Prostatic Artery Embolization

How the Procedure Works

Our interventionL radiologists at AUNC perform PAE by accessing the arterial system, usually through a small puncture in the wrist (radial artery) or the groin (femoral artery). Using advanced X-ray guidance (fluoroscopy), the physician navigates micro-catheters into the tiny prostatic arteries on both sides of the pelvis. Once the target vessels are reached, microscopic particles are injected to block the blood flow to the prostate gland. Deprived of its blood supply, the prostate gradually shrinks over the following weeks and months, relieving pressure on the urethra and alleviating urinary symptoms.

Ideal Candidates

• Men experiencing moderate-to-severe lower urinary tract symptoms (LUTS) due to BPH that have not responded adequately to medications.
• Patients who want to avoid the potential sexual side effects of traditional surgery, such as retrograde ejaculation.
• Individuals who are poor candidates for conventional surgery due to age, overall health, or the use of blood thinners.
• Patients seeking to avoid or discontinue long-term medical therapydue to side effects.

Key Benefits

• Minimally Invasive
• No Surgical Incisions
• Preservation of Sexual Function: Preserves erectile function and carries a very low risk of retrograde ejaculation compared to surgical alternatives.
• Outpatient Procedure: Avoiding the high costs of hospitals.
• Rapid Recovery: Most patients returning to normal daily activities within a few days.
• Catheter-Free

Potential Risks and Side Effects

While PAE is generally safe, like any medical procedure, it carries potential risks. Most side effects are temporary and mild:

• Post-Embolization Syndrome: A temporary flu-like condition including mild pelvic pain, nausea, fatigue, and low-grade fever, typically lasting a few days.
• Urinary Symptoms: Temporary worsening of urinary urgency, frequency, or burning during the first week as the prostate shrinks.
• Non-Target Embolization: A rare risk where microspheres travel to unintended tissues (such as the bladder wall or rectum), potentially causing localized irritation or injury.
• Urinary Retention: A temporary inability to urinate, occasionally requiring short-term catheterization.
• Infection: A low risk of urinary tract infection or infection at the access site.

What to Expect: Recovery and Results

• Recovery Timeline: Patients typically rest in the recovery area for a few hours post-procedure and are discharged home the same day. Strenuous activity should be avoided for about a week.
• Symptom Improvement: Relief is not instantaneous; as the prostate gradually shrinks over 1 to 3 months, urinary flow improves and symptoms such as nighttime waking (nocturia), hesitancy, and urgency subside.
• Long-Term Efficacy: Clinical studies show sustained symptom relief and improved quality of life for years following the procedure, though a small percentage of patients may require retreatment down the line.