery for conditions like an enlarged prostate. Board-certified interventional radiologist Dr. Saleh has over a decade of experience in innovative techniques such as prostate artery embolization that deliver improved results with faster recovery and a reduced risk of unwanted side effects. To learn more about PAE or to book a consultation, contact the Vein & Fibroid Treatment Center here.