Prostate Artery Embolization
Prostate enlargement (BPH) Is a common condition that affects most men, starting at age 40.
Our BPH webpage provides an overview of the evaluation of the condition, and a review of the treatment options available.
What is prostate artery embolization? How does it work?
Prostate artery embolization (PAE) has emerged as an alternative to more invasive surgical procedures.
PAE is an interventional radiology procedure that injects small particles directly into the arteries (blood vessels) that supply blood to the prostate, which leads to devascularization (decrease in blood supply) of the obstructing portion of the prostate.
When the prostate reduces in size, (because the blood supply is slowed), there is lessening of obstruction along the urinary pathway and less pressure on the bladder.
Watch a quick overview here: PAE Animated Procedure Overview
Where does prostate artery embolization fit in with the other treatment options for BPH?
The standard approaches to address urinary bother associated with the enlarged prostate are procedures that remove the part of the prostate that blocks the urinary pathway, and include TURP, greenlight laser, and HOLEP. These procedures can provide excellent outcomes for patients but are associated with potential hazards which can include sexual dysfunction, bleeding (which may require blood transfusion), and incontinence.
Alternative minimally invasive surgical techniques now available include Urolift and Rezum. Of note, the minimally invasive procedures are restricted by the size of the prostate, and if the prostate is too large, then the minimally invasive techniques are less likely to provide benefit.
PAE is an increasingly used treatment option for the management of lower urinary tract symptoms associated with prostate enlargement (BPH). It provides an innovative and effective alternative to surgical procedures and offers the opportunity for fewer hazards related to treatment.
How is prostate artery embolization done?
The PAE procedure is carried out by an interventional radiologist. A tiny catheter is placed through the artery in the groin (called the femoral artery) and directed under x-ray vision to the prostate artery, so that small particles can be placed into the prostate artery to decrease the blood supply to the prostate.
It is an outpatient procedure, carried out with sedation or a ‘twilight sleep’, and does not require general anesthetia.
What are the benefits? What are the potential hazards?
The PAE procedure can lead to improvement in urination, with reduction of bothersome symptoms and improvement in quality of life.
Potential burdens of treatment include the post-operative temporary presence of blood in the urine, blood in the semen, and a temporary (5-7 days average) increase in urinary frequency. There is a rare potential for urinary tract infection, or urinary catheterization or skin discoloration, however these are not encountered frequently. Patients typically do not have bothersome pain after the procedure. The procedure does not also typically involve placing a urinary catheter or anything via the penis.
By Unknown author – National Cancer Institute, AV Number: CDR462221, Public Domain
What is Interventional Radiology?
Interventional radiology (IR) is a medical specialty that performs minimally invasive treatments using radiologic imaging for procedure guidance. Interventional radiology treatments have become the primary method of care for a variety of conditions. IR treatments can offer less risk, less pain and shorter recovery time compared to surgery.
Interventional radiologists use X-Rays, CT, MRI, or other imaging guidance to navigate small instruments through blood vessels and organs to treat a variety of diseases. Examples of treatments administered by interventional radiologists include embolization, image-guided thermal ablation, biopsy, thrombolysis, angioplasty and heart stents. These minimally invasive treatments can cure or alleviate symptoms of osteo arthritis, frozen shoulder enlarged prostate, uterine fibroids, enlarged veins, vascular disease, stroke and cancer.
Interventional radiologists are also experts at reading and interpreting X-rays, ultrasound, CTs, MRIs, and other forms of medical imaging.
What are the advantages of Interventional Radiology?
The advantages of theses minimally invasive techniques include reduced risks, faster recovery, greater comfort, and quicker return to work. The effectiveness of treatment may be better than with traditional treatments. IR is particularly relevant for patients who are in frail health or who have already undergone numerous surgeries.
Click to view PAE Info Graphic
Dr. Trevor J. Holland is a board-certified vascular and interventional radiologist dedicated to providing innovative, patient-centered care. He is excited to bring his expertise to IR Centers, where he specializes in minimally invasive procedures that enhance patient outcomes and quality of life.
Dr. Holland earned his medical degree from the University of Louisville School of Medicine. He completed his diagnostic radiology residency at Loyola University Medical Center in Hines, Illinois, and advanced his specialization with a fellowship in vascular and interventional radiology at Rush University Medical Center in Chicago, Illinois.
Dr. Holland’s clinical interests include interventional oncology treatments for liver, spine, renal, and lung tumors. He is also highly skilled in minimally invasive procedures such as uterine fibroid embolization, inferior vena cava (IVC) filter removal, and venous thromboembolism management. His philosophy of care centers on precision, compassion, and the use of the latest medical advancements to provide the best possible outcomes for his patients.
Fellowship: Vascular and Interventional Radiology, Rush University Medical Center, Chicago, IL, 2017
Residency: Diagnostic Radiology, Loyola University Medical Center, Hines, IL, 2016
Internship: Resurrection Medical Center, Chicago, IL, 2012
Medical Degree: University of Louisville School of Medicine, Louisville, KY, 2011
Dr. Holland’s dedication to his field is reflected in his extensive training and commitment to providing cutting-edge care. His passion for minimally invasive therapies and his patient-focused approach make him a valuable addition to the IR Centers team.
Dr. Larry Kelly is an experienced interventional radiologist specializing in minimally invasive, image-guided procedures to diagnose and treat a wide range of conditions. He brings a patient-centered approach to care, with a focus on providing advanced alternatives to traditional surgery that reduce recovery times and improve outcomes.
Dr. Kelly completed his medical degree at the University of Louisville School of Medicine, followed by a residency in diagnostic radiology and a fellowship in vascular and interventional radiology at the University of Cincinnati Medical Center. He is board certified by the American Board of Radiology with subspecialty certification in vascular and interventional radiology.
Throughout his career, Dr. Kelly has developed expertise in procedures including peripheral vascular interventions, embolization techniques for a variety of conditions, and image-guided treatments for oncology, pain, and women’s health. He is dedicated to maintaining the highest standards of quality and safety, and actively collaborates with referring physicians to provide comprehensive care tailored to each patient’s needs.
Dr. Kelly joins IR Centers in Louisville, where he continues to advance access to leading-edge interventional treatments for patients across Kentucky and the surrounding region.