If you’re finding yourself waking up two, three, or four times a night just to use the bathroom, or you feel like you can never quite completely empty your bladder, you’re not just getting older, this is most likely a sign of something else going on. There are millions of men dealing with these exact same frustrations related to an enlarged prostate, and for a long time it seemed like the only ways to fix it were a lifetime of pills or undergoing major surgery. The good news is that there’s another option available called prostate artery embolization (PAE). It’s a minimally invasive prostate procedure that a surprising number of men have never even heard of, and it just might be the thing that finally gives you back a full night of sleep.
What’s an enlarged prostate, and why do BPH symptoms get worse at night?
An enlarged prostate, known medically as benign prostatic hyperplasia, is incredibly common as men age. In fact, there are studies showing that BPH affects roughly half of men in their 60s and the large majority of men past 70. As the prostate grows, it squeezes the urethra (the tube that carries urine out of the body), and that’s what contributes to all of the associated lower urinary tract symptoms. Some of the most common symptoms include a weak stream, trouble starting urination, dribbling at the end, a strong sense of urgency, and that maddening need to go again and again. These symptoms often feel worse at night because lying down shifts the fluid around, and your bladder keeps filling up while you’re trying to rest. So, you wake up, again and again, and your quality of sleep is what pays the price.
How prostate artery embolization works
Prostate artery embolization, also known as PAE, is a minimally invasive procedure that shrinks the prostate by reducing its blood supply. An interventional radiologist makes a tiny pinhole, usually in the wrist or groin, and gently guides a thin catheter to the small arteries that feed your prostate. Then microscopic particles, about the size of grains of sand, are released to slow the blood flow on both sides. Without that steady blood supply, the prostate gradually softens and shrinks, which eases the pressure on your urethra, so things start flowing more naturally again. It’s done without any cutting or removal of prostate tissue, and the procedure usually only takes a couple of hours. You won’t feel an instant change, and that is completely normal. The relief tends to build over the following weeks as the prostate continues to shrink.
Prostate artery embolization: a less invasive alternative to TURP surgery
For decades, the standard surgical fix was something called TURP (transurethral resection of the prostate), and it works very well. But nowadays, it isn’t the only option available. As an alternative to TURP, PAE doesn’t involve cutting tissue, and there is no need for general anesthesia, so it’s done on an outpatient basis, without need for an overnight hospital admission. Most men are back to their routine within a few days.
There’s also another reason that many men find it to be the better option. Because there’s no resection, PAE tends to preserve sexual function far better than surgery does, and one large study that followed 1,000 men for up to six years reported lasting symptom relief with no change in erectile function. PAE’s symptom improvement may be slightly lower than TURP’s, and a portion of men may need a follow-up procedure down the road. Even so, the research is strong, with reported significant improvements in symptoms.
Is prostate artery embolization the right BPH treatment for you?
Prostate artery embolization is a great BPH treatment for a lot of men, but it isn’t always right for everyone. There are a few situations where it usually isn’t recommended. For example, if you have an active urinary infection, certain bladder or nerve problems, or if there’s a known or suspected prostate cancer, PAE usually isn’t the right option. Men whose arteries are too narrow or have atherosclerotic calcifications beyond the level for safe access may not be candidates either.
If you’re dealing with symptoms, the pills have stopped helping, or the side effects are becoming too much to handle, this is the right time to ask about your options. The best way to know is a consultation with an interventional radiologist, who can review your imaging, your prostate size, and your goals together with you. If BPH symptoms are stealing your sleep and running your days, there are options out there, and you deserve to hear about every single one of them.
You don’t have to keep losing sleep to BPH. If you’re ready to find out if prostate artery embolization is right for you, the team at Raleigh Radiology is here to walk you through all of your options. Contact us today for more information.
Frequently Asked Questions
What are the possible side effects from prostate artery embolization?
There are a few possible adverse effects from prostate artery embolization. You can expect some pelvic discomfort, urinary frequency, and flu-like symptoms for a few days afterward, and rarely the prostate could grow back over time, so some men do need a follow-up procedure.
Does prostate artery embolization really work?
Yes, for most men it does. There are large studies showing significant, lasting relief from urinary symptoms, along with real improvements in quality of life and sleep, and those benefits have held up for years in long-term follow-up.
Who is not a good candidate for prostate artery embolization?
Prostate artery embolization generally isn’t recommended if you have an active urinary infection, suspected prostate cancer, or certain bladder and nerve conditions. Very narrow or hardened arteries can also make safe access difficult, so an evaluation will help determine if you’re a good candidate.
What is the success rate of prostate artery embolization?
Clinical success is reported in roughly 90 percent of men across many studies, and most see a meaningful drop in their symptom scores. Repeat procedures may be needed later on, but the majority of men enjoy long-lasting relief.