Treatments we provide
Prostate Artery Embolisation
Prostate Artery Embolisation (PAE) is a low-risk, minimally invasive, non-surgical procedure for men with lower urinary tract symptoms (LUTS) caused by an enlarged prostate. It involves blocking the blood supply to the prostate gland, causing it to shrink down and alleviate urinary tract symptoms. It is well recognised as an effective treatment for patients with benign prostatic hyperplasia and moderate to severe lower urinary tract symptoms.
Procedure
Prostate artery embolisation is a day procedure performed under local anaesthetic and twilight sedation. A small catheter is inserted into an artery in the groin and guided to the site of the prostatic arteries. Once the catheter is in appropriate position, tiny particles are injected to block the prostatic arteries and decrease blood flow to the prostate gland. Over the next few months the prostate gland decreases in size. The procedure takes approximately 2-3 hours.
Benefits of prostate artery embolisation
- High success rate – 85-90% successful improvement in BPH symptoms
- Minimally invasive low risk procedure (<1% risk of significant complications)
- Sexual function preserved
- No impotence
- No urinary incontinence
- Day case procedure with a short recovery
Risks
Prostate artery embolisation is considered to be a safe low-risk treatment option for benign prostatic hyperplasia. However, as with all procedures, there are some rare risks associated with the procedure including:
- Bleeding/bruising at the arterial access site in the groin
- Non-target embolisation (<1%) – this occurs when the particles injected go somewhere other than the prostate gland (e.g. bladder, bowel or penis). This is a very rare complication which often self-resolves. During the procedure, Dr McConnell uses cone beam CT to ensure the catheters are in exactly the right place prior to injecting the embolic particles.
What investigations are needed prior to prostate artery embolisation?
We will arrange an outpatient consultation with Dr Ryan McConnell to fully discuss prostate artery embolisation and organise the following tests:
- International Prostate Symptoms Score (IPSS) – this is a questionnaire to indicate the severity of the patient’s urinary tract symptoms.
- Blood tests – routine checks prior to prostate artery embolisation
- Prostate specific antigen (PSA) – a blood test to screen/exclude prostate cancer.
- Urine sample test – to check for a urinary tract infection.
- Renal tract ultrasound and urodynamic testing
- CT angiogram (CTA) – this is a non-invasive imaging test to assess the prostate gland and its blood supply to help plan the prostate artery embolisation.
- Prostate MRI – another non-invasive imaging modality to assess the prostate gland.
After all investigations have been performed, Dr McConnell will be able to advise whether you are suitable for prostate artery embolisation and answer any questions you may have. If you are ready to go ahead we can then book a date for your procedure.
What is the recovery like after prostate artery embolisation?
There is generally a quick recovery after prostate artery embolisation. After the procedure patients are discharged from the hospital with a 1 week course of antibiotics and pain relief.
It is common for patients to experience one or two side effects for 3-7 days after prostate artery embolisation.
The most common side effect is a stinging sensation with passing urine, which usually settles within a week. Patients may also notice a small amount of blood when urinating, which usually settles within 5 days post procedure.
Occasionally, patients will have a small amount of blood in semen on ejaculation. This can continue for a couple of months but is nothing to worry about and will resolve.
Rarely, patients find it difficult to pass urine immediately after the procedure. If this does occur, a urinary catheter will be inserted. The urinary catheter will stay in place for 2 weeks and then removed to allow any prostate swelling to settle down.
Follow-up After Prostate Artery Embolisation
Dr McConnell will contact you by telephone 2 weeks post procedure to see how you are progressing. He will organise for you to have a MRI 3 months post procedure and be reviewed in his consulting rooms.