The prostate is a small gland that is involved in male sperm production. As men age, the gland often enlarges. This condition is called benign prostatic hyperplasia (BPH). BPH often leads to urinary issues such as problems emptying the bladder, which results in a sensation of the urge to urinate. Prostate embolization is an interventional radiology procedure that is very effective at reducing the symptoms of BPH. During prostate embolization, small blocking materials are inserted into the prostate to reduce the blood supply causing the enlargement. The lack of blood flow should cause the prostate to shrink back down in size, alleviating uncomfortable urinary symptoms.
Why Prostate Embolization is Performed
Benign prostatic hyperplasia is a common condition in men. Symptoms often emerge starting in a man’s 50s. While there are medical and surgical approaches to alleviate the symptoms of BPH, they are not always as successful as prostate embolization in men contending with moderate or severe symptoms. These symptoms may include:
- Impeded urine flow
- Urinary retention that creates an urge to urinate frequently
- A slow urine flow
- Difficulty initiating urination
- Frequent urinary tract infections
Prostate artery embolization is a relatively new procedure that shrinks the enlarged prostate by reducing blood flow to the organ. This happens by the selective blockage of prostate blood vessels. Over time, the prostate relaxes, returning to a smaller size and alleviating the symptoms of BPH.
What to Expect During Prostate Embolization
Most prostate embolizations take under two hours, though a single overnight hospital stay for observation is usually required following the procedure. The patient receives IV sedation in order to relax. Next, the skin in the man’s upper thigh area is numbed and a small incision is made. From here, the interventional radiologist threads a catheter (thin plastic tube) through the incision until it reaches the blood vessels of the prostate gland. X-ray imaging ensures that the catheter is threaded safely. Once the catheter reaches the prostate vein, embolic agents are injected. Embolic agents are synthetic particles that may be miniscule coils, beads, or a thick glue-like fluid. Once the chosen materials lodge themselves into the prostate blood vessel, blood flow slows, giving the prostate the chance to heal. As this happens, urinary symptoms fade away over time.
Risks and Benefits of Prostate Embolization
Embolization is a safe procedure that shows high success rates across several medical applications. Since prostate embolization is non-invasive, only requiring a very small incision, it has fewer complications than a surgical intervention for BPH. For example, there is less chance of bleeding that with surgery. But since prostate embolization is a medical procedure, there are risks. Any time a catheter is used, there is the slight risk of unintended blood vessel damage. Bruising and infection at the incision site are also potential complications. But overall, prostate embolization is well-tolerated by men, with no significant effects. Immediately following the procedure, a patient may have localized pain or pain with urination, but these issues should resolve quickly.
How to Prepare for Prostate Embolization
After reviewing the patient’s medications, the care team will recommend any therapies, such as blood thinners, that must be paused ahead of the scheduled procedure. Routine pre-procedural bloodwork may also be ordered. The team will provide directions around when to stop eating and drinking the night before the procedure, as well as pertinent arrival information for the day of the procedure. Since a prostate embolization typically requires an overnight hospital stay, the patient should arrange for transportation home the following day.
Post Prostate Embolization
Patients will be encouraged to rest for the first day after returning home. It is not unusual to feel fatigued for several days following a prostate embolization. It is also normal to see small amounts of blood in the urine and feel a burning sensation during urination. These symptoms and any increased need to urinate should resolve within a few days. Any discomfort or fever can be treated with over-the-counter medication. Most men are back to their normal daily activities within a week.