Who is a Good Candidate for Prostate Artery Embolization?

Benign prostatic hyperplasia (BPH), more commonly known as an enlarged prostate, is a common condition that affects men over the age of 50. Essentially, BPH occurs when the prostate grows larger, which can squeeze the urethra and cause symptoms like frequent urination, weak urine flow, and the feeling that the bladder isn’t fully emptied, making daily life more difficult. While traditional surgeries like TURP and UroLift have been common treatments for BPH, prostate artery embolization (PAE) offers a modern, minimally invasive alternative that reduces risks and helps men regain control of their health. In this blog, we’ll explore who may benefit from PAE, its advantages, and why it might be the right choice for you.

What is Prostate Artery Embolization?

Prostate artery embolization is a minimally invasive procedure used to treat BPH, which works by blocking the blood vessels that supply the prostate with blood. During the procedure, a catheter is inserted into the arteries that feed the prostate. From there, tiny particles are injected to reduce blood flow, causing the prostate to shrink while relieving symptoms of BPH. Performed by our highly skilled interventional radiologists, this procedure boasts quicker recovery times, minimal pain, and fewer complications compared to more invasive interventions like TURP or UroLift. PAE is also performed in an outpatient setting, allowing most patients to go home the same day and return to their normal activities in just a few days.

Who Should Consider PAE?

Prostate artery embolization is not suitable for everyone with BPH. Doctors carefully evaluate each patient’s symptoms, prostate size, overall health, and personal preferences to determine if they are a good candidate. Below are factors that make someone an ideal candidate for PAE:

1. Men with Moderate to Severe BPH Symptoms

PAE is recommended for men experiencing significant urinary symptoms that affect their daily life. These symptoms often include:

• Frequent urination, especially at night (nocturia).
• Difficulty starting or stopping urination.
• Weak or interrupted urine flow.
• A feeling of incomplete bladder emptying.
• Urgency or straining during urination.

2. Men Looking for a Minimally Invasive Option

PAE is ideal for patients who want to avoid invasive surgical procedures like TURP. It is performed through a small incision and does not require general anesthesia, making it a safer option for men who may be at higher risk during surgery.

3. Men Unable to Undergo Surgery

Some men are not good candidates for traditional BPH surgeries due to underlying health conditions, such as:

• Cardiovascular disease
• Severe peripheral artery disease
• Kidney disease
• Bleeding disorders
• Advanced age

PAE is a safe alternative for these patients because it is performed under local anesthesia and has a lower risk of complications.

4. Men with Large Prostate Glands

While many surgical options are effective for smaller prostates, PAE is particularly beneficial for men with significantly enlarged prostate glands (greater than 80-100 grams). It is often challenging to treat large prostates with standard surgeries, but PAE can effectively shrink even large glands without requiring invasive techniques.

5. Men Who Want to Preserve Sexual Function

One of the advantages of PAE is its low risk of sexual side effects, such as erectile dysfunction or retrograde ejaculation, which are more common with surgical treatments like TURP. Men who are concerned about preserving their sexual function may find PAE to be a better option.

6. Men with Recurrent Urinary Retention

For men who experience repeated episodes of urinary retention (inability to empty the bladder), PAE can help by reducing the size of the prostate and relieving the blockage that prevents proper bladder emptying.

7. Men Interested in Shorter Recovery Times

PAE allows patients to resume normal activities much faster than traditional surgeries. Most men can return to work and daily activities within a few days to a week after the procedure, making it ideal for those who cannot afford long recovery periods.

Who Is Not a Good Candidate for PAE?

While PAE is a safe and effective treatment option for many men, it may not be suitable for everyone. Patients who may not be a good candidate for PAE:

1. Men with Prostate Cancer

PAE is specifically designed to treat benign prostatic hyperplasia and is not appropriate for men with prostate cancer. If cancer is suspected or confirmed, alternative treatments focusing on the malignancy are necessary.

2. Men with Kidney Disease

Since PAE involves using contrast dye, it can be harmful to men who have poor kidney function and is not recommended for any patient with kidney disease.

3. Men with a Urinary Tract Infection

If a patient has a urinary tract infection (UTI), PAE should be postponed until the infection or inflammation is resolved.

4. Men with Bleeding Disorders

Men who have major blood clotting or bleeding disorders that are untreated may not be ideal candidates for PAE. 

5. Men with Allergies to Contrast Dye

Men who have allergies to contrast dye may not be suitable for PAE. If this is the case, alternative treatment options should be considered.

6. Severe Urinary Symptoms Caused by Other Conditions

If urinary symptoms are caused by conditions other than BPH, such as bladder stones, bladder cancer, or neurological disorders, PAE may not address the underlying issue.

7. Men with Severe Peripheral Artery Disease 

Men with severe peripheral artery disease (PAD) may not be suitable candidates for PAE. Advanced PAD can make it challenging to navigate the catheter to the prostate arteries or may increase the risk of complications.

How to Determine If You are a Good Candidate for PAE

If you think you might be a good candidate for PAE, the first step is to consult with a prostate specialist, such as an interventional radiologist. They will conduct a thorough evaluation to determine if the procedure is right for you. Here’s what to expect during the evaluation process:

1. Medical History and Symptom Assessment

Your doctor will ask about your medical history, current symptoms, and how they affect your quality of life. The severity of your symptoms will help guide treatment decisions.

2. Prostate Imaging

Imaging tests such as ultrasound may be used to assess the size and shape of your prostate and to identify the location of blood vessels that supply the gland.

3. Blood and Urine Tests

Blood and urine tests can help rule out infections, cancer, or other conditions that could be contributing to your symptoms.

4. Specialized Tests

Additional tests, such as a urodynamic study or a prostate-specific antigen (PSA) test, may be performed to evaluate bladder function and screen for prostate cancer.

Benefits of PAE

For men who are good candidates, PAE offers several advantages when comparing it to alternative treatment methods, including:

• Outpatient Procedure – PAE is typically performed as an outpatient procedure, allowing you to go home the same day.
• Quick Recovery – With minimal downtime, most patients are able to return to their regular activities within a week or two.
• Reduced Risk of Side Effects – PAE has a lower risk of sexual dysfunction and urinary incontinence compared to more invasive surgeries.
• Less Pain and Swelling – Most men experience minimal discomfort and swelling after the procedure.
• Effective Symptom Relief: Studies show that PAE significantly improves urinary symptoms and quality of life for most patients.
• No Limitations on Prostate Size – PAE can treat prostate enlargement, regardless of how large the prostate has become, unlike some surgical options.

Consult With a Prostate Specialist at American Prostate Centers

If you’re among the millions of men dealing with BPH symptoms, American Prostate Centers offers PAE for men in New York to help you find relief from your symptoms and improve your prostate health. Please contact us today to schedule an appointment to see if PAE is the right choice for you!