Weighing The Pros And Cons Of PAE: What You Need To Know

Prostate artery embolization (PAE) has become a popular treatment for benign prostatic hyperplasia, otherwise known as an enlarged prostate. As you would with any medical procedure, you’ll want to understand the advantages and benefits of PAE to help you decide if it’s the right choice for you. This article provides a comprehensive overview of the pros and cons of PAE, supported by relevant statistics. But before going any further, let’s provide a brief explanation of the procedure.

What is prostate artery embolization?

PAE is a cutting-edge technique performed by interventional radiologists to help alleviate LUTS (lower urinary tract symptoms) resulting from BPH – a condition that leads to enlargement of the prostate. During the procedure, tiny embolic beads are injected into the arteries feeding the prostate to block the flow of blood, effectively shrinking its size over time.

Multiple studies have shown PAE to be safe and clinically effective with patients experiencing a significant reduction in prostate volume and improvement in urinary flow rates.

So now you have an understanding of the procedure, let’s dive into the pros and cons of PAE.

Pros of prostate artery embolization

1. Minimally invasive procedure - Perhaps the biggest benefit for those choosing to undergo PAE is its minimally invasive nature. Unlike other surgeries, PAE only requires a small incision in either the groin or wrist to enable a catheter to be fed into the artery and guided to the prostate. PAE is performed on an outpatient basis with most patients able to return home the same day, eliminating the need for a hospital stay.
2. Shorter recovery time – Typically patients recover faster when compared to other surgeries such as TURP. Patients can recover in the comfort of their homes and can usually resume normal activities within a few days. However, exercise, heavy lifting, and sexual activity will need to be avoided for about one week. This brings us nicely to the next advantage of PAE.
3. Preservation of sexual function – Traditional surgeries for BPH such as TURP have long been associated with sexual dysfunction but this is not the case with PAE. Findings suggest that PAE does not adversely affect sexual function and preserves erectile function and ejaculation in most patients.
4. Reduced risk of urinary incontinence: PAE has a lower incidence of urinary incontinence compared to surgical options. The procedure targets the blood vessels supplying the prostate without affecting the urinary sphincter, thereby maintaining continence.
5. Effectiveness in symptom relief – Troublesome urinary symptoms such as an urgent or frequent need to urinate, especially at night; a weak urine stream or incomplete emptying of the bladder can seriously get in the way of everyday living. PAE improves the quality of life for most patients.
6. Suitable for those unable to have surgery – PAE is a great alternative for patients unable to have surgery for medical reasons or who prefer not to go ‘under the knife’. Furthermore, men with permanent catheters for acute urinary retention are often told there is no other option but it’s quite common for men to be able to remove their catheter following the PAE procedure.
7. Most effective for large prostates - In some cases doctors are unwilling to operate on those with overly large prostates as surgical access can be difficult. PAE actually works better on large prostates which is good news for BPH sufferers who may have been turned down for prostate surgery.

So now you know the pros of prostate artery embolization let’s take a look at the downsides of the procedure since we promised to tell you about the pros and cons of PAE.

Cons of prostate artery embolization

1. Potential for non-target embolization - One of the risks associated with PAE is the accidental blockage of arteries other than those supplying the prostate. This can lead to complications if nearby organs or tissues are affected. However, experienced interventional radiologists utilize advanced imaging techniques to minimize this risk.
2. Possibility of symptoms recurring – While PAE significantly improves urinary symptoms for many sufferers of BPH, some patients find their symptoms recur over time. Fortunately, it is possible in many cases for PAE to be repeated. Here’s an article relating to this subject that we published earlier.
3. Limited long-term data – PAE is still a relative newcomer compared to traditional surgical methods, which means that longer-term data relating to the procedure's efficacy and safety is still being collected. Although short and medium-term results are promising, ongoing studies aim to provide more comprehensive long-term outcomes.
4. Not suitable for everyone – PAE may not be for everyone. Those with anatomical variations, specific medical conditions, or severe atherosclerosis may not be a good fit for the procedure. A comprehensive examination with a qualified specialist is always necessary to determine candidacy.
5. Availability and expertise - PAE requires specialized training and equipment, and not all medical centers offer this treatment. It's crucial to seek out experienced interventional radiologists who are proficient in performing PAE to ensure optimal outcomes.

Statistical insights

Symptom improvement: Studies have shown that PAE provides satisfactory improvement in 67% to 92% of cases, with effects lasting up to 3-4 years.

Prostate size reduction: Patients can expect a prostate size reduction of approximately 20%- 40% over six months following the procedure.

Complication rates: Complications are rare, with most being minor and manageable. Potential risks include bleeding, infection, and temporary urinary retention.

So, there you have it, all you need to know about the pros and cons of PAE.

Final thoughts

Prostate Artery Embolization offers a promising alternative to traditional surgical treatments for BPH, especially for those seeking a minimally invasive option with a lower risk of sexual dysfunction and urinary incontinence. However, it's essential to consider individual health factors, potential risks, and the availability of experienced practitioners when deciding if PAE is the right choice.

If you're experiencing symptoms of an enlarged prostate and are exploring treatment options, the Midwest Institute for Non-Surgical Therapy (MINT) specializes in performing PAE on an outpatient basis. With locations in St. Louis, MO, and Swansea, IL, MINT offers expert care to help you find relief from BPH symptoms. Contact MINT today to schedule a consultation and learn more about how PAE can improve your quality of life.