Which doctor performs the PAE procedure?
A specially trained doctor called an interventional radiologist performs the procedure. Interventional radiologists have special expertise in using image-guidance to perform minimally invasive procedures and are specifically trained to navigate small catheters and micro guidewires through arteries and ensure correct placement and localised treatment.
Where does the PAE procedure take place?
Because the PAE procedure requires X-ray image guidance, it is performed in a special theatre called a CATH (catheter LAB) or vascular suite. A special X-ray machine with ‘real-time X-rays’ assists to guide the interventional radiologist into the prostate artery after a special ‘roadmap’ of the arteries is produced after injection of a contrast ‘dye’.
How long does the procedure take?
The procedure usually takes approximately an hour. Each patient is however different and therefore the anatomy and origin of the prostatic artery can vary greatly therefore the procedure may take a little longer depending on the these factors.
Is the procedure performed under general anaesthetic?
No. The procedure is performed under ‘deep sedation’. This is not general anaesthetic but rather like a deep sleep.
Will the procedure be painful?
The procedure is performed with you asleep and therefore you will not feel anything or remember anything. There is also only minimal discomfort following the procedure.
No Scars-No stiches!
Because the procedure is performed through a tiny pinhole in the wrist, there are no scars and no stiches.
A small wrist band is applied to the hole over the radial artery and a small balloon is inflated which prevents the artery from bleeding. This band stays on the wrist for 2 hours and is then removed.
How long will I be in hospital?
Following the procedure you will be taken to the ward and kept overnight in case of minimal discomfort. Most patients will be discharged the following day.
What can I expect immediately after the procedure?
There is usually minimal discomfort following the procedure with only slight burning during urination, a feeling of wanting to urinate as well as a little blood in the urine. This usually settles over a few days.
Are there any risks or complications?
Prostate artery embolization is a relatively new procedure however has been found to be safe with minimal risks and no significant complications. There are however risks and complications related to any medical and surgical treatment.
There may occasionally be bleeding or bruising at the access site of the needle which also may become infected as can any skin opening. This is however easily treated with antibiotics.
Some patients may also be unable to pass urine following the procedure, which is called urinary retention. This can also be promptly and easily managed with the insertion of a temporary catheter.
How long will I be off work?
Patients are given one week off work however are usually well enough to go back to normal duties after 2-3 days.
What results can I expect after the PAE procedure?
70% of patients will have improvement of their urinary symptoms.
Most patients report an improved quality of life related to the above.
After one year the average prostate size is seen to shrink by approximately 30% which correlates with a significant improvement of symptoms and quality of life.