Prostatic Artery Embolization

For more information or to schedule an appointment, call UVA Health Interventional Radiology at (434) 924-9401 and press Option #3.

Prostatic Artery Embolization (PAE) is a minimally invasive procedure designed to treat benign prostatic hyperplasia (BPH), which is the non-cancerous enlargement of the prostate gland. This condition is common in older men and can cause uncomfortable urinary symptoms. It is performed by an interventional radiologist.

UVA Health’s Ziv Haskal, MD, who established and leads the University of Virginia’s PAE clinic, is an expert at the procedure and has authored scientific literature on the subject. Dr. Haskal has been performing PAE since its earliest days in 2017, even before it became more widely available.

Finding out you have benign prostatic hyperplasia (BPH) brings lots of questions. Although you now know why you have urinary symptoms, like increased need to go and trouble holding it, you want guidance on how to relieve these symptoms. Prostate Artery Embolization (PAE) performed by an expert interventional radiologist can help.

BPH is a non-cancerous enlargement of the prostate. This is a typical event that increasingly occurs in many men as they age past 50 — your prostate simply gets larger as you age.

This condition can lead to a variety of lower urinary tract symptoms, including:

• A frequent urge to ‘go,’ without much urine
• Need to wake up and urinate at night
• Difficulty initiating urination and fully emptying your bladder
• Weak urine stream
• Incontinence or leaking
• Inability to urinate, which may require long-term or intermittent catheter placements
• Repeated infections
• Blood in your urine
• Sexual function issues

What is PAE, and why should I consider it?

Prostatic artery embolization is a non-surgical, minimally invasive procedure performed by an interventional radiologist. The procedure aims to shrink a patient’s prostate over time. PAE works by blocking the blood flow to the prostate gland, causing it to shrink and making it easier for the patient to urinate.

At UVA, PAE is typically done through a tiny nick in the skin over the wrist or groin. The procedure is done under intravenous sedation— ‘light twilight.’ There is no need for general anesthesia.

The benefits of PAE include:

• Less pain
• No incontinence or need for a catheter
• A proven easier and shorter recovery (compared to TURP, a urologic procedure)
• Lower risk of side effects compared to traditional surgery

PAE is proven to be safe and effective. It is an accepted option for men with BPH symptoms, by national and international medical societies and specialties, within both urology and interventional radiology.

During your initial Interventional Radiology UVA PAE Clinic visit, your interventional radiologist will evaluate you, determine your potential suitability for PAE, and discuss the risks, benefits, and immediate and long-term outcomes of PAE and how those may apply to you.

What Happens During a PAE Prostate Procedure?

During a PAE, you will be very relaxed and comfortable. There is no need for deep or general anesthesia.

An interventional radiologist will thread a catheter — a tiny tube much smaller than a spaghetti — through your blood vessels to reach those that supply just your prostate. Small amounts of tiny blocking particles are then injected slowly into the prostate arteries, under moving x-ray camera guidance (fluoroscopy) causing the prostate to gradually shrink.  You will be able to go home the same day.

The next morning, you should be able to shower and walk around, and expect to mostly use over-the-counter pain medications. It is recommended that you avoid heavy lifting or exercise. You IR doctor will follow up with you in 10 to 14 days, and periodically afterwards.

Within 2-4 weeks you should notice improvements, such as:

• Improved flow of urine
• Decreased need to urinate
• Decreased need to get up to urinate at night
• No bleeding (for patients who had blood in their urine)
• Potential to become free of a catheter (for patients who had needed one beforehand)

The Prostate Artery Embolization Clinic at UVA Health

Experience matters in performing a PAE. Our PAE specialist Dr. Ziv Haskal has been performing PAE since its earliest days — before most hospitals in the U.S. even offered the treatment — and has published relevant scientific literature on the subject.

We work with an interdisciplinary team of urologists and interventional radiologists, so that we can provide you the best range of potential treatments for your BPH.

Choosing UVA Health for a prostatic artery embolization procedure means you receive expert care from a multidisciplinary team that has the highest expertise– and understands your needs.

At UVA Health, you’ll have access to the latest advancements in PAE and a team dedicated to your comfort and recovery. Along with expert interventional radiologists, your care team includes experienced nurses, urologists, and other staff. We’ve treated a huge number of patients, and we’re always seeing new ones.

We don’t just treat your enlarged prostate. We find the best treatment for your specific condition.

Contact

To make an appointment at UVA Health in Charlottesville, VA, call Interventional Radiology at (434) 924-9401.

About Ziv Haskal, MD, FSIR

Professor Ziv J Haskal, MD, FSIR, FAHA, FACR, FCIRSE, established and leads the UVA PAE Clinic. In 2017, he established the clinic together with UVA Urology colleagues to provide patients with the full range of treatments for their symptomatic BPH. Dr. Haskal has lectured and published on PAE as well.   He is world renowned in Interventional Radiology, having published over 400 scientific papers, books, editorials, chapters and abstracts, and delivered over 750 invited lectures worldwide. Dr. Haskal has led or participated in over 45 research trials, and received numerous national and international awards, including honorary fellowships, gold medals, named lectureships, and innovation awards.