Prostate Artery Embolization for Enlarged Prostate Treatment

Benign prostatic hyperplasia, commonly known as an enlarged prostate, is a condition that affects a significant portion of the male population as they age. In fact, research published in the Journal of Clinical Medicine indicates that BPH symptoms affect approximately 80 percent of men by 70 years of age. As the prostate gland grows, it can constrict the urethra, leading to uncomfortable and sometimes debilitating lower urinary tract symptoms. These symptoms can include increased urinary frequency, urgency, a weak stream, and the feeling of incomplete bladder emptying.

For many years, the standard approach to treating an enlarged prostate that did not respond to medication was surgery, specifically a procedure known as transurethral resection of the prostate (TURP). While TURP is effective, it is a major surgery that requires general anesthesia, a hospital stay, and a lengthy recovery period. Today, we offer a modern, minimally invasive alternative called Prostate Artery Embolization (PAE). This innovative procedure provides significant relief from BPH symptoms without the need for traditional surgery.

Understanding Prostate Artery Embolization

Prostate Artery Embolization is a cutting edge, minimally invasive procedure performed by our highly trained interventional radiologists. Instead of cutting away prostate tissue through the urethra, PAE tackles the problem by reducing the blood supply to the prostate gland itself.

During the procedure, our interventional radiologist makes a tiny pinhole puncture in the artery of the wrist or groin. Using advanced imaging guidance, a small, flexible tube called a catheter is carefully navigated through the blood vessels until it reaches the specific arteries that supply blood to the prostate. Once the catheter is in the correct position, we inject tiny, round microspheres into these blood vessels. These particles block the blood flow to the prostate tissue.

By restricting the blood supply, the prostate gland is essentially starved of the nutrients it needs to maintain its enlarged size. Over the days and weeks following the procedure, the prostate begins to shrink and soften. As the gland decreases in size, the pressure on the urethra is relieved, allowing urine to flow more freely and significantly improving lower urinary tract symptoms.

The Benefits of Choosing PAE

When considering treatments for an enlarged prostate, it is important to weigh the benefits of each option. PAE offers several distinct advantages over traditional surgical methods, making it an appealing choice for many men.

First and foremost, PAE is a minimally invasive outpatient procedure. This means there is no need for a hospital stay. Patients can typically return home the very same day. Furthermore, the procedure does not require general anesthesia, which eliminates the risks and grogginess associated with being put to sleep. Instead, patients receive moderate sedation to keep them comfortable and relaxed throughout the process.

Another major benefit of PAE is the significantly reduced risk of sexual side effects. Traditional surgeries like TURP carry a known risk of causing retrograde ejaculation or erectile dysfunction. Because PAE does not involve cutting or removing tissue near the nerves responsible for sexual function, the risk of these side effects is remarkably low. A study in the International Journal of Clinical Practice reported promising results for PAE in preserving antegrade ejaculation and erectile function. This makes PAE an excellent option for men who wish to preserve their sexual health while effectively treating their BPH symptoms.

Additionally, the recovery time for PAE is much faster than that of traditional surgery. Most men can resume their normal, light activities within a few days to a week, compared to the several weeks of recovery often required after a TURP procedure.

PAE vs TURP: A Treatment Comparison

When exploring options for enlarged prostate treatment, it is natural to compare the newer PAE procedure with the long standing gold standard, TURP. Both procedures aim to relieve the symptoms of BPH, but they go about it in very different ways.

TURP involves inserting a surgical instrument through the urethra to physically cut away and remove the excess prostate tissue that is blocking urine flow. It is a highly effective procedure with a long track record of success. However, as a more invasive surgery, it requires general or spinal anesthesia and usually involves a hospital stay of one to three days. The recovery period can take anywhere from two to six weeks, during which patients may experience bleeding and discomfort. Furthermore, TURP carries a higher risk of complications, including urinary incontinence and sexual dysfunction. In fact, research shows the reported incidence of retrograde ejaculation after TURP is 50 to 70 percent.

In contrast, PAE is performed entirely through the blood vessels, leaving the urethra untouched. There is no cutting, no tissue removal, and no need for a catheter to be left in the penis during recovery. The procedure is performed under conscious sedation, and patients go home the same day. While TURP may offer slightly more immediate relief of symptoms due to the physical removal of tissue, PAE provides a gradual but significant improvement as the prostate shrinks over time. A randomized controlled trial published in The BMJ concluded that PAE is associated with fewer complications than TURP. Furthermore, clinical studies have shown that PAE has a high success rate, with clinical success achieved in 93 percent of patients at 3 months.

Ultimately, the choice between PAE and TURP depends on the individual patient's medical history, the size of their prostate, and their personal preferences regarding recovery time and potential side effects. Our team of specialists is dedicated to helping each patient make an informed decision that best suits their unique needs.

What to Expect During Recovery

Recovery from Prostate Artery Embolization is generally smooth and straightforward. Because it is an outpatient procedure, you will be able to recover in the comfort of your own home.

In the days immediately following the procedure, it is common to experience what is known as "post PAE syndrome." This can include mild symptoms such as nausea, a low grade fever, pelvic discomfort, or frequent and sometimes painful urination. These symptoms are a normal part of the healing process and typically resolve on their own within a few days. We will provide you with specific instructions and medications to help manage any discomfort.

We advise our patients to take it easy for the first few days after the procedure. You should avoid heavy lifting, strenuous exercise, and any activities that put undue stress on the puncture site in your wrist or groin. Most men find that they can return to work and resume their normal daily routines within a week.

As the weeks progress, you will begin to notice a gradual improvement in your urinary symptoms. The prostate will continue to shrink, and the pressure on your urethra will lessen. We will schedule follow up appointments to monitor your progress and ensure that you are achieving the desired results.

Is PAE Right for You?

If you are experiencing the frustrating symptoms of an enlarged prostate and are looking for a treatment option that avoids the risks and lengthy recovery of traditional surgery, Prostate Artery Embolization may be the ideal solution. It is particularly well suited for men who have very large prostates, those who are not good candidates for surgery due to other health conditions, or those who simply prefer a less invasive approach.

At Murfreesboro Vascular and Interventional, our board certified interventional radiologists have extensive experience in performing PAE. We are committed to providing our patients with the highest quality of care using the most advanced, minimally invasive techniques available.

To determine if you are a candidate for PAE, we will conduct a comprehensive evaluation, which may include a review of your medical history, a physical exam, and imaging studies such as an ultrasound or MRI of the prostate. We will take the time to discuss your symptoms, answer all of your questions, and help you decide if PAE is the right path forward for you.

Do not let an enlarged prostate control your life any longer. Contact us today to schedule a consultation and learn more about how Prostate Artery Embolization in Nashville can help you find relief and get back to enjoying your life.