Prostatic artery embolization (PAE) is a minimally invasive treatment that helps improve lower urinary tract symptoms caused by Benign Prostatic Hyperplasia (BPH) which is a noncancerous enlargement of the prostate gland or a benign tumor of the gland. PAE consists of placing a tiny Foley catheter into the arteries that feed the prostate gland and blocking the blood supply to the gland by injecting a solution containing microscopic plastic beads. The PAE procedure results in death and necrosis of the isolated and affected areas of the prostate gland. PAE has a high rate of success and it does not affect sexual performance. Unlike open surgery and medication, PAE does not cause erectile dysfunction. Drugs used to treat this condition affect muscles in the urethra and can also lead to fatigue and dizziness. Similarly, open surgery for BPH often causes incontinence and can impair sexual performance.
PAE is also FDA-approved to treat enlarged prostates and the duration of the procedure is less than three hours. Moreover, the recovery period does not exceed ten days and the procedure can be repeated if necessary.
Risks, Potential Side Effects and Post-PAE Syndrome
Doctors that provide enlarged prostate treatment options say that, however safe, PAE is still a medical procedure and it entails certain risks and potential side effects. The latter include: profuse bleeding, injury to the gland, blood clots, hematoma and infection. Similarly, risks consist of: allergic reactions, procedure failures and unnecessary blockage of blood flow. Post-PAE syndrome can also occur in some of the older patients. The syndrome manifests through: fever, painful urination, vomiting, pelvic pain, blood in the urine or semen and bladder spasm. Moreover, there is no data on long-term outcome and the effectiveness and safety of the procedure usually depend on the number of blood vessels that require treatment. Similarly, the recovery period depends on the complexity of the PAE. However, the patient is not expected to rest in bed for more than ten hours unlike the recipients of open surgery.
Insurance Coverage
PAE is not fully covered by Medicare and a few other types of medical insurance. Nevertheless, the cost of PAE without medical insurance rarely exceeds three thousand dollars (including hospitalization follow-up care).
There are insurance companies that cover PAE alongside prostate surgery, but the insurance policy has to be reviewed beforehand with the insurance provider. Most insurance companies only cover drugs because it is the most common type of treatment. The medication usually consists of Alpha blockers meant to relax muscles and make urination less painful.
The Wide Use of Embolization as Alternative Treatment
Even though PAE is not considered the most common type of treatment covered by insurance companies, embolization is a widely acclaimed procedure. It is used for other organs as well. It is a safer and more effective alternative to open surgery. The only major disadvantage to this procedure is the post-embolization syndrome, which lasts for an average of seventy-two hours and a maximum of seven days. Embolization is performed using only a thin, flexible tube that can be used as a catheter. Only beads or sponges are used to block blood vessels and stop the blood flow abnormal tissue or tumors.