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What is benign prostatic hyperplasia (BPH)?
Benign Prostatic Hyperplasia or (BPH) is an enlarged prostate gland. BPH is the most common non-cancerous prostate problem in patients.
Urinary symptoms of BPH include:
- incomplete emptying of bladder,
- weak or intermittent stream,
- urine leaks
- nighttime urination
Risks and Benefits of PAE
What are the possible benefits of PAE?
- The PAE procedure is a minimally invasive procedure.
- It is usually performed as an outpatient procedure.
- PAE has a lower risk of sexual dysfunction than many other treatments for BPH.
- Approximately 80% of patients experience an improvement in overall urinary symptoms when both prostate arteries can be embolized
- Patients experience noticeable improvement in urinary symptoms over a period of weeks to month
What are the possible risks of PAE?
- A delayed urinary tract infection is possible, however, it rarely occurs. The procedure is performed in a sterile environment.
- The puncture site is sealed after the procedure. However, rare delayed bleeding at the puncture site is possible.
- Rarely, temporary acute urinary retention (the inability to urinate) for a couple of weeks requiring an indwelling catheter.
- There have been rare reports in the literature of non-target embolization, which occurs if beads enter vessels supplying adjacent structures. However, the use of Cone Beam CT during the procedure decreases this risk.
What factors can make the procedure less effective or more challenging?
The procedure may be less effective if you have a weak or spastic bladder or no bladder function. On rare occasions, selecting the prostatic artery may be challenging due to individual severe hardening, narrowing, and/or twisting of arteries.
Before Your Procedure
What should I expect at my first office visit?
- You will meet with the Interventional Radiologist and Advanced Practice Nurse.
- A medical history and physical examination will be performed.
- You will complete a questionnaire to assess your urinary symptoms.
- You will receive an explanation of the PAE procedure.
- There will be a discussion of pre and post procedure medications.
What diagnostic tests and clearances do I need?
- You will need bloodwork.
- You may need a CAT Scan Angiogram of your pelvis with intravenous contrast to check the arteries that supply your prostate.
- On occasion, you may need a Magnetic Resonance Imaging (MRI) scan to evaluate the prostate for cancer if the Prostate Specific Antigen (PSA) blood level is elevated or your urologist recommends it prior to PAE.
- You may require medical clearance from your primary care physician.