Prostate Artery Embolization (PAE)

What is Prostate Artery Embolization (PAE)?

Prostate artery embolization (PAE) is a minimally invasive procedure to treat an enlarged prostate gland (benign prostatic hyperplasia or BPH). PAE causes the prostate to shrink over time, relieving urinary symptoms such as urinary incontinence and frequent urination without removing the prostate itself.

PAE typically requires only moderate sedation, has fewer sexual side effects than surgery, and allows for a quicker recovery, with most patients returning home the same day.

Prostate Artery Embolization_Tower Urology

Why is this procedure performed?

The PAE procedure is another option for the treatment of prostate enlargement and BPH. It aims to improve urinary symptoms and improve quality of life while minimizing the risk of erectile dysfunction and retrograde ejaculation.

Who is the ideal candidate for prostate artery embolization?

PAE is an excellent option for a patient who desires a minimally invasive, ejaculation-sparing approach for their BPH. This procedure is an excellent option for patients who are suitable candidates for nonsurgical treatment.

PAE is not a treatment for prostate cancer.

Who is not a good candidate for prostate artery embolization?

Patients with severe atherosclerosis are generally not candidates for PAE.

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How is PAE performed?

Prostate artery embolization is performed under general anesthesia. During PAE, your interventional radiologist will insert a small microcatheter into your groin or wrist. They will guide this catheter to the arteries that supply blood to the prostate gland. Tiny microparticles are then injected to block these blood vessels, reducing blood flow to the prostate.

What is the success rate of prostate artery embolization?

Surgeons operating Prostate artery embolization general anesthesia

Most men will significantly reduce their BPH symptoms after PAE. For example, urine flow and bladder emptying improve, although not quite as much as with surgical treatment. PAE results are generally long-lasting, although about one in five men will require re-treatment within 5 years and 30-60% within 10 years.

What are PAE’s risk factors?

PAE is an interventional radiology embolization rather than traditional surgery. It is considered a minimally invasive treatment, so it is generally regarded as safe and effective. Even so, the procedure is technically nuanced, and good outcomes depend on having an interventional radiologist who is an expert in this exact procedure.

Side effects

Post-PAE syndrome: This is the most common side effect, which can include urinary urgency, urinary frequency, dysuria, and pelvic pain or pressure.
Temporary discomfort: Following the procedure, patients may experience mild pain, bruising, or discomfort in the lower abdominal or pelvic region.
Urinary issues: Some patients may experience hematuria (blood in urine), acute urinary retention, or difficulty urinating.

Potential complications

Infection: There’s a risk of lower urinary tract symptoms, such as urinary tract infections or infection at the incision site.
Non-target embolization: In rare cases, embolic material may travel to unintended areas, potentially causing damage to surrounding tissues or organs.
Bleeding: Although uncommon, there’s a small risk of excessive bleeding during or after the procedure.

In rare cases, PAE can lead to necrosis (death of most of all of the cells) of surrounding structures including the bladder, penis, and rectum.

What is PAE’s recovery like?

As a non-surgical, outpatient procedure, the recovery time is minimal. Patients can go home on the same day.

One unique aspect of PAE recovery is that many patients experience flu-like symptoms after the procedure.

Are there other procedures to consider instead of PAE to treat BPH?

Yes, there are many options for treating BPH, but not all will suit every patient.

The available options depend first on the size of your prostate and then on the anatomy of your prostate (usually determined with imaging and/or cystoscopy).

Then, based on your priorities, your Tower urologist will discuss BPH procedures that best fit your priorities.

While Tower Urologists do not perform PAE themselves, we have a close working relationship with two radiologists who are experts in PAE. This professional co-operative team will work closely with you if PAE is the right option.

Why choose Tower Urology in Los Angeles for prostate artery embolization care?

There are several compelling reasons to choose Tower Urology for your general urological care:

Expertise and Experience

Tower Urology has a long-standing history of excellence in urological care, dating back over 50 years. Our practice has grown to include multiple, highly skilled urologists, each with specialized expertise.

Comprehensive Care

Our practice offers a wide range of urological services, including innovative treatments for prostate and bladder cancers, kidney stones, and sexual dysfunction. We continually expand our capabilities through the adoption of new technologies and procedures.

Team Approach

Tower Urology emphasizes a collaborative approach. Physicians collaborate and consult frequently to provide the best possible care for all patients.

Advanced Technology

The practice has recently introduced targeted MRI/ultrasound fusion biopsy for prostate care, demonstrating our commitment to offering cutting-edge diagnostic and treatment options.

Patient-Centered Philosophy

Tower Urology’s approach is personal—we treat patients, not just pathology.

Our philosophy centers on delivering excellence in urologic care, including follow-up. Our dedicated staff of health professionals supports our physicians.

Tower Urology’s doctors are conveniently located for patients throughout Southern California and the Los Angeles area, Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, and Downtown Los Angeles.

We invite you to establish a care plan with Tower Urology.

Call us or request your appointment online:

(855) 246-2700

Request your appointment online

Sources

Benign prostatic hyperplasia: prostatic arterial embolization versus transurethral resection of the prostate
https://pubmed.ncbi.nlm.nih.gov/24475799/

Comparison of prostatic artery embolisation (PAE) versus transurethral resection of the prostate (TURP)
https://pubmed.ncbi.nlm.nih.gov/29921613/

Decoding the complexity of benign prostatic hyperplasia therapies
https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(23)00239-9/fulltext

Early experience of prostate artery embolization: a retrospective single-centre study
https://medicaljournalssweden.se/SJU/article/view/42495

Prostate artery embolisation: an initial experience from an Indian perspective
https://pmc.ncbi.nlm.nih.gov/articles/PMC6384402/

Prostatic artery embolisation versus medical treatment in patients with benign prostatic hyperplasia
https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(23)00091-1/fulltext

Randomised Clinical Trial of Prostatic Artery Embolisation Versus a Sham Procedure for Benign Prostatic Hyperplasia
https://pubmed.ncbi.nlm.nih.gov/31831295/

The State of Evidence in Prostate Artery Embolization
https://pmc.ncbi.nlm.nih.gov/articles/PMC9767761/

What patients say about Tower Urology

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Over 346 Reviews

Dr Josephson has a magic hand. after protate surgery usually most of the patients get leaks but mine was perfect. He is very intelligent, helpful, patient, and polite. I recommend him to all my friends and family

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