Prostate Artery Embolization

If you have benign prostatic hyperplasia (BPH), this treatment may help you enjoy a better quality of life.

We know that BPH can affect your everyday life. Prostate artery embolization (PAE) treats BPH. It can help you get back to doing the things you love with confidence.

Northwestern Medicine PAE Program

Our team has more than 10 years of experience in performing PAE, an innovative, minimally invasive procedure. We’re here for you with specially trained clinicians and leading-edge equipment. As an academic health system, we conduct PAE research and clinical trials so we can offer you the best care possible.

What Is BPH?

As men age, the prostate gland tends to grow larger. BPH is the non-cancerous enlargement of the prostate. It’s very common. More than 80% of men experience BPH in their lifetime, and 50% experience it by the age of 50.

The enlarged prostate presses on the urethra and bladder. This leads to urinary symptoms such as:

• Urinating more often
• Straining or hesitancy while urinating
• Weak urine stream
• Urgency to urinate
• Feeling of incomplete bladder emptying
• Excessive urination at night (nocturia)

If it’s not treated, BPH can lead to more serious conditions such as:

• Incontinence (loss of bladder control)
• Kidney stones
• Bladder damage and infections

If you’re experiencing these symptoms, seek treatment early. This can help prevent complications.

What Is PAE?

PAE is a nonsurgical procedure for people with moderate to severe urinary symptoms caused by BPH. PAE uses advanced imaging, such as X-ray, to target the prostate without incisions or general anesthesia.

During PAE, an interventional radiologist inserts a small catheter (a thin, hollow tube) into an artery in your wrist or leg. Using 3D X-ray imaging, they will guide the catheter to the arteries that supply blood to your prostate.

Once the catheter is in place, the care team injects microscopic beads (embolic agents) through the catheter. They block blood flow to the prostate. Over time, this causes the prostate to shrink, relieving pressure on the urethra and reducing urinary symptoms.

The American Urological Association recommends PAE as an effective treatment for patients with BPH. PAE can help lessen your symptoms while minimizing risks linked with traditional surgeries.

Why Choose Northwestern Medicine for PAE?

At Northwestern Medicine, we offer:

• World-class expertise: Our team of interventional radiologists is at the forefront of the PAE field. With more than 10 years of experience in performing PAE, we're dedicated to ensuring you receive the highest quality care.
• Patient-centered care: Here, you’re at the center of your care team. We take the time to understand your needs and provide personalized care every step of the way.
• Advanced technology: Our facilities are equipped with state-of-the-art imaging systems. This helps ensure you receive the most effective treatment possible.
• Better patient safety: Your safety and well-being are our top priorities. That’s why we use embolic agents cleared by the U.S. Food and Drug Administration (FDA) for PAE. This helps ensure safe and effective treatment.
• Minimally invasive approach: PAE is performed under local anesthesia with sedation. This means most patients have no incisions, less discomfort and a faster recovery.

Benefits

• Outpatient procedure: PAE is performed as a same-day procedure, so most patients can go home within hours. General anesthesia is not used.
• Quick recovery: Most patients return to normal activities the next day, with only mild discomfort managed by over-the-counter medications. We will not use a Foley catheter. Foley catheters are put into your urethra (opening at the tip of your penis) to drain urine.
• Effective results: Many patients’ symptoms improve within a month, with long term durability of several years.
• Lower risk of complications: PAE has a lower risk of sexual dysfunction compared to traditional surgery. In addition, many patients can stop using BPH medications after the procedure.
• Minimally invasive approach: PAE is performed under local anesthesia with sedation. This means most patients have no incisions, less discomfort and a faster recovery.

The PAE Procedure: What to Expect

1. Initial consultation: An interventional radiologist will perform a thorough consultation. We will review your symptoms and medical history to determine if PAE is the right option for you.
2. During the procedure: The PAE typically takes about two hours. Patients typically get local anesthesia with mild sedation. With 3D X-ray imaging, the radiologist will guide the catheter to the arteries supplying the prostate. They will deliver the embolic agents through the catheter. Embolic agents block blood flow in a blood vessel, helping shrink your enlarged prostate over one to three months.
3. Post-procedure and recovery: After the PAE, you will spend about two hours recovering before you go home. Patients typically have minor side effects such as:
• Urinating more often
• Feeling more urgent needs to urinate
4. These side effects usually go away on their own within one week.

Recovery

After PAE:

• Most people go home the same day as the procedure.
• You will go home with:
• Over-the-counter pain medication
• Antibiotics to take for a short time
• Most people can go back to their normal activities the next day.
• Symptoms often get better within one month. Improvements may continue for up to six months.
• Our data shows that 80% to 90% of our patients who receive PAE have significant improvement in urinary symptoms.

Side Effects

PAE is nonsurgical. That means side effects are often minimal and go away on their own after a short time.

Side effects may include:

• Urinary tract infection (UTI): This happens in fewer than 1% of patients. We will give you antibiotics to prevent this.
• Increased urinary frequency, urgency or burning: These symptoms can last for up to one week after PAE.

Unlike traditional BPH treatments, PAE is not linked with sexual dysfunction. At Northwestern Medicine, our advanced imaging techniques help ensure patients have minimal side effects and can often stop BPH medications after the procedure.

Frequently Asked Questions

Is PAE safe?
Yes, PAE is considered a safe, minimally invasive procedure. It has a low risk of complications. Your physician will review the potential risks and benefits with you during your consultation.

How long does it take to recover from PAE?
Most patients return to normal activities the day after the procedure. Typically, symptoms improve within a few weeks. Symptoms may keep improving over the next few months.

Will PAE affect my sexual function?
It is not linked with sexual dysfunction or erectile dysfunction. In fact, many patients have no bad side effects on sexual health.

For More Information

For more information about PAE, contact the location most convenient for you.

• Chicago
• Kimberly Jenkins, BSN, RN, CRN, nurse clinician coordinator, at 312.695.9327 or by email at kjenkins@nm.org
• Sam Mouli, MD, MS, FSIR, associate professor of Radiology, at s-mouli@northwestern.edu
• Grayslake and Lake Forest
• Krista Smith, BSN, RN, CRN, nurse navigator, at 847.535.8165 or by email at ksheehy@nm.org
• Elias Hohlastos, MD, FSIR, at elias.hohlastos@nm.org