Prostate Artery Embolization: A Minimally Invasive Treatment for Enlarged Prostate
Frequent urination. Waking up multiple times during the night. Urgency. A weak urinary stream. Feeling like your bladder never completely empties.
For many men, these symptoms become increasingly common with age. One of the most frequent causes is benign prostatic hyperplasia, or BPH, commonly referred to as an enlarged prostate.
Medications are often the first step in treating BPH. But what happens when medications are no longer providing enough relief, cause unwanted side effects, or you simply do not want to take them indefinitely?
For some men, prostate artery embolization, or PAE, can provide another option between medication and traditional prostate surgery.
At Image Guided Solutions of Missouri in Columbia, Missouri, interventional radiologist Dr. Kavi Devulapalli performs prostate artery embolization as a minimally invasive treatment for appropriately selected men experiencing symptoms from an enlarged prostate.
Why Does an Enlarged Prostate Cause Urinary Problems?
The prostate is a small gland located beneath the bladder. The urethra, the tube that carries urine out of the body, passes directly through it.
As men age, the prostate commonly grows larger. This condition is called benign prostatic hyperplasia. BPH is not prostate cancer, but the growing prostate can squeeze the urethra and make it harder for urine to pass.
The bladder then has to work harder to empty.
Common symptoms can include:
- Frequent urination
- Urinary urgency
- Waking multiple times at night to urinate
- Weak urinary stream
- Difficulty starting urination
- Straining to urinate
- Feeling that the bladder has not completely emptied
- Urinary retention in more severe cases
Symptoms can begin during a man's 40s and tend to become increasingly common after age 50.
When Are BPH Medications No Longer Enough?
Many men initially manage enlarged prostate symptoms with lifestyle changes and medications such as alpha blockers, including tamsulosin, commonly known as Flomax, or other BPH medications.
For some patients, medication works very well.
Others eventually reach a point where symptoms continue despite medication. Some experience dizziness, sexual side effects, or other unwanted effects. Others simply do not want to continue adding medications indefinitely.
Traditionally, the next step has often been a surgical procedure performed by a urologist.
That can feel like a substantial jump from taking medication.
Prostate artery embolization can help fill that gap for certain patients by providing a minimally invasive alternative to traditional prostate surgery.
What Is Prostate Artery Embolization?
Prostate artery embolization is an image-guided procedure performed by an interventional radiologist.
Instead of surgically removing prostate tissue, PAE works through the blood vessels supplying the prostate.
During the procedure, a very small catheter is inserted through a tiny opening in an artery, generally near the hip or sometimes through the wrist. Using ultrasound and live X-ray imaging, the physician carefully guides the catheter into the arteries supplying the prostate.
Tiny particles are then delivered into those arteries.
These particles reduce blood flow to selected areas of the prostate. Over time, the prostate tissue shrinks, reducing pressure around the urethra and helping improve urinary symptoms.
There is no surgical incision, and no prostate tissue is physically removed.
What Is the PAE Procedure Like?
At Image Guided Solutions of Missouri, prostate artery embolization is performed as an outpatient procedure in Columbia, Missouri.
Patients typically receive local anesthetic along with light sedation rather than general anesthesia.
Depending on a patient's anatomy and blood vessels, the procedure may take approximately one to two hours. Patients return home the same day and will need someone to drive them home because of the sedation.
Unlike many traditional prostate surgeries, most patients who do not already have a urinary catheter will not need one following PAE.
How Long Does Recovery Take After PAE?
Recovery from prostate artery embolization is typically relatively short.
During the first several days, patients may temporarily experience increased urinary frequency, inflammation, discomfort, or other urinary symptoms. Medication can help control these symptoms.
Dr. Devulapalli generally recommends avoiding strenuous activity and lifting more than approximately 10 pounds during the first week.
Most patients can otherwise return to normal activity relatively quickly.
The important thing to understand is that PAE does not produce immediate results.
Because the prostate gradually shrinks after treatment, improvement typically develops over several weeks.
Many patients begin to notice improvement around the first month, with further improvement over the following two to three months. A stronger urinary stream and improved bladder emptying may appear first, while symptoms such as waking frequently during the night may take longer to improve.
Who May Be a Candidate for Prostate Artery Embolization?
PAE may be worth discussing if you:
- Have moderate to severe urinary symptoms from BPH
- Have already tried medications without enough improvement
- Experience unwanted medication side effects
- Want to avoid traditional surgery or general anesthesia
- Have a particularly large prostate
- Want to minimize the risk of sexual side effects
- Have medical conditions that may increase the risks of traditional surgery
- Take blood-thinning medication
- Currently require a urinary catheter because of prostate-related urinary retention
Having a larger prostate can actually make PAE particularly useful for some patients, including men whose prostate size may limit other treatment options.
However, prostate artery embolization is not the right procedure for everyone.
Image Guided Solutions of Missouri typically performs a detailed consultation, reviews medical history and treatment goals, and may obtain CT or MRI imaging to evaluate the prostate and blood vessels before treatment.
Dr. Devulapalli also recommends involving a urologist in the patient's care. Urinary symptoms can have causes other than BPH, and evaluation for prostate cancer and other urologic conditions remains important.
Prostate Artery Embolization in Columbia, Missouri
Men throughout Mid-Missouri do not necessarily have to choose between living with worsening urinary symptoms and immediately pursuing traditional prostate surgery.
Prostate artery embolization in Columbia, Missouri provides another treatment option for men with BPH who want to explore a minimally invasive approach.
Image Guided Solutions of Missouri performs PAE in Columbia and evaluates patients from throughout Missouri to determine whether the procedure is appropriate for their condition and goals.
If enlarged prostate symptoms are affecting your sleep, travel, work, daily activities, or quality of life, the next step is a consultation to understand all of your treatment options.
Schedule your consultation today!
Frequently Asked Questions About Prostate Artery Embolization
Is prostate artery embolization surgery?
No. PAE is a minimally invasive image-guided procedure performed through the arteries. It does not require a traditional surgical incision or removal of prostate tissue.
Is PAE performed under general anesthesia?
Typically, no. Dr. Devulapalli performs the procedure using local anesthetic and light sedation.
How quickly does prostate artery embolization work?
Improvement is gradual. Many patients begin noticing changes approximately one month after treatment, with further improvement developing during the next two to three months.
Will I need a catheter after PAE?
Most patients who do not already have a catheter will not require one after the procedure. Dr. Devulapalli noted that the likelihood is generally less than 10%.
Can PAE be performed on a very large prostate?
Yes. In fact, patients with larger prostates can be particularly well suited for prostate artery embolization. Candidacy still depends on the individual's anatomy, symptoms, and overall health.
Does PAE affect sexual function?
Because PAE works through the blood vessels rather than surgically removing tissue through the urethra, it is designed to minimize sexual side effects compared with many traditional prostate surgeries.
Can I stop taking my prostate medication after PAE?
Patients generally continue their medication initially. If symptoms improve sufficiently, medication may later be discontinued under the direction of the treating physician.
Do I need to see a urologist before considering PAE?
You can consult with an interventional radiologist about PAE, but urologic evaluation remains an important part of care. A urologist can help rule out other causes of urinary symptoms and evaluate prostate cancer risk.
Is prostate artery embolization permanent?
The prostate can grow again over time after any BPH treatment. Dr. Devulapalli noted that symptoms can eventually return in some patients and PAE may be repeatable when appropriate.
Where is prostate artery embolization offered in Mid-Missouri?
Image Guided Solutions of Missouri offers prostate artery embolization in Columbia, Missouri, and evaluates men from throughout the state who are interested in minimally invasive treatment for BPH.
This article is for educational purposes and is not a substitute for individualized medical advice. Treatment recommendations depend on each patient's symptoms, medical history, imaging, and evaluation by their healthcare providers.