Prostate Artery Embolisation (PAE)
Prostate artery embolisation (PAE) is used to treat an enlarged prostate gland. This is sometimes referred to as benign prostatic hyperplasia or BPH. Doctors usually perform PAE as a day case procedure. In other words you don’t need to be admitted to hospital overnight. During the procedure your doctor injects tiny plastic beads into the prostate arteries to block them. This can help to reduce the size of the prostate and relieve your symptoms.
Benign prostate hyperplasia is an enlarged prostate gland. BPH mostly affects older men and it is very common. In fact, by the age of 70 around 80% of men develop an enlarged prostate.
The prostate gland surrounds the urethra, which is the passage through which urine flows. When the prostate becomes enlarged, it presses against the urethra. In some men there are no symptoms but for others it can cause a range of problems including:
- Needing to urinate more often
- Being unable to completely empty the bladder which carries a risk of urinary tract infections
- A delay in the flow of urine or a characteristic dribble
- Erectile dysfunction
We can arrange a clinic appointment London or Reading, where you will meet either Professor Little or Dr Briggs, who are world renowned experts in PAE. The clinic appointment is an opportunity to discuss your symptoms, ideas, concerns, and expectations. It is very important that you are given time to understand what is involved in the procedure, and ask any questions.
If the doctor feels PAE is in your best interests, we will book a CT scan for you. As part of the scan the doctor will inject contrast dye to identify the small prostate arteries and plan the procedure. In some cases, the doctor will arrange an MRI of the prostate to gain more detailed information about the prostate prior to the procedure.
The Prostate Artery Embolisation Procedure
Prostate artery embolisation is a minimally-invasive day-case procedure. Doctors perform it under local anaesthetic so you will be awake throughout but unable to feel any pain. We may give you a sedative to help you relax.
On the day of the procedure, our team will ask you to stop eating six hours beforehand and you will need to attend the radiology day case unit at either The Royal Berkshire Hospital, or Princess Grace Hospital, London. We will give you antibiotics to minimise the risk of developing a urinary tract infection.
After sterilising and numbing the area, the doctor will insert a catheter into either the artery in your groin or wrist. We use X-rays to help guide a small catheter into both of your prostate arteries (left and right).
Once correctly positioned, we perform a specialist on-table CT scan to check the position, minimising complications, and increasing clinical success. We then inject tiny plastic beads (particles) into the prostate arteries blocking them off. These particles are harmless and remain inside your body.
Once the procedure is complete, which can take up to 2 hours, the doctor will remove the catheter and apply pressure to the injection site to stop bleeding or we may give you a small stitch.
Your Recovery After PAE
Our team will carefully monitor you after the procedure. After that, once you are fully recovered and are able to urinate, you will be able to go home. You will be sent home with painkillers, as some men get discomfort in the prostate area for a few days after the procedure. After prostate artery embolisation you may feel tired and we recommend resting for one to two weeks.
Prostate embolisation is a routine treatment for benign prostatic hyperplasia with minimal risks. Blocking the arteries causes the prostate gland to shrink and most patients who have the procedure experience a reduction in the size of their prostate and an improvement in symptoms.
From the scientific studies, the procedure is successful in 75% of men. Unlike other surgical alternatives, the procedure has only a small impact on sexual function. In addition it can also be beneficial in patients who’ve had a long-term catheter, in which the success of catheter removal is 80%. If PAE is not successful, you can still have any other treatment for your BPH.
Although prostate artery embolisation is considered a safe procedure, any type of surgery involves some risk. Your consultant will discuss these with you beforehand but among the possible risks are:
- Infection in the surgery site, which is treated with antibiotics.
- Bruising or bleeding at the injection site or damage to the blood vessel.
- Very small risk of injury to the bladder, rectum or genitals.
- Allergic reaction to the contrast dye used in the injection.
- Post embolisation syndrome which causes increased urgency and needing to go for a wee more often. This is treated with antibiotics and anti-inflammatories and symptoms usually pass quickly.
Why choose Berkshire Imaging?
We are one of the largest private radiology groups in Berkshire, providing imaging for patients across the county. We are leaders in medical imaging and image guided treatments. As a result we use cutting edge technologies to diagnose and treat many different and often complex conditions.
When you are concerned about your health, you want a doctor to see and treat you as quickly as possible. With Berkshire Imaging you will receive a prompt and accurate diagnosis. This can help ensure better outcomes if you need treatment or put your mind at ease if you don’t.
Where Are You Based?
We provide imaging for patients right across Berkshire. From Newbury and Thatcham in the West along the M4 corridor to Reading, Bracknell and Wokingham and as far as Maidenhead and Slough, we have helped hundreds of patients in Berkshire. Our strong relationships with all the major private hospitals across Berkshire enable us to offer rapid access to private scans in several locations.
Dear Sirs, I would like to give a patient’s point of view of the exciting curative opportunity PAE can offer, compared with surgery or long term drugs. I had a PAE in June 2017. Previously, I had had 5 years of mild LUTS, controlled by lifestyle. But over two months I progressed to an IPSS score of 30+ and found myself in AUR. The pre-PAE MRI reported prostate volume at 116cc; no suspicion of carcinoma. I was offered HoLEP but the downsides were 3 – 3 ½ hours under general anaesthetic; 3% need for repeat; 5% risk of a stricture (I was now catheterised); an outside chance of pulmonary embolism and/or stroke, and a 100% chance I would never ejaculate normally forwards again, I didn’t fancy the op. I talked to a urologist with experience of 100+ PAEs. His advice: PAE fails in about 20% of cases but since I…