What is benign prostatic hyperplasia (BPH)?
Benign Prostatic Hyperplasia or (BPH) is an enlarged prostate gland. BPH is the most common non-cancerous prostate problem in patients.
Urinary symptoms of BPH include:
- hesitancy
- incomplete emptying of bladder,
- weak or intermittent stream,
- straining
- dribbling
- frequency
- urgency
- urine leaks
- nighttime urination
What is a prostate arterial embolization (PAE)?
- PAE is a new minimally invasive procedure that treats BPH.
- It reduces the blood supply to the enlarged prostate in order to shrink it.
- The shrinking of the prostate decreases pressure on the urethra (portion of the urinary tube that travels through the prostate).
- The decreased pressure on the urethra helps improve BPH related urinary symptoms.
- Interventional radiologists and urologists work together in order to identify patients with lower urinary tract symptoms due to BPH and to recommend the best treatment options.
How is PAE Performed?
- The procedure consists of a catheter being placed through a groin artery and then into the small arteries that feed the prostate gland.
- Tiny beads are then inserted through the catheter into the prostatic artery.
- The beads are permanently lodged in the arteries to reduce the blood flow to the prostate.
- Hackensack University Medical Center has state-of-the-art technology, including Cone Beam CT, to guide the procedure.
- A Cone Beam CT Scan is a special X-ray machine that provides a three dimensional image of your prostate during the procedure.
- Utilizing Cone Beam CT increases safety for patients and minimizes the risk of complications from the procedure.
Risks and Benefits of PAE
What are the possible benefits of PAE?
- The PAE procedure is a minimally invasive procedure.
- It is usually performed as an outpatient procedure.
- PAE has a lower risk of sexual dysfunction than many other treatments for BPH.
- Approximately 80% of patients experience an improvement in overall urinary symptoms when both prostate arteries can be embolized
- Patients experience noticeable improvement in urinary symptoms over a period of weeks to month
What are the possible risks of PAE?
- A delayed urinary tract infection is possible, however, it rarely occurs. The procedure is performed in a sterile environment.
- The puncture site is sealed after the procedure. However, rare delayed bleeding at the puncture site is possible.
- Rarely, temporary acute urinary retention (the inability to urinate) for a couple of weeks requiring an indwelling catheter.
- There have been rare reports in the literature of non-target embolization, which occurs if beads enter vessels supplying adjacent structures. However, the use of Cone Beam CT during the procedure decreases this risk.
What factors can make the procedure less effective or more challenging?
The procedure may be less effective if you have a weak or spastic bladder or no bladder function. On rare occasions, selecting the prostatic artery may be challenging due to individual severe hardening, narrowing, and/or twisting of arteries.