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.
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.
Dr. Brian Stephen Wong graduated from Emory University with a Bachelors of Science in Chemistry. He earned an academic scholarship to attend Texas Tech Health Sciences Center School of Medicine, where he completed the combined medical doctorate /masters in public health (MD/MPH) program. He completed a transitional year at University of Central Florida-Ocala Regional Medical Center. He then completed his Diagnostic Radiology residency training at University of Texas Medical Branch and was selected for the early specialization in interventional radiology (ESIR) pathway where continued to actively engage in clinical care.
During residency, Dr. Wong was selected for multiple awards including the Outstanding Resident Leadership Award and Resident Research Award. He travelled to the South Pole during the Covid-19 pandemic and earned an Antarctica Service Medal for his role in direct patient care for members of the National Science Foundation and US Antarctic Program. He served as the Membership Co-chair for the Residents, Fellows, and Students Section of the Society of Interventional Radiology (SIR). He has earned multiple awards including the Resident In-training scholarship for the Society of Interventional Oncology (SIO). He has presented in multiple national and international conferences including the European Congress on Interventional Oncology (ECIO) and authored publications in peer-reviewed journals and book chapters on interventional oncology.
As a fellow at Miami Cardiac and Vascular Institute, he continued his clinical education on peripheral vascular, aortic, venous, oncologic, hepatobiliary, and urologic disease. He interpreted studies for the multispecialty noninvasive vascular lab and participated in enrolling patients onto clinical trials.
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