Prostate Artery Embolization (PAE)
A Minimally Invasive Procedure
What are the most common symptoms of Benign Prostatic Hyperplasia (BPH)
The most common symptoms include:
- Increased frequency of urination with voiding small amounts of urine, particularly at night
- Weak and/or interrupted urinary stream
- Sensation of incomplete bladder emptying after urination and/or difficulty in starting urination
- Urinary urgency with difficulty controlling urination
- Inability to urinate, resulting in urinary retention and leading to catheterization
- Blood in the urine
- Erectile dysfunction, generally caused by medication
What is the prostate?
The prostate is an accessory organ of the male reproductive system. Located below the bladder and shaped like a walnut, it produces a slightly thick fluid that helps preserve sperm after ejaculation, helping it to remain viable outside the body. Because the prostate surrounds the urethra, urination can be affected when prostate disease is present.
Symptoms related to Benign Prostatic Hyperplasia (BPH) are present in about one in four men by age 55, and in half of 75-year-old men. Treatment is only necessary if symptoms become bothersome. The PAE procedure has a lower risk of urinary incontinence and sexual side effects when compared with more invasive surgical procedures.
The objective of PAE is to interrupt the arterial blood supply to the prostate. PAE targets the central enlarging tissue predominantly. With reduced blood supply the abnormally enlarged prostatic tissue atrophies and this relieves pressure on the urethra. The consequence of this is that lower urinary tract symptoms improve or disappear.
An analysis of “real-world” clinical practice data shows African-American men with BPH have a much great risk of developing prostate cancer than similar Caucasian men. This highlights the need for education and early detection for African-American men.
What happens during Prostate Artery Embolization?
- PAE is performed through a small catheter inserted by your doctor into the artery in your wrist or groin. The doctor will then guide the catheter into the vessels that supply blood to your prostate.
- An arteriogram (an X-ray in which dye is injected into the blood vessels) is done to map the blood vessels feeding your prostate.
- Tiny round microspheres (particles) are injected through the catheter and into the blood vessels that feed your prostate to reduce its blood supply.
- The doctor will move the catheter in order to treat the other side of your prostate, repeating the steps above.
- If a Foley catheter (a thin, hollow tube held in place with a balloon at the end) has been inserted into your urethra and positioned in your bladder to provide a reference point for the surrounding anatomy it will be gently removed at the conclusion of the procedure.
- Following this procedure, the prostate will begin to shrink, relieving and improving symptoms usually within days of the procedure.
- Blood in the urine is largely diminished or eliminated. An analysis of “real-world” clinical practice data shows African-American men with BPH have a much great risk of developing prostate cancer than similar Caucasian men. This highlights the need for education and early detection for African-American men.
PAE is typically covered by insurance.
What is the success rate of Prostate Artery Embolization?
Prostate Artery Embolization has a high rate of success. Unlike other treatments that may have unwanted sexual side effects, PAE does not affect sexual performance. It may allow for the removal of an indwelling catheter and the termination of catheter dependence.
Our Medical Director
Phillip T. Zeni, Jr., M.D., FSIR is a board-certified Interventional Radiologist with over twenty years of experience serving patients in the greater Memphis metropolitan area.
He is the founding owner and medical director of Zenith Vascular & Fibroid Center. He previously served as the Chairman of Interventional Radiology for Baptist Memorial Healthcare more than fifteen years. He was the first physician to perform Prostate Artery Embolization (PAE) in the city of Memphis.