Prostate Artery Embolisation

Embolisation of the prostate arteries is a minimally invasive operation where the arteries to the prostate are blocked off, causing the prostate to reduce in size, and relieve the lower urinary symptoms (LUTS).

An enlarged prostate gland can cause many troublesome symptoms such as frequent urination, urgency, hesitancy, incomplete emptying, dribbling, prolonged urinary or intermittent stream. Prostate artery embolisation can relieve these symptoms without the need for a more invasive operation.

PAE is best for men experiencing moderate-to-severe BPH symptoms who have either not responded to or cannot tolerate medications, and who want to avoid traditional surgery. It is particularly beneficial for men with very large prostates or those who have other medical conditions that make surgery risky.

Embolisation of the prostate arteries is usually done under sedation in an operating room with specialised medical imaging equipment. Your interventional radiologist will use an ultrasound to guide a tube into the artery at either the groin or wrist. They will then pass a catheter (thin plastic tube) into the pelvic arteries and inject x-ray dye to define the anatomy of the pelvic arteries. A very fine catheter (microcatheter) is then passed into the prostate artery. Microscopic plastic particles will then be slowed injected into the arteries supplying the prostate, blocking them up, similar to how silt blocks up a drain. By blocking off the blood supply, the prostate reduces in size, relieving the pressure around the urethra.

The PAE procedure is virtually painless, as the patient is sedated and the entry point is numbed.

After the procedure, most patients can go home on the same day. Generally it’s recommended that patients rest for 2-3 days and avoid any strenuous exercise or heavy lifting for 1-2 weeks.

Prostate shrinkage begins immediately after the procedure, with significant noticeable improvement beginning within a few weeks after the prostate shrinks and softens. Studies indicate that PAE provides long term relief, with most patients experiencing benefits for 5 – 10 years.

After the procedure patients may experience mild pelvic cramping, general fatigue, blood in the urine, or a burning sensation while urinating. These symptoms are temporarily and managed with mild painkillers such as paracetamol.

It’s rare to experience serious complications due to PAE, and risks associated with PAE such as sexual dysfunction and retrograde ejaculation are extremely low when compared to traditional surgery.