PAE (prostate artery embolization) can be performed by an endovascular specialist alongside an IR (interventional radiologist) who uses X-rays and other types of imaging to treat the prostate gland. PAE is known to have a very high rate of success and no dreaded side effects such as sexual dysfunction. Moreover, the benefits of the BPH treatment procedure can have lasting effects up to five years.
PAE is performed by introducing a Foley catheter in order to shrink the prostate. It also involves the placement of microspheres into prostate blood vessels. The procedure is a minimally invasive alternative to surgery. In addition, the costs and risks are very low. However, PAE is still considered an experimental and investigational procedure, which is why Medicare will not cover it despite the fact that its effectiveness and safety have been well established by means of clinical evidence and peer review. Nevertheless, there are many insurance companies that do cover PAE. Moreover, in comparison with TURP (the standard procedure for treating enlarged prostates), PAE does not impact erectile function. Its effects only consist of: pressure relief on the urethra, shrinkage of the prostate and improved urinary tract symptoms. In addition, PAE can be safely repeated every five years if medication does not have the desired results.
The endovascular specialist may also recommend UroLift –a procedure very similar to PAE. It is only suitable for relatively small glands and there is no long-term data on its effectiveness. Moreover, it is not recommended for more vascular prostates.
A third option recommended by an endovascular specialist could be the aquablation of the prostate which is a surgical treatment in the form of an incision-less procedure carried out in an operating room. During this particular procedure, an image-guided robotic arm will remove excess prostate tissue by means of a water jet.