Frequently Asked Questions
What are the benefits of prostate artery embolization?
Prostate artery embolization (PAE) is a minimally invasive treatment for enlarged prostate.
It is an outpatient procedure and requires less recovery time than surgery to treat enlarged prostate.
PAE also has a lower risk of side effects than other surgical treatments, including urinary incontinence and lower sex drive.
What are the risks of prostate artery embolization?
Complications are rare and most can be treated. Risks include but are not limited to:
- Bleeding
- Infection
- Temporary inability to urinate
- Blockage of other blood vessels outside of the prostate gland.
Your doctor will perform a series of specialized 3-dimensional scans during your procedure to ensure the blockage particles are delivered to the prostate gland.
Your doctor will have an in-depth conversation with you about the risks of the procedure during your consultation.
What are the advantages of prostate artery embolization vs. TURP?
Prostate artery embolization can improve urinary tract symptoms similarly to transurethral resection of the prostate (TURP), a surgery also used to treat enlarged prostate.
However, PAE has advantages vs. TURP, including:
- Faster recovery time without hospitalization
- Lower risk of complications
- Fewer or more minor complications
What should I expect during prostate artery embolization?
Prostate artery embolization is an outpatient procedure, meaning you will not need to stay in the hospital overnight. It is done under local anesthetic and intravenous ‘twilight’ anesthesia, allowing you to remain comfortable without the need for general anesthesia.
It is generally safe to take routine medications before the procedure. However, some medications, such as blood thinners, should be avoided to prevent complications.
Your interventional radiologist will review your medications at your initial office visit and advise you on how to prepare. Do not eat or drink anything for at least 6 hours before PAE. Your procedure may be rescheduled or canceled if you eat or drink. However, you may take sips of water with your medications.
What is recovery like after prostate artery embolization?
Prostate artery embolization is generally a well-tolerated procedure. Most people have only minor symptoms in the first few days of recovery, including:
- A low grade fever
- Fatigue
- Mild pelvic cramping
Some patients also experience a brief increase in urinary frequency, urgency, blood in urine and burning with urination.
You’ll be prescribed medications both before and after your procedure to lower the risk of blockages that affect urine flow, infection, and discomfort.
You should not do activities that may cause direct trauma to the puncture site for the first few days, such as heavy lifting or aerobic exercise, nor any skydiving, steer roping or mixed martial arts. Otherwise, you may resume most normal activities the day after your procedure.
One week after your procedure, you will have a follow-up appointment with your care team. You’ll also have imaging done three months after your procedure to check progress. Your care team is also available to you at any time to answer questions about your treatment or discuss concerns.
Who is a candidate for prostate artery embolization?
Enlarged prostate affects about 70 percent of men older than 70. The central portion of the prostate gland may enlarge as you age, restricting flow of urine. This can cause many uncomfortable symptoms, including but not limited to:
- The urge to urinate
- Urinating more frequently
- Intermittent urination
- Disrupted sleep because of the need to urinate frequently overnight
- Weak stream
- Sensation of incomplete emptying of the bladder
- Urinary retention requiring catheterization
Prostate artery embolization reduces and may eliminate these symptoms by disrupting blood flow to the prostate. This causes the gland to shrink.
Prostate artery embolization may be right for you if you:
- Have blood in your urine (hematuria) secondary to an enlarged prostate
- Are being treated for prostate cancer
- Take long-term medications to prevent blood clots that require frequent urological intervention
To determine if you are a candidate for PAE, we will evaluate your medical history, perform a physical exam and review any relevant imaging.
Does insurance cover prostate artery embolization?
Yes. Most insurance carriers cover PAE. Please check with your insurance provider to see if your specific plan covers the procedure.
References
Society of Interventional Radiology
DeMeritt JS, Elmasri FF, Esposito MP, Rosenberg GS. Relief of benign prostatic hyperplasia– related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization. J Vasc Interv Radiol. 2000;11:767–770.
Carnevale FC, Antunes AA, da Motta Leal Filho JM, et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc Intervent Radiol. 2010;33:355e61.
Insausti I, Sáez de Ocáriz A, Galbete A, Capdevila F, Solchaga S, et al. Randomized comparison of prostatic artery embolization versus transurethral resection of the prostate for treatment of benign prostatic hypertrophy. J Vasc Interv Radiol. 2020 Jun;31(6):882-890.