What is Benign Prostatic Hyperplasia (BPH)?

An enlarged prostate gland, also called BPH, is a common condition in older men. BPH can lead to troublesome urinary symptoms, as well as bladder, urinary tract, or kidney problems. Normally the size of a walnut, the prostate gland sits below the bladder and surrounds the urethra (the tube that moves urine from the bladder out of the body). BPH is not cancer and it does not raise your risk for prostate cancer. In the U.S., a surprisingly high number of men have an enlarged prostate or benign prostatic hyperplasia (BPH).

50% of men over age 50

70% of men age 60-69

80% of men age 70+

What are the symptoms of BPH?

• Difficulty starting a urination stream
• Dribbling at the end of urination
• Having to urinate frequently at night
• Increased urinary frequency or urgency
• Unable to completely empty the bladder
• Unable to urinate
• Urinary tract infections (UTIs)
• Urine that is pink in color due to the presence of blood
• Urine stream that is weak, or stops and starts

What is Prostate Artery Embolization (PAE)?

Prostate Artery Embolization (PAE) is a minimally invasive treatment that can relieve lower urinary tract symptoms (LUTS) such as feelings of urgency and frequency especially at night (nocturia), incomplete bladder emptying, weak urine stream, intermittency, and straining while urinating. PAE has a number of benefits over traditional surgery.

• Minimally invasive
• Can be performed as an outpatient procedure
• 1 week recovery
• Less need for catheter use (for most patients)
• No sexual side effects. No risk of erectile dysfunction or retrograde ejaculation
• No risk of incontinence leakage surrounding healthy tissue
• Minimal pain and swelling
• Lower risk of erectile dysfunction
• Can be performed on moderate or large size prostate gland with no upper size limit
• PSA counts generally drop to very low levels after the procedure
• Less than 1% complication rate

How is Prostate Artery Embolization Performed?

Prostatic artery embolization is performed through a small puncture in the wrist or the groin. Using specialized X-ray equipment, your physician guides a catheter through the artery toward the prostate. Once the catheter is positioned in the artery supplying blood to the prostate, tiny particles are injected that are lodged in the tiny branches within the prostate, blocking blood flow. The blockage of these branches is called embolization. The procedure is then repeated on the other side of the prostate. The procedure can take anywhere from 1 to 2.5 hours, depending on the location and size of the prostatic arteries. Most men will not feel any pain during the procedure except minor pinch at the access point in wrist or groin. Mild sedatives are used to alleviate anxiety, however patients are awake during the procedure.

Post Procedure & Follow Up

PAE is usually performed as an outpatient procedure and no general anesthesia is required. Depriving the prostate of oxygenated blood will cause it to shrink, thereby improving your urinary symptoms. As a treatment option, PAE is a safe alternative and, like other minimally invasive procedures, has meaningful advantages over traditional surgery. One year after having the procedure, the average prostate size has shown to shrink by approximately 30%, easing a patient's urinary symptoms, sparing erectile function, and improving the overall quality of life. Men who have undergone PAE have reported experiencing a high degree of satisfaction, which was also sustained during the first year following the procedure.