Prostatic Artery Embolisation (PAE)

A Minimally Invasive Treatment for BPH

PAE is a minimally invasive technique and represents an alternative treatment for BPH (NICE**2 recommended). It is a relatively new application of a long-standing technology.

PAE resolves the problem rapidly, is long-lasting, and preserves the prostate. The objective of PAE is to partially stem the blood flow supplying the prostate. Without blood flow, the abnormally enlarged prostatic tissue decreases, and symptoms improve or disappear.

Embolisation is performed under local anaesthesia and involves no blood loss.

Benefits of PAE

1. A non-surgical procedure performed under local anaesthesia.

2. Safe and clinically proven treatment

3. Low rate of side effects

4. Effective and long-lasting treatment solving urination problems and other distressing symptoms.

5. Erectile and sexual functions are maintained

Steps of the Procedure

A small opening measuring 1.5 mm in diameter is made in the groin, through which a thin catheter is inserted into the artery.
The catheter is guided towards the prostatic arteries, while the radiologist watches the progress of the procedure using a moving x-ray (fluoroscope).
Tiny microspheres, the size of grains of sand, are injected into the artery that is supplying blood to the prostate, cutting off the blood flow.
The embolisation is then repeated for the prostatic artery on the opposite side, through the same opening and using the same catheter and microcatheter combination.

Certainly! Here’s the text with British spelling, merged into one paragraph: The technique generally takes between 1 and 2 hours while the patient remains conscious. Most patients experience no symptoms during the procedure, but some may experience mild pain, burning, or a hot feeling of the urethra or around the anus, which are easily controlled by the appropriate medication. In general, six hours after the PAE, the patient can get out of bed and is encouraged to urinate. Usually, the patient may be discharged from the hospital in 1 to 3 days.

Frequently Asked Questions

When is PAE a good option for me?

PAE represents a good treatment option for you if you suffer from common symptoms caused by an enlarged prostate gland. It is also indicated if you do not benefit from drug therapy, cannot have general anaesthesia and / or show prostate dimensions not suitable for surgical treatment. The results of the tests your urologist ordered (Prostate Ultrasound with rectal probe, PSA level, Uroflowmetry, and sometimes cystoscopy and pressure study, known as Urodynamic) need to qualify you for embolisation. If embolisation is indicated, you will need a CT angiography to evaluate the pelvic vessels and determine whether or not you are a candidate for PAE treatment. After undergoing this examination, you will be contacted by the hospital medical team and informed about your expected degree of treatment success.

What are the contraindications for PAE?

Before embolisation, patients must be examined to rule out the presence of a malignant tumour, which contraindicates a PAE. Other contraindications include atherosclerosis and a tortuous (twisted) pelvic and/or prostatic vessel anatomy, as demonstrated by CT (computed tomography) angiography. Regardless of prostate enlargement, the patients must be symptomatic to qualify for PAE surgery.

Who will be doing the procedure?

PAE is performed by specially trained doctors known as image-guided surgeons. They have special expertise in using X-ray equipment and interpreting the images produced. They look at these images while carrying out the procedure. These experts are skilled at inserting needles and catheters into blood vessels through the skin and placing them correctly.

How do I prepare for prostate artery embolisation?

On the day of treatment, you will be admitted to the hospital. You should not eat for six hours before PAE. It is allowed to only drink water. You may receive a sedative to relieve anxiety. As the procedure is generally carried out using the artery in the groin or wrist, you will be asked to put on a hospital gown. It is very important that you inform your doctor about any allergies you might have and/or previous allergic reactions to contrast medium.

Will my sexual function be affected?

Based on studies to date, patients treated with PAE for BPH have not experienced a decline in sexual function. Sexual dysfunction is mostly associated with the side effects of the prescription medication therapy that patients used to treat BPH, prior to the PAE procedure.