Interventional Radiology: Prostate Artery Embolization
At NewYork-Presbyterian Hudson Valley Hospital, board-certified interventional radiologists from ColumbiaDoctors perform prostate artery embolization, a minimally invasive treatment for benign prostatic hyperplasia (BPH) that shrinks the prostate by blocking its blood supply. Prostate artery embolization is a life-changing event for many men, restoring wellbeing and quality of life.
What is Benign Prostatic Hyperplasia?
Benign prostatic hyperplasia is a common condition in men. The prostate becomes enlarged causing symptoms such as frequent urination, incomplete emptying of the bladder, difficulty urinating, and incontinence. More than half of men over the age of 60 have some urinary symptoms due to BPH and up to 90% of men over the age of 70 experience symptoms. For some people, the symptoms interfere with daily activity and sleep. BPH is a noncancerous condition and does not require treatment unless the symptoms interfere with your quality of life.
Prostate Artery Embolization
Prostate artery embolization (PAE) is a minimally invasive, safe, and highly effective treatment for BPH that shrinks the prostate by blocking its blood supply. PAE is performed by interventional radiologists using tiny tools and imaging to perform procedures that would otherwise require invasive urologic intervention or open surgery. Most of the time, this means that patients go home on the day of their procedure with a Band-Aid instead of an incision.
During this procedure, an interventional radiologist uses X-ray imaging to navigate a catheter (a thin, hollow tube) to the vessels that supply the prostate with blood. Tiny round beads—each measuring the size of a grain of sand—are injected into the catheter and into the prostate-feeding vessels. The tiny beads block the blood flow to the prostate, causing it to shrink.
Compared with more invasive procedures to treat BPH, such as transurethral resection of the prostate (TURP), PAE has a drastically lower risk of urinary incontinence and sexual side effects (retrograde ejaculation or erectile dysfunction).
Prostate artery embolization is performed in our state-of-the-art interventional radiology suite, equipped with the latest cutting-edge imaging technology that helps make PAE as safe and accurate as possible.
Am I a candidate for prostate artery embolization?
At NewYork-Presbyterian Hudson Valley Hospital, a multidisciplinary team of experts collaborate to evaluate your BPH symptoms and discuss your treatment options with you.
Patients who are ideal candidates for prostate artery embolization include men who:
- Have symptomatic BPH
- Want to preserve sexual function
- Have had an adverse reaction to or side effects from medications
- Don’t want or might not be good candidates for surgery
Recent studies have shown that close to 90% of patients demonstrate improvement after prostate artery embolization, with many patients showing up to ten years of good long-term results.
Your interventional radiologist will schedule an exam to determine if you are a candidate for prostate artery embolization. The exam may include a health history, urine test, rectal exam, and MRI or ultrasound imaging to determine the size of the prostate. As with any medical intervention, discuss the most current clinical data with your interventional radiologist before deciding on the treatment that is best for you.
What will happen during the procedure?
On the evening before your procedure, you should not eat or drink anything after midnight. Your doctor will tell you which medications you may take in the morning.
After you arrive in one of our outpatient offices and are ready for the procedure, we will administer a local anesthetic to numb your wrist or groin area, then insert a needle. This needle provides access for a catheter, which we will guide to the vessels that supply blood to the prostate. Your doctor will use an X-ray technique called fluoroscopy to guide the catheter into position.
Once the catheter is in place, we will inject a contrast dye—which enables us to see the blood supply to the prostate—into the vessels. After this procedure, called an arteriogram, we will slowly inject an embolic (blocking) agent (synthetic particles the size of grains of sand) into the artery through the catheter. The embolic agent flows with the blood toward the prostate and becomes wedged in the vessels supplying the prostate with blood. We will continue the procedure for several minutes until the blood flow is completely blocked, and then move the catheter to the other side of the prostate and repeat the process.
We routinely perform prostate artery embolization in under an hour, and you will then recover in your own private room. Most patients return to work or their normal routines in less than one week.
Are there any risks?
The procedure is relatively safe when performed by an experienced interventional radiologist. Major adverse effects are self-limiting and include post-PAE syndrome, consisting of mild pain, nausea, low-grade fever, and/or painful urination. These symptoms resolve within a day or two after the procedure.
Please discuss all risks and benefits with your doctor during your consultation.
After the procedure
Most patients are scheduled as the first ambulatory case of the day, recover in their own private room, and go home in the late afternoon. You will likely need about four days at home to recover. Most patients feel back to normal after a week to 10 days.
Most men experience six to 12 hours of discomfort after the procedure. We usually treat your pain with an oral or intravenous painkiller while you're in the hospital. The pain usually decreases during the first week and can be controlled with an oral painkiller.
Follow up care
We will schedule a follow-up appointment for you in a week to a month after the procedure and may order imaging tests to check the status of the prostate three to six months after the procedure.
Our Approach to Care
Comprehensive and patient-centered care
At NewYork-Presbyterian Hudson Valley, you, the patient, are at the center of our approach to superior imaging and treatments that meet your individualized needs. Our fellowship-trained Columbia interventional radiologists perform all procedures. We explain the findings to you in easy-to-understand terms and work closely with your referring physician so you can make educated and informed choices about your care.
Multidisciplinary team approach
Our interventional radiologists collaborate in multidisciplinary teams with NewYork-Presbyterian Hudson Valley’s highly skilled and dedicated physicians in a variety of specialties. This ensures that you receive the optimal treatment for your condition that is tailored to your needs.
Why Choose Us
Prostate artery embolization expertise
Prostate artery embolization (PAE) is a complex and challenging procedure that requires expertise and a cautious approach. Our board-certified interventional radiologists from ColumbiaDoctors, the faculty practice of Columbia University Irving Medical Center, offer unmatched expertise and experience in prostate artery embolization, even in the most complicated patients.
Cutting-edge technologies
At NewYork-Presbyterian Hudson Valley, we are continually committed to incorporating the latest cutting-edge imaging technologies into your care, including advanced X-ray fluoroscopy, computer tomography (CT), magnetic resonance imaging (MRI), and ultrasound. For prostate artery embolization, our 3D imaging technology helps to increase procedure safety, limit the risk of complications, and achieve the best possible outcomes.
Book Radiology Appointments via NYP.org/Connect
Patients can book Radiology appointments online via NYP.org/Connect as long as the patient has an Epic Order. Radiology appointments for X-Ray, ultrasound, bone density, echocardiogram, and limited CT and MRI scans.