Now a new procedure has been developed that is superior to TURP in recovery of the symptoms with no side effect. It is called Prostatic Artery Embolization or PAE.
The patients are admitted to the hospital on the day of the procedure after all basic investigations. During embolization, pain medication, anti-inflammatory drugs and antibiotic are given.
Embolization is performed under local anesthesia by unilateral approach, usually the right femoral artery. Initially, pelvic angiography is performed to evaluate the prostatic arteries. Then, a 4 or 5-F angiography catheter is introduced to reach in prostatic artery and a 3-F coaxial microcatheter advance in the ostium of the prostatic artery. For embolization, nonspherical PVA particles are used. The endpoint chosen for embolization is slow flow or near-stasis in the prostatic vessels with interruption of the arterial flow and prostatic gland opacification.
When embolization of the both prostatic arteries is finished, the catheter is removed. After 4- 6 hrs patients can start walking around in room without a urinary catheter. Same day he can resume the normal activities.
Picture 1: - Angiographic picture in a 74-year-old patient with urinary retention with a bladder catheter. Before and after Prostatic Artery Embolization.
Picture 2: - Pelvic MR images in a 78-year-old patient with BPH. Before PAE shows an enlarged prostate diameter of 59.2 mm and a prostate volume of 95.5 m. After 6 months of PAE shows significant reduction in size.