It can be incredibly frustrating. The constant search for a restroom. Waking up multiple times a night. That feeling of a weak stream no matter how hard you try. If this sounds familiar, you’re likely dealing with an enlarged prostate, and you are far from alone.
Many men dealing with the urinary tract symptoms of an enlarged prostate feel overwhelmed by their choices. You may have heard about medications or invasive surgical procedures. Today, you’ll learn about a different kind of BPH treatment, a modern and minimally invasive treatment called Prostate Artery Embolization.
Dealing with these urinary issues can seriously affect your quality of life. Prostate artery embolization offers real relief from the symptoms caused by benign prostatic hyperplasia without many of the drawbacks of older methods. It represents a significant advancement in men’s health care.
What is BPH, and Why Does It Cause Problems?
Benign Prostatic Hyperplasia, or BPH, is the medical term for a non-cancerous enlarged prostate. It’s a common condition that affects many men as they age, believed to be linked to hormonal changes. The condition is benign, meaning it is not related to prostate cancer, a distinction your doctor can help clarify.
As the prostate grows, it puts pressure on the urethra, the tube that carries urine from the bladder. Imagine a clamp slowly tightening on a garden hose; this is what an enlarged prostate does to your urethra. This squeezing effect is the root cause of the disruptive urinary symptoms you experience.
The obstruction leads to a variety of tract symptoms, including a weak stream, difficulty starting urination, and a feeling that the bladder never completely empties. You might also experience increased urinary frequency and sudden urges to go. This can lead to issues with bladder control or even urinary incontinence.
Internally, the bladder has to work much harder to push urine out. Over time, this can weaken the bladder muscle. Incomplete emptying can lead to more serious complications like urinary tract infections, painful bladder stones, or, in severe cases, kidney damage.
Prostate Artery Embolization: A New Approach
So, how can you solve the problem without invasive surgery? This is where the PAE procedure, short for prostate artery embolization, changes the landscape. It is a minimally invasive treatment performed by a specialist known as an interventional radiologist.
The main idea behind the PAE procedure is to shrink the prostate without cutting into it directly. Interventional radiologists, like Dr. Preston Smith of Summit IR use advanced imaging techniques to work inside the body through its natural pathways. This approach avoids the need for large incisions and the typical risks associated with surgery.
Instead of going through the penis and urethra, PAE uses the body’s vascular system. Using live X-ray guidance, the interventional radiologist navigates a small catheter, a thin hollow tube, to the specific prostatic arteries that supply blood to the prostate gland. It is a highly precise and targeted process.
How It Actually Works
Once the small catheter is perfectly positioned in the prostatic artery, the doctor injects tiny particles. These microspheres, smaller than a grain of sand, flow into the small vessels within the prostate. Their job is to block blood flow to the gland’s tissue.
By cutting off this blood supply, the prostatic tissue is deprived of oxygen and nutrients. This causes the benign prostatic tissue to soften and shrink over several weeks. As the prostate gets smaller, it stops squeezing the urethra.
The result is a wider channel for urine to pass through. Blocking blood flow is the key mechanism that allows the gland to shrink naturally. This ultimately leads to significant improvement in urinary symptoms for most men.
What Does the PAE Procedure Look Like?
One of the most appealing aspects of the PAE performed by interventional radiologists, like Dr. Preston Smith, is its simplicity for the patient. You do not need an overnight hospital stay or general anesthesia. The procedure is typically done with light sedation in an outpatient setting at a specialized medical center.
On the day of your appointment, a catheter inserted into an artery in your wrist or groin is the starting point. You’ll be comfortable and relaxed during the process, which usually takes about one to two hours. There is absolutely nothing inserted into your penis.
After a short recovery time of about an hour in the office, you are free to go home the same day. This means you can avoid the discomfort and inconvenience of a Foley catheter after the procedure. This is a major relief for most men considering BPH treatment.
Key Benefits of Choosing PAE
Men who choose Prostate Artery Embolization do so for several compelling reasons. This procedure offers significant advantages over traditional, more invasive treatment options. Let’s look at some of the biggest ones.
A Genuinely Minimally Invasive Option
Compared to invasive surgical procedures like TURP (transurethral resection of the prostate), PAE is far less physically demanding on the body. There is no surgical cutting or removal of prostate tissue. The only evidence of the procedure is a tiny puncture site that heals quickly without stitches.
Faster and Easier Recovery
The recovery time is remarkably short, which is a major benefit for active men. Most patients are advised to avoid heavy lifting and strenuous activity for just a few days. You can return to your normal routine much faster than with an invasive surgical option.
A common question is about resuming sexual activity. With PAE, the waiting period is typically just a few days. This is a significant improvement over the weeks or even months of recovery required by other procedures.
No Post-Procedure Catheter
We have to mention it again because it is a critical point for patient comfort and quality of life. The PAE procedure does not require you to wear a Foley catheter afterward. This single factor often makes PAE a more attractive choice for men anxious about post-operative care.
Preserves Sexual Function
Many treatments for benign prostatic hyperplasia (BPH) carry a risk of sexual side effects, including erectile dysfunction. PAE has a very low risk of impacting sexual function. In fact, results from a recent clinical trial have shown that sexual function is well-preserved.
Interestingly, some studies show a portion of men report an improvement in their erectile function compared to before the procedure. While the exact cause is studied, relieving pressure on nerves near the prostate may play a role. The minimal risk to sexual health makes it a popular choice for many men.
You Don’t Burn Any Bridges
Dr. Smith of Summit IR, uses a great analogy for PAE. He compares it to getting a haircut before a big event; you can always go back and cut a little more if needed. If you choose an irreversible option first, you lose that flexibility.
PAE is like that initial haircut. It effectively treats your symptoms but doesn’t prevent you from having another procedure, like a TURP or Aquablation, later on if your needs change. It keeps all of your future health care options on the table.
| Feature | Prostate Artery Embolization (PAE) | Traditional Surgery (TURP) |
|---|---|---|
| Invasiveness | Minimally invasive, no cutting of tissue. | Surgical, tissue is cut and removed. |
| Anesthesia | Local anesthetic and light sedation. | General anesthesia or spinal block. |
| Post-Op Catheter | No Foley catheter needed. | Yes, typically for several days. |
| Recovery Time | 2-3 days of light activity restriction. | Several weeks of restrictions. |
| Sexual Side Effects | Very rare, can sometimes improve. | Common, including retrograde ejaculation. |
Am I a Good Candidate for This Procedure?
PAE is a fantastic option, but it’s important to determine if it’s the right fit for you. The ideal candidate is typically a man over age 50 who is bothered by moderate to severe urinary symptoms from an enlarged prostate. A consultation with a urologist and an interventional radiologist is the first step to provide personalized care.
The size of your prostate is a critical factor. Your doctor will use imaging to measure the gland’s volume. PAE tends to work best on larger prostates, generally those larger than 50 grams, with even better results for prostates over 80 grams.
Men with very large prostates, sometimes over 150 grams, are also excellent candidates. In these situations, PAE can shrink the gland enough to make other procedures possible later if needed. Men who are not good surgical candidates due to other health conditions may also find PAE to be a safer alternative.
Results and Recovery Timeline
Improvement after PAE is a gradual process, not an overnight fix. As the prostate begins to shrink, your symptoms will steadily get better. The results are long-lasting and worth the short wait.
Most men begin to notice a difference in about 10 to 14 days, often describing the sensation as things “loosening up.” Your urinary stream is usually the first symptom to improve. Some men experience a temporary, mild bladder spasm, which resolves quickly.
Over the next few months, your other symptoms, such as increased urinary frequency and nighttime awakenings, will continue to fade. Your bladder, which has been working hard for years, begins to recover its normal function. To see the maximum benefits of the procedure, you should allow about three to six months for the full effect to be realized and to improve urinary health.
Does Insurance Cover PAE?
Cost is a valid concern with any medical procedure. The good news is that prostate artery embolization is a well-established procedure, not an experimental service. It has been proven effective and safe in numerous studies worldwide.
Because of its strong track record, most major insurance providers cover the PAE procedure, and this includes Medicare. This means that for most men, the out-of-pocket cost is limited to their standard copay or deductible. Always confirm coverage specifics with your insurance carrier before scheduling.
Conclusion
You do not have to let BPH symptoms control your life. For many men suffering from an enlarged prostate, prostate artery embolization offers a powerful and effective solution. It delivers significant relief with a quicker recovery and fewer side effects than traditional surgery.
This minimally invasive procedure allows your prostate to shrink, improves your flow, and helps you regain your freedom. It allows you to improve bladder control and reduce urinary frequency. It’s a smart step in managing your health because it also preserves your future treatment options.
If you are tired of the constant interruptions caused by an enlarged prostate, it’s time to explore your options. Talk to a urology specialist or an interventional radiologist to find out if prostate artery embolization is the right choice for you. Take control of your health and get back to living your life.