Prostate Artery Embolisation – Overview

Prostate artery embolisation is a minimally invasive technique used to treat an enlarged prostate, also known as benign prostatic hyperplasia (BPH).  BPH is a common condition in older men that causes problematic symptoms including

  • frequent or urgent need to urinate,
  • difficulty initiating the urinary stream (hesitancy),
  • interrupted or weak urine stream,
  • inability to empty the bladder completely,
  • feeling of persistent residual urine,
  • needing to strain or push to initiate and maintain urination,
  • increased urination at night (nocturnia)
  • decreased force of stream,
  • and loss of small amounts of urine due to a poor urinary stream (dribbling).

Traditionally in patients with severe symptoms, a urologist, may recommend a surgical procedure, such as transurethral resection of the prostate (TURP).

Prostate artery embolisation (PAE) is a minimally invasive non-surgical alternative to procedures such as TURP.  PAE shrinks the prostate by treating its blood vessels. It is performed by an interventional radiologist through a tiny pin hole in the wrist.

Traditional surgeries such as TURP can be associated with serious complications such as impotence and incontinence whereas PAE does not have the same complications.

Prostate Artery Embolisation – What to Expect?

  • PAE is performed by an interventional radiologist (IR) such as Dr Sanjay Nadkarni. Interventional Radiologists utilise cutting edge imaging techniques such as XRay to see inside the body and treat a range of conditions without traditional surgery.
  • PAE is usually performed under local anaesthetic and as a day case.
  • PAE is performed through a small catheter inserted by your interventional radiologist into the artery in your wrist or groin. The interventional radiologist will then guide the catheter into the vessels that supply blood to your prostate.
  • An arteriogram (an X-ray in which dye is injected into the blood vessels) is then performed to map the blood vessels feeding your prostate.
  • Tiny round microspheres are injected through the catheter and into the blood vessels flowing into your prostate to reduce its blood supply.
  • Following this procedure the prostate will begin to shrink, relieving and improving symptoms usually within days of the procedure.

 

Prostate Artery Embolisation – What are the risks?

Prostate artery embolisation is considered a safe procedure. However, as with any procedure, there are alwayssome risks.

  • Any procedure that involves the placement of a catheter inside a blood vessel carries with it certain risks. These risks include damage to the blood vessel and bruising or bleeding at the puncture site. It’s important to remember that when these procedures are performed by an experienced Interventional Radiologist, the chances of any of these complications arising are very small.
  • There is a small risk of infection and this can usually be treated with antibiotics.
  • Very rarely there is a chance that small particles can lodge in the wrong place and deprive normal tissue of its oxygen supply. To assist in avoiding these complications, Dr Sanjay Nadkarni pays close attention to the pattern of the blood vessels in the pelvis, and is aware that the pattern of the vessels can be different in each individual. Despite this there is a very small risk of injury to the bladder, rectum and genitals because of their close proximity to the prostate.
  • Occasionally patients may have an allergic reaction to the contrast dye used during the X-Ray prostate embolisation. These reactions can range from mild itching to more severe reactions that can affect breathing or blood pressure. Patients are carefully monitored during the procedure, so that any allergic reaction can be detected immediately and treated.
  • There is the possibility that the procedure will fail.

 

Prostate Artery Embolisation – What to expect after the procedure?

Post procedure you may feel tired and we recommend that you to rest for one to two weeks depending on the speed of your recovery. After this period you can return to work and resume your usual activities.

You can eat and drink as normal.

You can take any medication as per your usual schedule, but if you take any medications containing metformin, please do not take them for the first two days after your procedure.

You may have a burning feeling in your lower abdomen for a couple of days after the procedure. Dr Nadkarni will give prescribe medication, which you can take as prescribed to manage this.

You may notice a very small amount of blood mixed in your stool or urine. If the bleeding becomes excessive and you also have increasing pain and/or a temperature, you should contact our Clinic on 08 9284 2900 immediately or contact your regular GP.

The puncture site may be a little bruised this is completely normal. If you experience any bleeding or swelling at the site you should lie down and apply direct pressure to the site for ten minutes. If the bleeding or swelling continues after ten minutes you should visit your nearest Emergency Department. Bleeding or swelling at the site is extremely rare.

 

Prostate Artery Embolisation – Patient Video

For more information on the Prostate Artery Embolisation Procedure please feel free to download our guides on the links below or contact the clinic on 08 9284 2900.

1 – Prostate Artery Embolisation Patient Brochure

2 – Prostate Artery Embolisation Patient Summary