Prostate Artery Embolization (PAE) is a minimally invasive procedure for alleviating the urinary symptoms caused by an enlarged prostate (BPH) thereby avoiding the risk of sexual side effects associated with other BPH treatments. But before discussing what happens after the PAE prostate procedure, it’s probably a good time to explain how the PAE procedure works.
PAE takes place on an outpatient basis with most patients able to return home on the day of the procedure to complete their recovery. The embolization is performed under local anesthesia through a small incision in the groin area using advanced imaging to guide a tiny catheter toward the prostate and the main arteries feeding it with blood. Once the catheter is in place, tiny embolic particles are injected into the artery, blocking the blood flow and ‘starving’ the prostate. The main arteries on both sides of the prostate are treated typically through the same incision.
So what happens next?
The PAE procedure targets those areas of the prostate most affected by BHP, causing them to die. The prostate doesn’t die completely because it’s not possible to block all of the blood flow. However, the dead areas cause the prostate to initially feel softer, which, in turn, takes away some of the pressure that is squeezing the urethra, helping ease the troublesome urinary symptoms. Over several months, the dead tissue is resorbed by the body and replaced with a scar. As the scar tissue slowly contracts, the prostate gradually shrinks.
According to UNC Health, patients won’t notice any immediate results because there was no surgery and no part of the prostate was physically removed. However, while initially, the symptoms may worsen for a few days, patients will start to notice an improvement in their symptoms between 1 and 2 months after the procedure. Within six months, the prostate should lose between 20-40% of its volume, resulting in improved and less frequent urination and a far better quality of life.
By now, you’re probably wondering how successful PAE is and whether it’s worth doing.
Certain factors like the severity of your symptoms, prostate size, and expertise of the interventional radiologist will influence the success rate of the PAE procedure.
However, even with these variables, data continues to highlight the effectiveness of prostate artery embolization.
One study highlights that PAE demonstrates notable clinical success rates, with 85.1% in the short term, 81.9% in the medium term, and 76.3% in long-term follow-ups. Similarly, another study supports these encouraging results, reporting clinical success in 78.5% of patients who underwent the procedure.
Additional studies emphasize the considerable relief PAE offers for severe urinary issues caused by an enlarged prostate, reporting a notable long-term success rate of 66%.
Together, these studies highlight that PAE’s minimally invasive approach, excellent safety profile, quick recovery time, and the option for repeat treatments if needed make it a compelling choice for those dealing with an enlarged prostate, also known as benign prostatic hyperplasia (BPH).
The reason that PAE doesn’t work for some males is that the size and location of the arteries make it impossible to complete the embolization or there is an inherent weakness in the bladder that prevents it from resolving once the prostate has shrunk.
In 2023, the Society of Interventional Radiology (SIR) reported the findings of a new North American study of 1,000 patients who had undergone PAE treatment for BPH. They reported sustained relief from their urinary symptoms for up to six years and a significant improvement in their quality of life. The report also highlighted that prostate size continued to reduce over one year.
Like any medical procedure, there are risks, but fortunately, with PAE, any risks are mild. The largest risk is accidental injection of embolic particles into the bladder or rectum instead of the arteries feeding the prostate resulting in the death of tissue in these organs. This is why it’s crucial to choose a highly experienced team of interventional radiologists.
Other small risks include blood leaking into the semen, urine, or stool; bladder spasm; or infection of the incision site or prostate. These potential complications often resolve on their own or can be treated with a short course of medication.
Several factors determine whether PAE is right for you:
Here are some reasons you may not be a candidate for PAE.
To learn whether you are a suitable candidate for the PAE procedure, please contact the experienced team at Mint STL. An exam with one of our interventional radiologists and a chat about your symptoms will determine whether the procedure is right for you. Contact MINT today to schedule a consultation
