Chapters Transcript Video Prostate Artery Embolization (PAE) Dr. Adam Lustig, Interventional Radiology, describes what a patient can expect before, during, and after a Prostate Artery Embolization (PAE). Hi, welcome to this educational session on prostate artery embolization or pae. A minimally invasive procedure designed to help alleviate symptoms of an enlarged prostate, a condition medically known as benign prostatic hyperplasia or BPH. My name is Adam Lustig. I'm an interventional radiology physician and I specialize in the PAE procedure. Today, I will guide you through the entire pae experience providing you with a clear understanding of what to expect before during and after the procedure. Pae is a non surgical treatment for BPH. It involves blocking the blood supply to the prostate gland which reduces its size and relieves symptoms such as difficulty urinating preparation may involve undergoing certain tests such as blood work and imaging of your prostate, such as AC T scan. You'll be advised to stop taking certain medications like blood thinners and to fast for a specific period of time before the procedure. Pae is typically done on an outpatient basis, meaning you can go home the same day. However, arrangements for someone to drive you home should be made as you won't be able to drive for 24 hours after the procedure during the pae, you'll be under local anesthesia and light sedation. A small incision is made usually in your groin to access your arteries using X ray guidance. A catheter is then threaded through the arteries to the prostate. Tiny particles are then injected through the catheter to block the blood flow to the prostate gland. The particles are made of an inert substance such as a polyester or collagen based material. They are less than half a millimeter in size and look like grains of sand as they are injected, they stack up in the artery causing physical blockage of the blood flow. Most patients experience minimal discomfort during a pae, you might feel some pressure at the incision site or slight sensation as the catheter is being moved. But pain medication and sedatives are used to ensure your comfort during the case. The entire procedure typically lasts about 1 to 2 hours depending on various factors like the anatomy of your arteries and the size of your prostate. You will be taken to a recovery area where your vital signs will be monitored as the sedation wears off. Some patients report feeling groggy or having mild discomfort which can be usually managed with medications. Recovery varies from each individual but many patients can resume normal activities within a few days. You will be advised to avoid strenuous activities for three days. For the first week, you may notice stinging or burning when you urinate. This is a normal side effect. Other urinary symptoms such as urgency and frequency might get worse for the first week as well, but you will be prescribed medication to help ease these symptoms. Some men experience improvement as soon as a few weeks after the procedure. But for most, it takes up to a few months to see the full benefits as your prostate continues to shrink. As with any medical procedure. A pae can have side effects although they are generally minor and temporary. These may include pain bruising at the incision site and temporary worsening of your urinary symptoms like urgency. More serious complications are rare but can include infection or damage to the surrounding tissues. No, there are no sexual side effects after a pae. Unlike most other prostate procedures, average size reduction is 10 to 40% at six months after the procedure, it generally shrinks the most in the first three months and will continue to shrink for up to six months. Patients are typically seen three months after the procedure back in our office. A noncontrast pelvic ct is obtained to evaluate your prostate size reduction in overall results. Usually no further follow up is required after this point, published data shows that a pae on average lasts for 5 to 8 years. Yes, a repeat pae can be performed. This might be required if your symptoms return before five years. On average, a repeat pae is required less than 5% of the time this might happen if a small artery supplying the prostate enlarges over time to become the main source of blood flow to the prostate. Yes, a pae does not preclude any other prostate procedure. In fact, it might actually make some of them safer by reducing bleeding risk of those surgeries. The decision to undergo a pae should be made in consultation with your physician, considering your specific symptoms, health condition and lifestyle. It is an effective option for many but it's not suitable for everyone. I hope this session has been informative and has helped demystify the prostate artery embolization process for you. If you already have an appointment to see us, we look forward to meeting you very soon, if not, and you're interested, you can call our clinic to have your own consultation. Published May 10, 2024 Created by Related Presenters Adam C. Lustig, M.D. Medical Center Radiologists View full profile
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