Prostate artery embolization is a minimally invasive procedure used to treat benign prostate hyperplasia (BPH), which means a non-cancerous, enlarged prostate. Prostate artery embolization is approved by the FDA and has been used for more than 10 years to treat benign prostate hyperplasia. The procedure is usually covered by insurance. Prostate artery embolization has been proven to be a safe and effective treatment, with a 90 to 95% success rate.

Prostate artery embolization is performed by an interventional radiologist. Interventional radiologists are doctors who have completed medical school, an internship, residency, and then a subspecialty fellowship, which is advanced training in interventional radiology. As part of their training, interventional radiologists may perform at least 100 artery embolization procedures under the supervision of an experienced interventional radiologist before performing the procedures on their own.

Prostate artery embolization is a relatively painless procedure that uses a microscopic catheter inserted through the wrist or leg into an artery. Embolization means to plug up or block blood flow. In patients with benign prostate hyperplasia, the prostate has too much blood flow. After the microscopic catheter is inserted, tiny particles about the size of sand called beads are injected into the artery leading to the prostate gland. The beads block the blood flow and slow the blood supply to the prostate gland, causing it to shrink. The beads can be absorbable or made to stay in place.

Prostate artery embolization may also be used as an added treatment for patients with prostate cancer, in addition to surgery, radiation, and hormonal therapy. Some patients with prostate cancer may also develop benign prostate hyperplasia, which can be treated with prostate artery embolization.

Some patients with prostate cancer who have a very large prostate may be treated with prostate artery embolization before undergoing radiation therapy. Prostate artery embolization can help to reduce swelling and the size of the prostate to make radiation therapy more effective. Prostate artery embolization can also help to prevent patients with prostate cancer from developing urinary retention or requiring a catheter to drain their bladder.

Prostate artery embolization can be performed in an outpatient interventional radiology center or a hospital. Before undergoing prostate artery embolization, patients will have lab tests to make certain that their kidneys are working properly. Preoperative instructions include not eating or drinking for 6 hours before the procedure and stopping any blood thinners.

Prostate artery embolization usually takes about one to two hours. During the procedure, patients with be sedated with medication. For this reason, patients should arrange to have someone drop them off and pick them up.

After prostate artery embolization, some common side effects may appear, such as a sensation of needing to urinate, frequent urination, mild burning when urinating, and a small amount of blood in the urine. These common side effects will usually improve one to four weeks after the procedure.

After the procedure, patients may return home and resume most normal activities. Patients may drive and return to work the next day after prostate artery embolization. Avoid heavy lifting and strenuous exercise for 5 to 7 days after the procedure. There is no restriction on sexual activity. After prostate artery embolization, most patients will notice a dramatic improvement in the symptoms of benign prostate hyperplasia within 4 to 6 weeks.

Less common side effects after prostate artery embolization may include fever, chills, or night sweats. If these side effects occur, be certain to notify your doctor.

Complications are very low (less than 1%) after prostate artery embolization and may include bleeding, infection, or possible damage to a nearby structure. There is no risk of impotence or incontinence.

Prostate artery embolization is a safer, more comfortable procedure when compared to transurethral prostate resection, also called TURP, which can also be used to treat benign prostate hyperplasia. Transurethral prostate resection has increased risks of urine leakage or incontinence, erectile dysfunction, and retrograde ejaculation.

Ideally, prostate artery embolization should be performed on men whose prostates are between 40 to 80 grams in size. Some select patients with prostates over 80 grams may be considered for prostate artery embolization versus transurethral prostate resection. About 10 to 15% of patients who undergo prostate artery embolization for benign prostate hyperplasia may need retreatment after 5 years.

It is important to ask your doctor how many prostate artery embolization procedures they have performed and what their success and failure rates may be. Patients with benign prostate hyperplasia should discuss all treatment options with their doctor.