What is a Prostate Artery Embolisation?
PAE is a non-surgical way of treating an enlarged and troublesome prostate by blocking off the arteries that feed the gland and making it shrink. It is performed by an interventional radiologist.
Who will be doing the Prostate Artery Embolisation?
A specially trained doctor called an interventional radiologist. Interventional radiologists have special expertise in using X-ray equipment, and also in interpreting the images produced. They need to look at these images while carrying out the procedure.
What happens during Prostate Artery Embolisation?
PAE is a sterile procedure performed in an angiography suite in a hospital. You will lie on the X-ray table, generally flat on your back. You need to have a needle put into a vein in your arm, so that the radiologist can give you a sedative and painkillers. You may also have a monitoring device attached to your chest and finger, and may be given oxygen through small tubes in your nose.
The skin and deeper tissues over the artery in the groin will be anaesthetised with local anaesthetic, and then a needle will be inserted into this artery. Once the interventional radiologist is satisfied that this is correctly positioned, a guide wire is placed through the needle, and into this artery. Then the needle is withdrawn allowing a fine, plastic tube, called a catheter, to be placed over the wire and into this artery. The interventional radiologist will use the X-ray equipment to make sure that the catheter and the wire are then moved into the correct position, into the other arteries which are feeding the prostate. These arteries are quite small and rather variable. A special X-ray dye, called contrast medium, is injected down the catheter into these prostate arteries, and this may give you a hot feeling in the pelvis. Once the prostate blood supply has been identified, fluid containing thousands of tiny particles is injected through the catheter into these small arteries which nourish the prostate.
Are there any risks or complications?
There may occasionally be a small bruise, called a haematoma, around the site where the needle has been inserted.
Most patients feel some pain afterwards; this is usually mild. Very occasionally a urinary catheter may need to be placed.
Benefits of a Prostate Artery Embolisation
Men will gain symptomatic improvement after PAE with reduction in prostate volumes and an increase in urinary flow rates.