Meenakshi Radiology

Phone: +91 82485 90535
Address: Near New Bus stand, Tanjore

Prostatic Artery Embolisation (PAE)

  • Meenakshi Radiology
  • Specialities
  • Prostatic Artery Embolisation (PAE)

    • We welcome 

    Our first batch of DNB Radiology students in Meenakshi hospital, Tanjore

    Minimally Invasive Treatment for Benign Prostatic Hyperplasia (BPH)

    What is PAE?

    Prostatic Artery Embolisation (PAE) is a minimally invasive, image-guided procedure that blocks the blood supply to the prostate using tiny particles, causing the prostate to shrink and relieve urinary symptoms caused by BPH.

    Diagram Labels

    • Prostate gland (enlarged)
    • Bladder
    • Urethra
    • Prostatic arteries
    • Embolic particles
    • Catheter pathway

    Indications

    • Moderate to severe LUTS due to BPH (IPSS ≥ 8–19 or more)
    • Large prostate (> 40–50 mL)
    • Patients who are poor surgical candidates
    • Patients who wish to avoid surgery or have failed medical therapy
    • Urinary retention requiring catheter dependent
    • Recurrent symptoms after prior BPH surgery

    PAE Procedure: Step by Step

    PAE

    01.Vascular Access

    1

    Local anaesthesia is given and the common femoral artery is punctured. A catheter is inserted.

    Jan

    02.Catheter Navigation

    2

    The catheter is navigated through the aorta into the internal iliac arteries on both sides.

    Jan

    03.Angiography

    3

    Contrast dye is injected to identify the prostatic arteries arising from the internal iliac arteries.

    Jan

    04.Catheter Positioning

    4

    The microcatheter is selectively advanced into the prostatic artery supplying the prostate.

    Jan

    05.Embolisation

    5

    Embolic particles are injected to block blood flow to the prostate, causing it to shrink over time.

    Jan

    06. Completion

    6

    Post-embolisation angiogram confirms reduced blood flow to the prostate.

    Jan

    Contraindications

    • Known or suspected prostate malignancy
    • Severe allergy to contrast media
    • Uncorrected coagulopathy
    • Severe renal impairment (eGFR < 30 mL/min) (not on dialysis)
    • Active urinary tract infection
    • Atherosclerotic occlusion preventing catheter access
    • Non-target embolisation risk that cannot be avoided

    ADVANTAGES

    Minimally invasive (no cuts or general anaesthesia)
    Preserves sexual function (very low risk of retrograde ejaculation)

    Short hospital stay (usually 1 day)

    Quick recovery and return to normal activities

    Effective symptom relief

    Suitable for large prostates

    Low complication rate

    Can be performed in patients who are poor surgical candidates

    Repeatable if symptoms recur

    Prostatic Arterial Supply
    (Common Sources)

    • Superior vesical artery
    • Obturator artery
    • Internal pudendal artery
    • Inferior vesical artery
    • Middle rectal artery
    • Prostatic arteries
    • Internal iliac artery

    Symptoms of BPH​

    Frequent urination
    Night time urination (Nocturia)
    Weak urine stream
    Straining to urinate
    Incomplete emptying
    Urgency

    Before & After PAE

    Good Candidate for PAE

    • Moderate to severe urinary symptoms
    • Large prostate
    • Wishes to avoid surgery
    • Not responding to medicines
    • Medical conditions that make surgery high risk

    Possible Complications (Uncommon)

    • Access site bleeding or hematoma
    • Non-target embolisation
    • Dysuria / urinary frequency (temporary)
    • Hematuria (temporary)
    • Urinary tract infection
    • Urinary tract infection
    • Contrast reaction

    Important Advice

    • PAE is a safe, effective and prostate-preserving treatment option for men with BPH.

    Note

    • This information is for educational purposes only. Consult your vascular specialist to know if EVLA is right for you.