PAE is a relatively new nonsurgical treatment effective in alleviating the troublesome symptoms related to benign hypertrophy of the prostate (BPH). The procedure is performed by a skilled interventional radiologist who places a small catheter into the arteries to the prostate and closes them with tiny particles designed specifically for the task. The world’s first PAE procedure was performed in 2009. Mountain Medical has been offering PAE service since January 2014, and were the first medical practice in Utah to perform this procedure. PAE has a very low risk of sexual dysfunction and incontinence (much lower than surgery). Most PAE patients are able to undergo the procedure on an outpatient basis.
These symptoms are collectively described as “Lower Urinary Tract Symptoms” or LUTS.
Patients with significant symptoms who desire nonsurgical therapy (or who cannot have surgery), and have ideal arteries (as indicated by pre-procedure testing) are the most reasonable candidates for PAE.
We will take your history and perform a physical examination. You will also be asked to fill out a short questionnaire to evaluate the severity of your symptoms. After this, you will meet with the interventional radiologist who will discuss your treatment options and explain any pre-procedure testing that needs to be performed. Patients routinely undergo a special CT scan of their pelvis to evaluate the arterial supply to the prostate gland. Occasionally, an MRI or ultrasound of the prostate may be ordered, as well as a short test to evaluate their rate of urine flow. Certain blood testing will be needed to ensure the procedure can be safely performed. If you do not have an existing urologist, we will refer you to one so they can determine there are no other causes for your symptoms, and to discuss surgical options.
The procedure is performed on an outpatient basis. General anesthesia is not required, however, you are given IV medications to promote relaxation and to minimize discomfort (similar to the drugs administered during a colonoscopy).
A dime-sized site on your right hip will be numbed with local anesthetic, and a spaghetti noodle-sized catheter is placed into the arteries that supply the prostate. Through this catheter, small particles are injected into the arteries to block them off - causing a reduction in the size of the prostate. The catheter is removed, and pressure is placed on the site for roughly 15 minutes to prevent any bleeding.
The procedure can be performed using one site-of-access in virtually all patients. Most patients go home within 2-3 hours, and return to work within 3-5 days.
90% of patients experience significant symptom relief and fewer than 3% of patients experience either sexual dysfunction or incontinence.
Studies suggest that over time, as many as 14% of patients may see a recurrence of some of their symptoms. You may repeat this procedure if necessary.
For those few who do not respond to PAE, traditional surgical therapies remain an option.
Complications from PAE are uncommon, however, complications may include: a hematoma (bruise) at the catheter site; transient blood in urine, semen, or stool; diarrhea; and a feeling of apathy for up to one week. Even more rarely (<1%), you may experience the loss of tissue in adjacent organs such as the bladder or rectum. The loss of tissue may be related to non-target embolization, and in most cases, does not require specific therapy to treat.
If you would like to determine your candidacy for prostatic artery embolization, please contact Mountain Medical Interventional Radiology Clinic at our Murray location (801) 281-7777 or our Ogden location at (801) 394-6677. You can also fill out the form below with any questions you may have and we will contact you very soon.
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