What is PAE?

Prostatic artery embolization (PAE) is a minimally invasive treatment that helps improve lower urinary tract symptoms caused by an enlarged prostate, with lower risk of the sexual side effects such as retrograde ejaculation or erectile dysfunction, which can occur from surgery.

PAE is performed by an interventional radiologist(IR), a doctor who uses X-rays and other advanced imaging to see inside the body and treat conditions without surgery.

Before the PAE Procedure

Depending on your IR’s procedural protocol, a Foley catheter (a thin, hollow tube held in place with a balloon at the end) may be inserted into your urethra and positioned in your bladder to provide a reference point for the surrounding anatomy.

During the PAE Procedure

During PAE, you are given a local anesthetic and mild sedation medication, but remain awake.

The PAE procedure begins with a tiny incision in your upper thigh or wrist. The IR uses this incision to insert a catheter into your arteries and guide it near your prostate. Once the catheter is in position, an arteriogram (an X-ray in which dye is injected into the blood vessels) is done to map the blood vessels feeding the prostate. Next, Embosphere® Microspheres, tiny round particles each about the size of a grain of sand, are injected through the catheter and into the blood vessels that feed your prostate, reducing its blood supply. The IR then repositions the catheter in order to treat the other side of your prostate, the same way as previously described.

After the PAE Procedure

In most cases relief begins to occur within days as the prostate shrinks, relieving pressure on the urethra and improving symptoms.

PAE Benefits

PAE offers many benefits compared to surgical procedures:

1. Shorter hospital stay and recovery time
2. Low risk of sexual side effects
3. Low risk of urinary incontinence
4. Shorter urinary catheterization time (may be avoided completely)
5. Decreased discomfort Both transurethral resection of the prostate (TURP) and open prostatectomy are invasive surgeries that can result in higher rates of retrograde ejaculation (ejaculation into the bladder rather than out through the urethra), impotence, and urinary incontinence. There have been few reports of these side effects caused by PAE.

Possible Risks

The greatest risk comes from non-targeted embolization, the injection of microspheres into arteries not supplying the prostate, potentially causing severe complications. PAE is a challenging procedure that should only be performed by experienced and properly trained interventional radiologists possessing a strong understanding of pelvic vascular anatomy.

Patients may experience “post-PAE syndrome” for days following the procedure, which can include nausea, vomiting, fever, pelvic pain, or painful or frequent urination.

Other risks include hematoma at the incision site, blood in the urine, semen, or stool; bladder spasm; or infection of the puncture site or prostate.

About Embosphere® Microspheres

Embosphere® Microspheres are the first and only embolic to be cleared for prostatic artery embolization(PAE) by the U.S. Food & Drug Administration.