Prostatic Artery Embolization (PAE) is a minimally invasive procedure performed by an interventional radiologist to treat symptoms of Benign Prostatic Hyperplasia (BPH). Here’s a step-by-step overview of what the procedure involves:

1. Pre-Procedure Preparation

• Consultation and Evaluation: Before the procedure, the patient will have a consultation with an interventional radiologist. This includes reviewing medical history, symptoms, and diagnostic tests like ultrasound, MRI, or CT scans to assess the prostate’s size and blood supply.
• Fasting and Medications: Patients are usually advised to fast (not eat or drink) for several hours before the procedure. Depending on individual health conditions, certain medications (especially blood thinners) may need to be paused.
• Consent and Anesthesia: The patient will sign a consent form, and a mild sedative may be administered to help them relax. PAE is typically done under local anesthesia, meaning only the entry site will be numbed.

2. During the Procedure

• Accessing the Artery:
  • The interventional radiologist will make a tiny incision, usually in the upper thigh (femoral artery) or wrist (radial artery).
  • A thin, flexible tube called a catheter is inserted into the artery through the incision.
• Guiding the Catheter:
  • Using fluoroscopy (a type of real-time X-ray imaging), the catheter is carefully guided through the blood vessels to reach the arteries supplying the prostate.
• Injecting Contrast Dye:
  • A contrast dye is injected through the catheter to highlight the blood vessels on the X-ray, allowing the radiologist to precisely locate the prostatic arteries.
• Embolization:
  • Once the prostatic arteries are identified, tiny particles (microspheres) are injected through the catheter.
  • These particles block the blood flow to the prostate, causing it to gradually shrink over time, which relieves the symptoms of BPH.
• Repeat on Both Sides (if needed):

3. Post-Procedure Recovery

• Monitoring: After the procedure, the catheter is removed, and pressure is applied to the entry site to prevent bleeding. Patients are monitored for a few hours in a recovery area.
• Same-Day Discharge: Most patients can go home the same day after a brief observation period. However, someone should be available to drive the patient home.
• Recovery at Home:
  • Patients may experience mild discomfort, such as pelvic pain or a burning sensation when urinating, for a few days after the procedure. Over-the-counter pain relievers are usually sufficient.
  • Most people can return to normal activities very quickly, but heavy lifting or strenuous exercise should be avoided for about a week.

4. Follow-Up

• Symptom Improvement: Symptom relief may begin within days to weeks, but the full effect of prostate shrinkage can take 1-3 months.
• Follow-Up Appointments: A follow-up visit with the doctor is typically scheduled to monitor progress and assess symptom improvement.

BPH – Benign Prostatic Hyperplasia