PROSTATE ARTERY EMBOLIZATION (PAE) for BENIGN PROSTATIC HYPERPLASIA (BPH)
Arizona Interventional Associates (AIA) specializes in interventional radiology for the treatment of a variety of conditions. AIA is especially focused on prostate artery embolization (PAE), an exciting and advanced therapy for the treatment of BPH that is safer, less painful, has a shorter recovery time, and has fewer urinary and sexual side effects thanks to the minimally invasive nature of the procedure. Prostate artery embolization is a great alternative to transurethral resection of the prostate (TURP) surgery for those with BPH, and is the only FDA-approved non-surgical intervention for this condition.
What Is Prostate Artery Embolization (PAE)?
Prostate artery embolization (PAE) is a minimally invasive procedure for the treatment of benign prostate hyperplasia (BPA) that uses vascular interventional radiology to target arteries supplying the enlarged prostate and temporarily block them to cause the prostate to shrink, soften, and absorb over time. During the procedure, the doctor will make a small puncture in a wrist or groin artery, then gently guide a small, flexible tube called a microcatheter into the prostate arteries. Then, the microcatheter delivers microscopic beads into the arteries of the prostate, which temporarily blocks blood flow to reduce the size of the prostate over time.
HOW DO I KNOW IF PAE IS FOR ME?
PAE is recommended for patients who:
• Do not wish to have surgery
• Have an enlarged prostate > 50 grams
• Unsatisfactory results from BPH medication
• Have refractory meaturia
• Have chronic kidney disease
• Are on anticoagulation medications
Who Is Prostate Artery Embolization (PAE) For?
Prostate artery embolization is for the treatment of benign prostatic hyperplasia (BPH). BPH is a common, noncancerous enlargement of the prostate which can cause bladder and urinary tract obstructions, leading to symptoms such as frequent urination and inability to completely empty the bladder. Those that have these symptoms can have their eligibility for a PAE procedure determined through urinalysis, a prostate-specific antigen (PSA), a rectal exam, and/or an ultrasound or MRI of the prostate gland itself. These tests confirm BPH while ruling out cancer, which would require other interventions. Generally speaking, patients will need to have tried a BPH medication for at least 6 months before being considered a candidate for prostate artery embolization.
75 — 80% of men who undergo prostate artery embolization report satisfactory symptom improvement.1
How Do I Know if I Have Benign Prostate Hyperplasia (BPH)?
Half of all men 51 – 60 years old, and up to 90% of men older than 80 have BPH1. With 14 million American men with BPH1, it is among the most common age-related health conditions.
The prostate gland is located next to the bladder. When it grows in BPH, it pushes against the urethra and can block the flow of urine. This causes frequent and/or urgent needs to urinate (especially at night), difficulty beginning urination, a weak urine stream, and an inability to completely empty the bladder. BPH is also correlated to erectile dysfunction and reduced libido. If BPH is left untreated, it can cause a host of problems, including urinary tract infections (UTIs), bladder or kidney damage, bladder stones, urinary retention, and even chronic renal failure.
Advantages of Prostate
Artery Embolization for
Treatment of BPH
Prostate artery embolization has numerous advantages over older interventions for BPH such as transurethral resection of the prostate (TURP) surgery.
Fast, 1-hour procedure
Fast recovery
Outpatient operation with light sedation—no general anesthesia
No surgical incisions or insertion of devices into the urethra
Minimal side effects which resolve within 1 – 3 days
Much lower risk of bleeding and complications than invasive surgeries like TURP
Extremely low complication rates
No reports of impotence or incontinence
Symptoms improve within 2 – 3 weeks
Prostate Artery
Embolization
Risks
Prostate artery embolization is considered safe and effective. However, like all medical interventions, PAE carries risks of complications and side effects. The most impactful complication of PAE is nontarget embolization, when microparticles are accidentally injected into arteries supplying either the bladder or rectum rather than the prostate. This can potentially cause necrosis and organ damage. However, with the use of the latest interventional radiology imaging technology and simulated injections before the actual injection proceeds, the risk of nontarget embolization has been minimized.2
Side effects can occur following the PAE procedure, which may include brief periods of blood in the urine, semen, or stool, or a bout of urinary retention. Sometimes post-PAE syndrome occurs, which causes urinary urgency and frequency, dysuria, and/or pelvic pressure/pain. Puncture site bleeding or infection may also occur. In the vast majority of cases, these side effects resolve on their own, or can be treated with medications.2
Dr. Aaron Brandis graduated Summa cum Laude with honors from the University of Arizona in 2004 where he received a Bachelor of Science in Biochemistry and Molecular Biophysics. He then went on to study medicine at the University of Arizona in Tucson. During his time in medical school, he received many honors including membership in the Alpha Omega Alpha medical honor society and the Gold Humanism Foundation, as well as the outstanding senior medical student award for the class of 2008. He completed his internship in General Surgery at the Mayo Clinic Arizona, followed by his residency in Diagnostic Radiology at University of Pennsylvania Health System, Pennsylvania Hospital in Philadelphia. He underwent subspecialty fellowship training in Vascular and Interventional Radiology at the University of Pennsylvania.