Prostatic Artery Embolization (PAE)

1. Prostatic Artery Embolization(PAE) What isit? Prostatic artery embolization (PAE) is a minimally invasive treatment to improve lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH). BPH is a non-cancerous enlargement of the prostate gland and is the most common benign tumor found inmen. The PAE procedure 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 withoutsurgery. • Why(Indications)? • As the prostate enlarges, it may partly block the urethra, causing symptoms suchas: • Urinary incontinence, which can range from some leaking to complete loss of bladdercontrol • Irritative voidingsymptoms • Increased urinary frequency, urgency, and pain uponurination. • How do I know if PAE is right for me? • The PAE procedure is for candidates who are either ineligible or not interested in traditional surgery. An exam with an interventional radiologist can determine if you are a candidate for PAE. At this appointment, you may be asked how often you have urinary symptoms of BPH, how severe they are, and how much they affect your quality oflife. • Why not(Contraindications)? • Patients are excluded from treatment if they have malignancy, renal insufficiency, bladder stones, a neurogenic bladder (a neurologic disorder that may affect bladder function), urethral stricture, an active urinary tract infection, orprostatitis. • What you are to do before procedure(Preparation)? • Book prior appointment if elective or get admission in causality ifemergency • Lab investigation (*PT/INR, CBC, Serum Creatinine, Viral markers)and previous records.An MRI or ultrasound of the prostategland. • Urine test(urinalysis) • In some cases, a PSA (prostate specific antigen) test is done to rule out prostatecancer. • 4-6 Hoursfasting.

2. If you are on blood thinner like Aspirin inform duringappointment. • One accompanyingperson • Need to sign a consent form forprocedure • What happens duringPAE? • PAE is performed through a small catheter inserted by your interventional radiologist into the artery in your groin. • The interventional radiologist will then guide the catheter into the vessels that supply blood to yourprostate. • An arteriogram (an X-ray in which dye is injected into the blood vessels) is done to map the blood vessels feeding yourprostate. • The agent (glue/particles)is injected through the catheter and into the blood vessels that feed your prostate to reduce its bloodsupply. • The interventional radiologist will move the catheter in order to treat the other side of your prostate, repeating the stepsabove. • Following this procedure the prostate will begin to shrink, relieving and improving symptoms usually within days of theprocedure. • Approx. Stay inhospital? • We have very fast and competent working team (Consultant, fellow, clinical assistant, technician and ward assistant) which provide you comfortable atmosphere and ease your nerves. Usual time of stay is around 1day. • Complications • Minor complications include dysuria (9%), urinary tract infection (7.6%),microscopic • hematuria (5.6%), acute urinary retention (2.5%), and rectal bleeding(2.5%) • Resume towork? • You can resume your work after 1 day if existing diseaseallows. • Results? • Cumulative rates of clinical success are 80-85%.